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Heart Failure


​​​​​​​​​​​​​​​​​​Heart failure is when the heart can't pump enough blood to meet the body's needs. 

In some cases, the heart can't fill with enough blood. In other cases, the heart can't pump blood to the rest of the body with enough force. Some people have both problems.

Heart failure is sometimes called congestive heart failure.

The term "heart failure" doesn't mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care. It develops over time as the heart's pumping action grows weaker. 

The condition can affect the right side of the heart only or both sides. Most cases involve both sides of the heart.

Right-side heart failure occurs if the heart can't pu​mp enough blood to the lungs to pick up oxygen. Left-side heart failure occurs if the heart can't pump enough oxygen-rich blood to the rest of the body. 

Right-side heart failure may cause fluid to build up in the feet, ankles, legs, liver, abdomen and the veins in the neck. Right-side and left-side heart failure may also cause shortness of breath and fatigue (tiredness).

Heart failure is a very common condition. Nearly 6 million people in the United States have heart failure. Currently there is no cure. 

However, treatment such as medicines and lifestyle change can help people who have the condition live longer and more active lives.

Symptoms of Heart Failure

Call your doctor if you have any of these symptoms for more than a week.

The most common symptoms of heart failure are:

  • Shortness of breath that makes it difficult to talk or finish an activity
  • Unusual or excessive fatigue, weakness or faintness
  • Pulse feels fast or irregular, or sensation of feeling the heart beat
  • Waking in the night coughing, shortness of breath or gasping for air
  • Sudden or unexpected weight gain
  • Dizziness or light-headedness
  • Swollen feet, ankles, fingers, legs or abdomen
  • Need to urinate frequently at night
  • Loss of appetite

All of these symptoms are the result of fluid buildup in your body. When symptoms start, you may feel tired and short of breath after routine physical effort, like climbing stairs. 

As your heart grows weaker, symptoms get worse. You may begin to feel tired and short of breath after getting dressed or walking across the room. Some people have shortness of breath while lying flat.

Fluid buildup from heart failure also causes weight gain, frequent urination and a cough that's worse at night and when you're lying down. This cough may be a sign of acute pulmonary edema. 

This is a condition in which too much fluid builds up in your lungs and requires emergency treatment.

Causes of Heart Failure

Conditions that damage or overwork the heart muscle can cause heart failure. Over time the heart weakens and is no longer able to fill with and/or pump blood as well as it should. 

As the heart weakens, certain proteins and substances might be released into the blood. These substances have a toxic effect on the heart and blood flow that increases the likelihood of heart failure.

​​​The most common causes of heart failure are coronary heart disease, high blood pressure and diabet​es​. Treating these problems can prevent or improve heart failure. 

​​Other causes are cardiomyopathy (heart muscle disease), heart valve disease (this may be present at birth or caused by infection and interrupts the normal flow of blood in the heart), arrhythmias (irregular heart beat) or congenital heart defects (problems with the heart's structure that are present at birth).

Other factors that can injure the heart muscle are treatments for cancer, thyroid disorder, alcohol or drug abuse and HIV/AIDs.

Other Risk Factors for Heart Failure?

While anyone can experience heart failure, there are some key characteristics that have shown to have increased risk:

  • People 65 years old or older – Aging can weaken the heart muscle. Older people may also have had diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays among people on Medicare.
  • African Americans – African Americans are more likely to have heart failure than people of other races. They're also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure.
  • People who are ​​overweight – Excess weight puts a strain on the heart. Being overweight also increases your risk of heart disease and type 2 diabetes that can lead to heart failure.
  • People who have had a heart attack.
  • Men – Men have a higher rate of heart failure than women.
  • Children who have congenital heart defects also can develop heart failure. These defects occur if the heart, heart valves or blood vessels near the heart don't form correctly while a baby is in the womb.

Diagnosis of Heart Failure

Your doctor can diagnose heart failure based on your medical and family histories, a physical exam and test results. Early diagnosis and treatment can help people live longer, more active lives. Typical procedures and tests include:

  • Electrocardiogram (EKG) – a painless test that records the heart's electrical activity
  • Doppler Ultrasound – uses sound waves to measure the speed and direction of blood flow
  • Stress Test – you may walk or run on a treadmill or pedal a bike to get your heart working hard and beating fast, this is when some heart problems can be best diagnosed
  • Holter Monitor – records the heart's electrical activity for 24-48 hours
  • Echocardiography – uses sound waves to create a moving picture of the heart, providing information about the size and shape of the heart and how well the chambers and valves are working
  • Chest X-Ray – can reveal signs of heart failure as well as lung disorders related to coronary heart disease
  • BNP Blood Tests – checks levels of a hormone called BNP, which rises during heart failure
  • Nuclear Heart Scan – shows how well blood is flowing through your heart and how much blood is reaching your heart muscle
  • Coronary Angiography – dye is inserted through a Cardiac Catheter and special x-rays are taken to look inside your coronary arteries to detect blockages


The kind of treatment(s) you may receive depends on the severity of your condition. Possible treatments include:

  • Medical Management
  • Heart Catheterization (PCI)
  • Implantable Cardioverter Defibrillator (ICD)
  • Heart Surgery
  • Trans Aortic Valve Replacement (TAVR)

Managing Heart Failure

The Heart Failure Improvement Clinic at Marshfield Clinic is a dedicated team of physicians, nurse practitioners, registered nurses, medical assistants and pharmacists whose sole purpose is to help you manage heart failure.

Learn more about our Heart Failure Improvement Clinic >

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Call: 866-520-2510
Monday-Friday 8 a.m. - 5 p.m.

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Appointments with your heart care team may be available via telehealth. Ask your care team if telehealth is right for you.

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