What Is Heart Failure?

When people have heart failure, it means their heart does not pump as well as it should. Fluid can build up in your feet, ankles, and legs—known as edema—or fluid can build up in your lungs, known as pulmonary edema.When this happens, organs such as your kidneys, liver, and lungs do not get enough blood and oxygen, so they won’t work normally.

An estimated 6.5 million Americans over the age of 20 have heart failure, and about 960,000 new cases are diagnosed every year, according to the Heart Failure Society of America. It’s serious, but with expert medical care, people with heart failure can manage their symptoms and live well.

Types of Heart Failure

Heart failure can be chronic (the disease worsens over time) or acute (the disease begins suddenly). Chronic heart failure may commonly be referred to as congestive heart failure.

We treat several different types of heart failure, including:

  • Diastolic heart failure — When your heart muscle becomes stiff and doesn’t relax normally between contractions.
  • Systolic heart failure — Your heart muscle becomes weak and enlarged. As a result, it can’t pump enough blood forward when your heart contracts,
  • Rght-sided heart failure — This occurs when the left chamber of your heart loses its ability to pump blood. Fluid may back up into your abdomen, legs, and feet, and cause swelling.
  • Left-sided heart failure — This occurs when the right chamber of your heart loses its ability to pump blood. This may cause fluid to back up into your lungs and lead to shortness of breath.

More complex types of heart failure may include:

  • advanced heart failure,
  • congenital heart failure (present at birth),
  • hypertrophic cardiomyopathy, a condition in which a portion of the heart muscle becomes abnormally thick without an obvious cause,
  • cardiac amyloidosis, and
  • cardiac sarcoidosis, a rare inflammatory disease in which clusters of white blood cells form in the heart muscle. This condition can cause irregular heartbeats (arrhythmia).

Heart Failure Causes

Coronary artery disease (plaque buildup in the arteries of your heart) is the most common cause of heart failure. Other causes include:

  • heart attack,
  • a virus infecting the heart,
  • abnormal genes that get passed down in a family (familial cardiomyopathy),
  • high blood pressure,
  • faulty heart valves,
  • abnormal heart rhythm (arrhythmia),
  • heart defects present at birth (congenital heart disease),
  • pregnancy,
  • alcohol or drug use, and
  • some cancer drugs.

While our goal is to help people manage their symptoms at home with a healthy diet and the right combination of medications, we recognize that some will need a higher level of care. This may include a heart transplant and a ventricular assist device (VAD). Our heart transplant and VAD programs are successfully comprehensive in finding solutions for every heart failure diagnosis to give patients the best chance at success.

Find a Heart Failure Specialist

Heart Failure Symptoms

Patients with heart failure can have the following symptoms:

  • shortness of breath, especially when lying down,
  • wheezing or coughing,
  • increased heart rate,
  • weight gain (fluid buildup) or weight fluctuations,
  • lack of appetite or nausea,
  • loss of muscle, and
  • an overall feeling of being tired or run-down.

If you notice that your symptoms are getting worse, contact your primary care provider or make an appointment with one of our heart failure specialists for an evaluation. You do not need a physician referral to see the heart failure specialist at U of U Health unless your insurance policy requires that you do—our heart failure team can help you look into this.

When Heart Failure Symptoms Are Severe

As long as your symptoms of heart failure stay about the same from one day to the next, your heart failure is stable. But if your symptoms start to get worse, it’s time to take action.

Please consider making an appointment with a U of U Health heart failure specialist for an evaluation, if any of the following statements apply to you.           

  • I have been hospitalized at least once for heart failure symptoms in the past year.
  • My doctor says I have Class III or Class IV heart failure symptoms (based on the New York Heart Association Classification scale).
  • The heart failure medication I have been taking is not working well for me anymore.
  • My doctor is concerned about my low blood pressure or high blood pressure.
  • I have low left ventricular ejection fraction (LVEF) or low right ventricular ejection fraction (RVEF).
  • I am taking or being considered for intravenous (IV) inotrope medication.
  • I need more diuretic medication than I did before, or my diuretic medication isn’t working well for me.
  • My doctor says my kidney function is getting worse.
  • My doctor says I am in end-stage organ failure.
  • My implantable cardioverter-defibrillator (ICD) has shocked me.
  • I have blockages in my arteries, but my doctor says it isn’t possible to fix that with surgery or medication .
  • I have been diagnosed with (or my doctor is concerned I might have) cardiac amyloidosis, cardiac sarcoidosis, or hypertrophic cardiomyopathy.

Heart Failure Diagnosis

To diagnose heart failure, the doctor will consider your medical history, do a physical examination and run a series of tests. The tests help identify the underlying cause of the chronic heart failure and can include:

  • Blood tests — These tests look for signs of disease that can affect the heart
  • Echocardiogram This ultrasound study creates a video image of you heart. It provides a view of the size and shape of your heart, along with any abnormalities.
  • Electrocardiogram (ECG) — A test to record the electrical activity of your heart.
  • Chest X-ray — These images provide a picture of the heart and can show if there is a buildup of fluid.
  • Stress test — This test shows how your heart responds while you are exercising.

Depending on your symptoms and condition, the doctor may order other tests, such as a cardiac computed tomography (CT) scan or magnetic resonance imaging (MRI) scan.

Heart Failure Treatment

us-news-world-report-heart-failure.jpgHeart failure is a chronic (ongoing) health problem. There is no cure, but your care team will help you manage your symptoms so that you can experience a better quality of life. Treatment for heart failure usually includes a combination of:

Medications

Doctors prescribe medications to help you feel better, improve how well your heart works and lower the chances that you’ll need to be hospitalized.

  • angiotensin-converting enzyme (ACE) inhibitors,
  • beta-blockers,
  • diuretics (“water pills”),
  • cholesterol-lowering drugs (statins),
  • anticoagulants (blood thinners),
  • antiarrhythmics (to help heart rhythm problems), and
  • many others.

Our pharmacist will explain how to take your medications safely and what side effects you may experience. You can always contact us with questions about your medications.

Lifestyle Changes

A heart-healthy diet and regular exercise are essential in making your heart work efficiently. Our heart failure team will help you learn how to:

  • read food labels,
  • prepare delicious, low-sodium meals, and
  • eat healthily at restaurants.

You may need to limit how much fluid you drink during the day. This can help keep your body from retaining too much fluid. The heart failure team will also help you quit using any products that may damage your heart, such as tobacco, drugs, and excessive amounts of alcohol. 

Implants & Surgeries

We use many kinds of cardiac devices and surgeries to treat patients with heart failure. Our cardiovascular surgeons and cardiac electrophysiologists (doctors who specialize in heart rhythm disorders, or arrhythmias) offer cutting-edge options and participate in research to advance this exciting area of medicine.

Some of the devices and surgeries available at U of U Health include:

  • cardiac bypass surgery to restore the flow through the arteries in your heart,
  • valve replacement or repair,
  • implantable cardioverter-defibrillator, a device that can shock the heart into a regular rhythm, and
  • cardiac resynchronization therapy or biventricular pacing. These devices can deliver electrical impulses to the main pumping chambers of the heart to get them in sync and restore the heart’s function.

Advanced Heart Failure

People who develop advanced heart failure (worsening of the symptoms described above) may need an even higher level of care to manage their symptoms. Advanced therapies for heart failure include:

  • heart transplantation, which replaces a patient’s diseased heart with a healthy heart from a donor, and
  • ventricular assist devices (VADs), which are attached to your heart and help your heart pump blood to the rest of your body. Your doctor may recommend using a VAD long term or just while you wait for a heart transplant.

We provide a comprehensive evaluation to help decide whether a person is a good candidate for a heart transplant or VAD. The evaluation will include extensive testing, procedure, and multiple appointments with specialists.

Making an Appointment

Physician referrals are welcome but not always necessary. To make an appointment for a heart failure evaluation at U of U Health, call 801-585-5122. Before scheduling your appointment, our team will request medical records from your cardiologist to help plan your visit. 

We look forward to meeting you and providing the care you need so that you can live a full life.

Bill Deist, heart failure patient, and Craig Selzman, MD

Hear From Our Patients

In March 2012, Bill Deist came down with a simple, run-of-the-mill cold. Or so he thought. What he discovered was a rare case in which a cold virus had begun to attack his heart. His local doctor in Winnemucca, Nevada suggested he go to University of Utah Health where he could get the expert care and attention he needed for his deteriorating condition.

In September, he saw Craig Selzman, MD, one of the country’s leading heart surgeons and director of the University of Utah Health's heart transplant program. 

Read Bill's Story