Understanding the Risks and Realities of Heart Failure: Expert Insights
Explore comprehensive expert advice on heart failure, its symptoms, risks, complications, and actionable lifestyle changes for prevention and management.
Ask the Expert: The Risks of Heart Failure
Written by Dr. Payal Kohli, M.D., FACC
Introduction
Heart failure is a prevalent yet complex clinical syndrome that affects millions globally. Despite the word ‘failure,’ the heart doesn’t entirely stop working; instead, it loses efficiency, often resulting in disabling symptoms and life-threatening complications. Understanding the risks, symptoms, long-term effects, and how to manage the condition with expert guidance can help people lead longer, healthier lives.
What is Heart Failure?
Heart failure occurs when the heart muscle cannot pump sufficient blood to meet the body’s needs for blood and oxygen. It is a chronic, progressive condition that can be classified by how the heart functions:
- Systolic Heart Failure: The heart muscle loses its ability to contract strongly, so less oxygen-rich blood is pumped out to the body with each beat.
- Diastolic Heart Failure: The heart muscle becomes stiff and fails to relax properly, impairing its ability to fill efficiently between contractions.
The underlying causes differ between these types, but both can result in similar, severe symptoms and complications over time.
Long-Term Effects and Symptoms of Heart Failure
The journey with heart failure is often marked by a range of persistent symptoms and long-term risks. Recognizing these signs early and managing them effectively is vital.
Common Symptoms
- Exercise intolerance: Difficulty performing physical activities that were once routine due to early fatigue or shortness of breath.
- Shortness of breath (dyspnea): This may occur on exertion or, as the condition worsens, even at rest.
- Weakness or fatigue: A constant sense of tiredness, often unrelated to recent activity.
- Weight gain: Rapid, unexplained increases can signal fluid retention, a hallmark of worsening heart failure.
- Swelling (edema): Notably in the abdomen, legs, or feet due to fluid buildup.
- Dizziness: May result directly from heart failure or as a side effect of heart failure medications.
Potential Long-Term Complications
- Organ Dysfunction: Chronic under-delivery of oxygenated blood can lead to kidney dysfunction and even liver problems.
- Anemia: Reduced red blood cell production or abnormal breakdown, often related to organ dysfunction.
- Electrolyte Imbalances: Disrupted regulation can result from both heart failure and certain medications used for treatment.
Expert Tip: A cornerstone of modern heart failure management is the “cocktail” of prescribed medications, targeting not just the heart but also aiming to protect other vital organs and prevent further complications.
Can You Die from Heart Failure?
Heart failure is serious, with consequences that can include death. The Centers for Disease Control and Prevention (CDC) reported that heart failure was a contributing factor in 1 out of every 8 deaths in the United States in 2017.
However, advancements in medication and management options have steadily reduced heart failure–related deaths over the years.
How Does Heart Failure Lead to Death?
- Cardiac Arrhythmias: Heart failure can cause dangerous abnormalities in heart rhythm (arrhythmias), which may result in sudden cardiac arrest. In high-risk individuals, implantable cardiac defibrillators (ICDs) are sometimes used to restore normal rhythm if needed.
- Progressive Pump Failure: As the heart’s function worsens, less and less blood reaches vital organs, potentially leading to multi-organ failure, profoundly limiting exercise tolerance, and causing shortness of breath even at rest.
What others are reading
For advanced-stage patients, treatment options might include ventricular assist devices (VADs) or even heart transplantation.
What Increases the Risk of Heart Failure?
Understanding what increases the risk can empower patients and caregivers to make informed choices.
Main Risk Factors for Heart Failure
- Coronary artery disease (CAD): Accumulation of cholesterol and fatty deposits in the heart’s arteries reduces blood supply, weakening heart muscle over time.
- High blood pressure (Hypertension): Chronically elevated blood pressure forces the heart to work harder, leading to muscle thickening or weakness and, ultimately, failure.
- Type 2 diabetes: Increases the risk via associated high blood pressure, high cholesterol, and excess weight.
- Metabolic syndrome: Cluster of abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, and high fasting blood sugar.
- Thyroid diseases: Both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid issues can stress the heart, increasing risk.
Medical Conditions Linked to Heart Failure
- Past heart attack (myocardial infarction): Damage from blocked arteries impairs how the heart pumps.
- Abnormal heart valves: Faulty heart valves (from disease, infection, or congenital defects) can overwork or damage the heart muscle.
- Cardiomyopathies (heart muscle diseases): Disorders that directly damage the heart muscle, including those caused by viruses, alcohol, or unknown factors.
- Congenital heart defects: Structural problems from birth can result in heart failure, even if symptoms arise later in life.
Manageable vs. Non-Manageable Risk Factors
| Manageable Risk Factors | Non-Manageable Risk Factors |
|---|---|
|
|
Even for non-manageable risk factors, lifestyle and medical care can still influence outcomes.
How Can You Prevent or Lower Your Risk?
While not every risk factor can be fully controlled, adopting healthy habits and effectively managing underlying health conditions can dramatically decrease long-term risk and improve quality of life for those already diagnosed.
Key Prevention Strategies
- Manage blood pressure: Regular screening and appropriate treatment to keep hypertension in check.
- Control blood sugar levels: Especially important for those with or at risk of diabetes.
- Eat a heart-healthy diet: Emphasize fruits, vegetables, whole grains, lean proteins, and minimize salt and saturated fat.
- Exercise regularly: Even moderate daily activity can have significant benefits. Consult with your doctor before starting new routines.
- Quit smoking: Smoking cessation is one of the single most impactful changes you can make for heart health.
- Limit alcohol and avoid drugs: Both can harm the heart and worsen underlying conditions.
- Address sleep-related problems: Treat sleep apnea and stick to good sleep hygiene.
- Monitor weight and watch for sudden changes: Rapid weight gain might signal fluid retention.
- Stay up to date on medical visits: Routine cardiovascular screening is vital, especially if you have risk factors or a family history.
What Does Heart Failure Feel Like?
Symptoms can vary widely between individuals and often fluctuate day to day. People may face periods where symptoms are mild, alternating with episodes of worsening shortness of breath or swelling. Recognizing subtle changes early, such as increasing fatigue or swelling, allows for immediate intervention—potentially preventing hospital admissions.
Heart failure is often described as “feeling tired all the time,” being short of breath even with everyday tasks, or needing to rest frequently. Swelling of the legs, abdomen, or feet, weight gain over a few days, and a persistent wheeze are common warning signs.
For many, the emotional and psychological impacts can be as significant as the physical symptoms. Addressing both is important for total well-being.
Life with Heart Failure: Treatments and Strategies
Management of heart failure relies on a multifaceted approach, combining medications, lifestyle changes, behavioral therapy, and sometimes surgical interventions. The following are foundations of optimal care:
Medication Management
- Diuretics: Help the body expel excess fluid, reducing swelling and easing breathing.
- ACE inhibitors/ARBs: Medications that relax blood vessels, reduce blood pressure, and lower the heart’s workload.
- Beta blockers: Slows the heart rate, reduces blood pressure, and curtails harmful effects of stress hormones.
- Aldosterone antagonists: Reduce fluid buildup and help preserve heart function.
- Other therapies: Iron supplementation for anemia, treatment of concurrent conditions (AFib, diabetes, sleep apnea, thyroid disease), and use of devices like ICDs or VADs in advanced cases.
Lifestyle Changes
- Diet and nutrition: Adopting a low-salt, heart-healthy diet is pivotal.
- Physical activity: Engage in consistent, moderate exercise as advised by your healthcare provider.
- Daily monitoring: Keep tabs on weight, note symptoms, and adjust activities as needed.
- Emotional support: Seek counseling or support groups to help manage the psychological impact of the diagnosis.
Frequently Asked Questions (FAQs)
Can someone live a normal life with heart failure?
Many people with heart failure lead active and fulfilling lives thanks to new therapies and diligent self-management. Nonetheless, the condition requires ongoing adjustments, and early intervention when symptoms worsen is crucial.
Do all people with risk factors develop heart failure?
No. While risk factors increase the probability, not everyone with high blood pressure, diabetes, or other risks develops heart failure. Prevention and effective management can substantially lower risk.
What should someone do if they experience new or worsening symptoms?
Contact your healthcare provider immediately. Sudden weight gain, shortness of breath at rest, fainting, or severe swelling require prompt medical attention. Early intervention can prevent severe complications.
Are there differences in risk or disease course by gender or race?
Yes. Men often develop heart failure at a younger age, while women may experience greater symptom severity. Black individuals face a higher risk, likely linked to healthcare and socioeconomic disparities.
Is heart failure the same as a heart attack?
No. A heart attack happens when blood flow to a part of the heart is blocked. Heart failure is a chronic condition that can occur after a heart attack or due to other chronic conditions or repeated injuries to the heart muscle.
What are the newest treatments for heart failure?
Innovations include newer classes of heart failure medications, remote monitoring, advanced cardiac devices, mechanical pumps such as VADs, and even heart transplantation for eligible individuals.
Summary: Key Takeaways
- Heart failure is a major cause of illness and death but is increasingly manageable through advances in care.
- Symptoms vary per individual, but often include fatigue, swelling, and shortness of breath.
- Both lifestyle changes and proven medications greatly affect outcomes.
- Early diagnosis and holistic, pro-active care enable better quality of life and longevity.
Consult your healthcare professional for personalized advice and regular screening—especially if you have any risk factors or warning signs noted above.
References
- https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure
- https://www.healthline.com/health/heart-failure/risk-factors-for-heart-failure
- https://www.healthline.com/health/heart-disease/ask-the-expert-the-risks-of-heart-failure
- https://www.healthline.com/health/video/ask-the-expert-the-risks-of-heart-failure
- https://www.cedars-sinai.org/newsroom/healthline-therapy-vs-antidepressants–which-is-best-for-people-with-heart-disease/
- https://my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heart-failure
- https://www.medicalnewstoday.com/articles/237191
- https://www.healthline.com/health/video/a-cardiologist-explains-what-your-diet-does-to-your-heart
- https://www.heartandstroke.ca/heart-disease/conditions/heart-failure
- https://www.nhlbi.nih.gov/health/heart-failure/causes
Similar Articles
Read full bio of Sneha Tete
