Heart Failure



The leading causes of heart failure are:

  • Coronary artery disease (CAD)
  • Heart attack

Other common causes include:

  • Problems with the heart's valves due to:
    • Rheumatic heart disease
    • Bacterial endocarditis
    • Defects that were present from birth
    • Calcium deposits from atherosclerosis
  • High blood pressure
  • Diabetes

Other less common causes include:

  • Cardiomyopathy—weakened, damaged heart muscle
  • Some medicines
  • Arrhythmias—abnormal heart beats
  • Hyperthyroidism—overactive thyroid
  • Amyloidosis
  • Kidney or liver failure
  • Thiamine (vitamin B1) deficiency

Risk Factors

Heart failure is more common in older adults. Other things that raise the risk of heart failure include:

  • Obesity
  • Excess intake of salt and fat
  • Excess alcohol intake
  • Smoking
  • Pregnancy
  • High fever
  • Severe infection, such as pneumonia
  • Chronic lung disease—emphysema
  • Chemotherapy
  • Mental health issues such as depression or anxiety



Heart failure can cause:

  • Shortness of breath—at first it only happens with activity, then it progresses to having shortness of breath at rest
  • Unexplained weight gain
  • Swelling of feet, ankles, or legs
  • Needing to sleep propped up
  • Fatigue, weakness
  • Wheezing
  • Cough—may be dry and hacking or wet sounding, may have a pink, frothy sputum
  • Frequent urination, especially at night
  • Belly pain


The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may note changes caused by heart failure such as fluid build up in legs. They may also hear abnormal sounds when they listen to the heart. Blood tests may be done to look for certain markers of change in the heart.

Tests can help show what parts of the heart are affected. They can also show changes in blood flow. This can be done with:

  • ECG
  • Echocardiogram
  • Nuclear scanning
  • Coronary angiography
  • Exercise stress test

Doctors will use the test results to determine level of heart failure. This will help guide the treatment plan.



The goal of treatment is to keep the symptoms from getting worse. Treatment can ease symptoms and improve quality of life. Some may also have some improvement in heart strength. Heart failure will need lifelong care.

Treatment will vary by person and over time. Tracking weight and symptoms every day will help catch changes early. Treating these changes fast may help keep heart failure from getting worse.

Heart failure may be caused by another health issue. Treating this issue may improve heart failure or prevent it from getting worse. For any form of heart failure, treatment may include:


Medicine may be given to ease the heart's workload by:

  • Widening blood vessels
  • Helping the heart pump
  • Slowing the heart rate and lowering blood pressure
  • Removing excess fluid
  • Reducing cholesterol levels

Lifestyle Changes

Daily habits can affect heart health. Changes that may help ease stress on the heart include:

  • Quitting smoking
  • Eating a heart healthy diet that is low in fat, high in fiber, and has lots vegetables and fruits
  • Reducing salt intake
  • Working out regularly
  • Keeping a healthy weight
  • Avoiding alcohol or recreational drugs that may stress the heart
  • Managing and reducing stress

Heart Support and Surgery

Heart failure may cause or be worsened by heart rhythm problems. A defibrillator or pacemaker may be implanted. They give electrical shocks if the heart starts dangerous rhythms.

Other devices can help support the heart. They may be needed for a short time to help recover from an injury or illness. They may also support the heart in the last stages of heart failure until a transplant can be done. These devices increase the amount of blood pumped to the body without making the heart work harder. Examples include:

  • Intra-aortic balloon pump (IABP)
  • Ventricular assist device

A heart transplant may be needed for severe heart failure if other treatments have not helped.


The best way to prevent heart failure is to reduce the risk of heart disease, high blood pressure, and diabetes. General steps include:

  • Aiming to be active 150 minutes each week
  • Quitting smoking
  • Limiting alcohol
  • Maintaining a healthy weight
  • Eating a healthy diet

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.