Heart failure is a condition in which the heart's muscle is weakened and may no longer pump effectively

As a result, the heart, organs and tissues cannot receive an adequate supply of blood, making it more difficult to do activities that may have been easy in the past.

When the heart muscle is weakened, the body compensates by working harder, which causes the heart walls to become thicker and the heart to enlarge. This also causes the release of stress hormones, causing the arteries to tighten.

The tightened arteries make it even more difficult for the heart to pump. In addition, the stress hormones cause the kidneys to hold onto salt and water, which increases the amount of blood that must be pumped. It is important for patients with heart failure to take medications regularly to block the actions of these hormones and to make it easier for the heart to pump.

Several causes of heart failure that the experts in our Dallas heart hospital treat include:

  • Blocked arteries in the heart
  • Heart attack
  • High blood pressure
  • Heart valve problems

Types of heart failure

The heart function and types of heart failure can be measured by having an echocardiogram, a test that we perform at our Dallas heart hospital that provides images of the heart

  • Systolic heart failure

    Systolic heart failure is diagnosed when the echocardiogram at our shows not enough blood is being pumped by the heart. The amount of blood pumped is called the ejection fraction. If this is less than 50%, it is weak and results in systolic heart failure. After an injury, the heart cannot pump the amount of blood the body needs. The blood backs up into the lungs, causing shortness of breath, and/or backs up into other parts of the body, which causes swelling in the legs. These systolic heart failure symptoms are controlled with medications and a low-sodium diet.

  • Diastolic heart failure

    Diastolic heart failure is diagnosed by an echocardiogram showing a stiff heart. In this case, the heart cannot relax, so it cannot properly fill with blood to circulate to the body. This causes increased pressure and blood to back up in the lungs, liver, legs and other areas of the body, causing symptoms of swelling, shortness of breath and the inability to tolerate activity. These diastolic heart failure symptoms can be controlled with medications and a low-sodium diet also.

  • Valvular heart failure

    Valvular heart failure is caused by either a backward flow of blood, a leaky valve in your heart or a narrowing of the valve area through which blood can flow. These are both abnormalities of the heart valves. Valvular heart failure may cause the heart muscle to weaken and pump less effectively, and/or cause increased pressure in the lungs.

Lifestyle changes can make a difference in the overall health of a heart failure patient

Heart failure is a progressive and chronic disease, but with proper treatment and lifestyle changes, many patients will experience a full and rewarding life

Living with heart failure

Medications play an important role in heart failure treatment

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Research shows that heart failure medications can stabilize the function of the heart, slow down the progression of heart failure and even improve heart function. Always stick to the heart failure medication plan unless you are instructed otherwise by a healthcare provider. Following a prescribed heart failure medication plan, like the one we recommend in our Dallas heart hospital, can:

  • Help extend life
  • Alleviate symptoms
  • Make breathing easier
  • Increase energy and activity levels
  • Alleviate swelling in the legs or ankles
  • Reduce hospital readmissions
  • Types of heart failure medications

Angiotensin converting enzyme inhibitors (ACE inhibitors)

ACE inhibitors are heart failure medications that make it easier for the heart to pump by widening the blood vessels. ACE inhibitors limit the amount of stress hormones in a heart failure patients' body. Stress hormones may cause tightening of arteries, increasing the blood pressure and the workload of the heart.

Like beta blockers, ACE inhibitors decrease the amount of stress hormones in the body that can worsen heart failure.

The long-term effects of ACE inhibitors can slow the progression of heart failure and improve symptoms.

ACE inhibitors can increase the amount of blood the heart pumps or ejection fraction over time.

Angiotensin receptor blockers (ARB)

This heart failure medication is for patients who cannot tolerate ACE inhibitors.

Like ACE inhibitors, ARBs block certain stress hormones from tightening the arteries, thus decreasing the stress hormones that can negatively affect the heart.

Diuretics, often called "water pills," help the body get rid of extra fluid, so there is less fluid for the heart to pump. Diuretics decrease the swelling in the legs and feet and improve breathing for heart failure patients. Most diuretics lower potassium levels, an important electrolyte for the heart, and increase urination, so these should be taken as advised by a physician.

Digoxin is a class of medications that help the heart pump slower and more effectively. This drug may not be appropriate for all types of heart failure patients.

Aldosterone antagonists are a group of medications that block a hormone called aldosterone, which causes fluid retention and can make the symptoms of heart failure worse. Aldosterone antagonists are a type of diuretic that prevent the body from losing potassium. Lab work may be ordered when patients start this heart failure medication.

Beta blockers

These heart failure medications are a class of drugs that block certain hormones that can put stress on the heart. These stress hormones can cause high blood pressure and/or a fast heart rate.

Beta blockers slow heart rate and widen (dilate) arteries, which lowers blood pressure. They allow a stiff heart more time to relax so it can properly fill with blood. Also, by widening the arteries, there is more blood flow to the kidneys.

It is important to remember that beta blockers are beneficial to the heart even if there is not a fast heart rate or high blood pressure, because they decrease the hormones that can put stress on the heart for a heart failure patient.

Heart failure devices for managing irregular heartbeats

The heart has its own special electrical system that enables the heart to beat and pump. There are special cells in the heart that create electrical impulses, beginning in the right atrium (the heart's natural pacemaker) and spread through the entire muscle, causing it to contract. If the heart’s electrical system does not follow the normal pathway to generate a heartbeat that causes the chambers to work together, the heart may not pump effectively. The regular contractions are what we know as heartbeats. Sometimes heart failure is related to problems with the electrical system in the heart. As a result, irregular beats or other abnormalities may occur, and a patient may need a heart failure device.

  • Internal Cardiac Defibrillator (ICD)

    Patients with weakened heart muscles and a low ejection fraction may be at risk for lethal arrhythmias or abnormal heart rhythms. Because of this, the Dallas heart doctor could recommend a heart failure device called an internal cardiac defibrillator (ICD), which is inserted through a small incision in the upper chest. Similar to a pacemaker, the ICD paces the heart back into a normal rhythm or delivers a shock to restore normal rhythm if a lethal rhythm abnormality occurs.

  • Biventricular Pacemaker or Biventricular ICD

    If the heart shows signs of dyssynchrony, meaning it doesn't beat effectively, the heart doctor could recommend a heart failure device called a biventricular pacemaker or ICD. Pacemaker leads would be placed in both sides of the heart, helping it beat in sync and more effectively while protecting against potentially dangerous abnormal heart rhythms. This heart failure therapy that we use in our Dallas heart hospital has been shown in research to improve heart function, improve symptoms and improve quality of life for patients living with heart failure.

For advanced heart failure patients

Patients with complex or chronic heart conditions on the Dallas campus have convenient access to care from doctors who specialize in heart and vascular conditions. Specialized care includes:

  • Management of advanced heart failure
  • Heart transplantation
  • Mechanical device support and extracorporeal membrane oxygenation (ECMO)
  • Education on heart medication
  • Lifestyle adjustments
  • Nutrition and support programs

Heart transplant information