Heart failure

Your heart is a muscle that works 24/7 to pump oxygenated blood throughout your body. Some conditions can take a toll on the heart muscle, causing it to weaken or stiffen. When this happens, the heart pumps inefficiently. Heart failure exists when the heart can no longer pump enough blood to meet the body’s needs.

Heart failure is a complex condition, and the care you need can change over time. As one of the top heart and vascular programs in the nation, Penn Medicine’s specialists work together to help you get the expertise and support you need as your condition changes. Our heart failure care program provides treatment for every stage of heart failure, from early management to complex, late-stage interventions.

There are two types of heart failure, each involving the lower heart chambers (ventricles). The type you have depends on which side of the heart is affected:

• Left-sided heart failure: When the left ventricle doesn’t pump or fill efficiently, blood can back up into the lungs. This can be systolic, when the left ventricle can’t contract enough to pump blood out, or diastolic, when it can’t relax enough to fill fully.
• Right-sided heart failure: When the right ventricle doesn’t pump efficiently, fluid can back up into the abdomen, legs, or feet.

Heart failure symptoms can range from mild to severe. Some people may not notice symptoms at first. As heart failure progresses, symptoms may become more noticeable, including:

• Belly pain: Fluid buildup can make you feel bloated or fuller after eating.
• Shortness of breath: You may have trouble breathing all the time or with exertion. You might also have a cough when lying down.
• Sleep disturbance: You may need to prop yourself up with pillows to prevent coughing.
• Sudden weight gain: You may gain up to 2 pounds overnight from fluid buildup.
• Swelling: Fluid buildup can cause swelling in your legs, ankles, or feet (edema).

Many conditions can damage or strain the heart over time, making it harder for the heart to pump effectively. Conditions that contribute to heart failure include:

• Cancer-related heart disease: Cancer treatment can effectively kill cancer cells, but it may also damage other cells in the body, including heart cells.
• Cardiac amyloidosis: This disorder causes abnormal protein deposits (amyloids) to build up in the heart muscle.
• Cardiac arrhythmias: These are abnormal heart rhythms caused by faulty electrical signals in the heart.
• Cardiomyopathy: A disease that leads to the heart muscle becoming stiffened, thickened, or enlarged.
• Congenital heart disease: These are heart abnormalities that develop before birth.
• Constrictive pericarditis: This is chronic inflammation of the membrane covering the heart, which can thicken or scar and prevent the heart from fully expanding as it beats.
• Coronary artery disease: This condition narrows the blood vessels that supply the heart with oxygenated blood.
• Heart valve disease: A condition that causes one or more of the heart’s four valves to work improperly.

Diagnosing heart failure starts with a physical exam, blood tests, and imaging tests to see how well your heart is pumping. Penn Medicine’s cardiovascular imaging services use advanced technology to help your heart failure specialist make an accurate diagnosis.

There are varying degrees of heart failure, and your treatment will depend on your condition. Mild heart failure can sometimes be reversed with lifestyle changes or medication, and Penn Medicine’s primary cardiology program can help you make those changes. If your condition worsens, you may need more advanced care. Our heart failure specialists offer treatment options not available everywhere else.