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Heart & Vascular:

Advanced Heart Failure Conditions

Heart failure happens when your heart doesn't pump as well as it should. Heart failure doesn't mean your heart is actually going to stop. A normal healthy heart pumps enough oxygen-rich blood to meet your body's oxygen needs. If your heart can’t squeeze or relax properly, it won't be able to pump enough blood. When this happens, symptoms of heart failure occur. There are two types of heart failure:

Systolic Heart Failure — In this type, a weak heart muscle doesn't squeeze as well as it should.

Diastolic Heart Failure — In this type, the heart can't fill with enough blood. This happens when the muscle has thickened or lost its ability to relax.

With both types of failure, blood can “back up” into your lungs and other parts of your body, including your hands, abdomen (belly), legs and feet. This fluid back up is sometimes called "congestion” or congestive heart failure. Congestion often causes heart failure symptoms. If you have moderate to severe systolic heart failure, you may have symptoms without congestion.

Heart Failure Symptoms and Causes


  • Shortness of breath with little exertion

  • Feeling weak or tired after little activity or exertion

  • Trouble sleeping due to breathing problems

  • A new or different cough, especially while lying flat

  • A swollen and/or tender abdomen

  • Loss of appetite

  • Increased urination at night

  • Swelling of the feet and legs


Heart failure is a common condition that develops over time. As the heart muscle weakens, it works harder to keep blood flowing. As the muscle works harder, it grows and changes shape. This can lead to cardiac dysfunction and symptoms of heart failure. Treatment and management can reduce this risk.

Heart Failure Stages and Meanings

Your doctors will use the American Heart Association’s stages of heart failure to help you better understand your condition and treatment plan:

Stage A — You have heart failure risk factors but no heart disease or symptoms

Stage B — You have heart disease but no symptoms (structural heart changes before symptoms occur)

Stage C — You have structural heart changes and symptoms

Stage D – You have advanced heart disease with continued heart failure

Heart Failure Classifications and How They Affect Your Activity Level

The New York Heart Association (NYHA) Functional Classification categories outline physical activity limitations. Your doctor will classify your condition by the severity of your symptoms:

Class I — No limits on physical activity. Ordinary activities don’t cause undue fatigue, palpitations (feeling heart beats), or shortness of breath.

Class II (Mild) — Slight limits on physical activity. You’re comfortable at rest, but ordinary physical activity results in fatigue, palpitations or shortness of breath.

Class III (Moderate) — Serious limits on physical activity. You’re comfortable at rest, but the simplest activities cause fatigue, palpitations or shortness of breath.

Class IV (Severe) — You have discomfort and heart symptoms (fatigue, palpitations, shortness of breath) even at rest. Discomfort increases with any physical activity.

How to Treat and Control Heart Failure

The right treatment and a stable care plan can help you control your heart failure. You can live a full and happy life if you take good care of yourself. Manage your condition and pay close attention to your body to reduce your symptoms and need for hospital visits.

Heart failure can improve or worsen over time. Your treatment may need to be adjusted. If your heart function improves, you may need less medicine. If your heart function worsens, you may need more advanced treatment. Either way, small changes can make a big difference in your heart's structure and function.

Heart Failure Statistics

  • Almost 5 million Americans live with congestive heart failure (CHF).
  • Doctors diagnose about 550,000 new cases in the U.S. each year.
  • Congestive heart failure affects people of all ages.
  • Almost 1.4 million people with CHF are younger than 60.
  • CHF affects men and women equally. African-Americans are 1.5 times more likely to develop heart failure than Caucasians.
  • Heart failure hospitalizes more people than all forms of cancer combined.
  • CHF is the most common diagnosis in hospital patients ages 65 and older.

Did You Know?

Over the last 50 years, deaths from heart failure have decreased an average 12 percent per decade.

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