Heart failure

Heart failure occurs when the heart cannot pump out enough blood to the body. Then the organs and cells do not get enough oxygen to function. Heart failure is a sign that you have another underlying cardiovascular disease. A typical symptom of heart failure is shortness of breath, especially during physical exertion. Heart failure is treated with drugs and sometimes surgery is needed.


The heart is a muscle that constantly works to pump blood to all parts of the body to supply the organs with oxygen. The heart consists of two atria and two ventricles.


When the heart muscle becomes overloaded it increases in size to be able to continue its pumping work. At the same time, the chambers inside the heart are enlarged, which makes the pumping capacity worse. As a consequence, fluid can accumulate in different parts of the body. The liver is enlarged and both the stomach and legs can swell due to a buildup of fluid– called edema. In the same way, you can get pulmonary edema.


Heart failure is associated with another underlying cardiovascular disease, such as high blood pressure, valve disease, or it can occur after a heart attack. In case of prolonged heart failure, you can get low blood pressure instead.


Various conditions can interfere with the heart’s ability to pump blood into the body. Common conditions leading to heart failure are:


  • Ischemic heart disease when coronary arteries cannot supply blood to the heart.
  • Heart muscle disease that enlarges the heart
  • Irregular heartbeat.
  • High blood pressure.


Acute heart failure can be caused by:


  • sudden anemia
  • acute myocardial infarction
  • acute heart rhythm disorder
  • plug in the lung
  • damage to the carotid artery
  • stress-triggered heart disease (Takotsubo)


Many other conditions can also contribute to heart failure: renal failure, type 2 diabetes, chronic obstructive pulmonary disease (COPD) or acute infection. 


Alcohol, smoking and some drugs can also cause heart failure.


Heart failure is divided into several stages where symptoms are described from minor to more severe. Symptoms usually develop slowly. If it comes suddenly it is urgent.


Common symptoms of heart failure are:


  • shortness of breath during exertion or rest (dyspnea)
  • difficult lying down on a flat surface
  • swollen legs
  • fatigue 


Sudden or acute deterioration of known heart failure has the following symptoms and requires urgent care:


  • roaring breathing
  • cough
  • cold sweats
  • pressure in the chest
  • anxiety
  • palpitation
  • blue lips.

Prevention and protection

It is important to understand what you can do to help your heart work effectively. Here are common recommendations:


  • stay physically active
  • stop smoking
  • reduce the amount of salt in the food
  • eat smaller portions
  • avoid alcohol


Adapt physical activity to your conditions. Regular walks, swimming or light weight training are some possibilities. A lot of salt binds fluid, so you should salt less.


Infection further burdens the heart and needs to be avoided. You should annually vaccinate against seasonal flu. There are also vaccines against pneumonia caused by bacteria.


To investigate heart failure, the doctor makes an overall assessment to find out what the possible causes of heart failure are. They also do a body examination and listen to your heart sounds. Other studies that can be done to investigate heart failure are:


  • Measurement of oxygen saturation in the blood.
  • ECG – measurement of cardiac electrical activity using electrodes on chest, arm and leg.
  • Ultrasound of the heart.
  • Blood tests.
  • X-ray of heart and lungs.


Heart failure is treated with drugs that facilitate the work of the heart and reduce symptoms. The treatment is directed to underlying factors, for example regulating blood pressure or to remedy any valve disease. More serious cases of heart failure can be treated with various surgical procedures. There are several different electronic aids that can regulate the heart’s pumping capacity, e.g. a pacemaker and defibrillator.

When to consult a doctor

Seek emergency care if you suffer from persistent chest pain.


Seek medical attention if you feel unusually tired and suffer from one or more of the following:


  • rapid gain weight
  • swollen legs
  • loss of appetite
  • shortness of breath on exertion
  • coughing

How Appotek can help

APPOTEK can help you if you suspect heart failure. A nurse or physician will make an initial assessment based on your symptoms, then prescribe treatment or refer you for further examination. In case of heart failure, a physical examination is required.


Our psychologists can also help with supportive conversations if you have been diagnosed and need someone to talk to.


Vadym Diadiun, Doctor of Medicine, M.D.