Acute Versus Chronic Heart Failure

A healthy heart pumps oxygen-rich blood throughout the body. When the heart is not able to do its job, this is known as heart failure (HF). HF can develop suddenly (acute) or slowly (chronic). In acute HF, new symptoms appear or existing symptoms become worse. In chronic HF, the symptoms develop over time (weeks to months).^1,2

Acute heart failure

Acute HF can cause symptoms in someone without previously known heart problems. It can also be a sudden worsening of symptoms of HF in someone with a known diagnosis of heart failure.^1-3

Acute HF is an emergency and requires immediate treatment. People with acute HF often need to be treated in a hospital. It is also common for people with acute HF to be readmitted to the hospital after being discharged.^1,3

Chronic heart failure

Chronic HF refers to a more stable condition in which the heart’s inability to properly pump blood and oxygen to the body happens over a longer period (weeks to months). Several factors, such as age, lifestyle, and other chronic conditions, can lead to weakening of the heart.¹

Causes of HF

Acute and chronic HF have similar causes and risk factors. But a key difference is that acute HF is usually caused by damage to the heart that happens over a short time (days). Acute HF can result from:^1,3

• Having an undiagnosed heart condition that makes it difficult for the heart to work properly.
• Developing a new heart condition.
• Heart damage caused by a heart attack, viral infection, or a blood clot in the lungs.

There can be many underlying causes of heart failure. Heart conditions that can lead to heart failure include:^2-5

• Coronary artery disease – This is also called ischemic heart disease. In this condition, blood flow is blocked from getting to the heart.
• Cardiomyopathy – This is a group of conditions that change the heart muscle, making it difficult to pump blood. They can make the heart muscle thick, stiff, or stretched out.
• Arrhythmia – The term “arrhythmia” refers to a fast or irregular heartbeat. This change in heart rhythm makes it harder for the heart to function properly. It can damage or weaken the heart over time.
• Heart valve disease – This is a group of conditions that damage the heart valves. Heart valves make sure that blood flows in a certain direction through your heart.

Risk factors

Having other health conditions can increase your chances of developing HF. These conditions include:^3,6

• High blood pressure
• Diabetes
• Chronic kidney disease
• Sleep disorders, such as sleep apnea

Other factors that can increase your risk of HF are:^2,3

• Advanced age
• Obesity
• Drinking alcohol
• Smoking
• Eating a diet high in salt and some types of fat

Symptoms of HF

Acute and chronic HF have similar symptoms. A common symptom of heart failure is a buildup of fluid in the body (fluid retention). This can show up in several ways, such as:^1-3

• Swollen jugular veins (these are the veins in the neck)
• Swelling in the arms or legs
• Swollen belly
• Weight gain
• Fluid in the lungs

Other common symptoms of both acute and chronic HF include:^1,2

• Shortness of breath
• Fatigue or getting tired easily
• Crackling sound in the chest
• Cough
• Discomfort or pain in the chest
• Arrhythmia
• Difficulty exercising
• Trouble lying flat due to shortness of breath

Diagnosis

To diagnose HF, your doctor will take a complete medical history and perform a physical exam. They may look for any signs of heart failure by listening to your heart or looking for any swelling caused by fluid buildup. Blood, imaging, and heart tests also may help them find the underlying cause of HF.^2,3

Treatment for HF

HF is a lifelong condition that may get worse over time. But several treatment options are available to help you manage its symptoms and live longer. Depending on the severity of your HF, your doctor may recommend:^4,6

• Changes in lifestyle, such as a healthy, low-salt diet and regular exercise
• Prescription medicines
• Implanted medical devices
• Surgery
• Treatment of other conditions such as sleep apnea
• Limiting alcohol and other substances