Types of Heart Failure

There are roughly 6.5 million adults in the U.S. with a diagnosis of heart failure.1 There once was a time when all these patients would be treated the same. However, researchers have learned that there are different types of heart failure.

What is heart failure (HF)?

It’s when your heart becomes a weaker pump. It may not fill with enough blood. It may be unable to pump blood fast enough to meet the demands of your body. Symptoms include shortness of breath, feet and ankle swelling, fatigue, difficulty exercising, coughing, and wheezing. Certain treatments can help control it.2,3

Left-sided heart failure

This is when the left ventricle becomes a weak pump. The left ventricle is responsible for pumping blood through your entire body, including your heart and lungs. Things that can cause it are hypertension and coronary artery disease. These both can make your blood vessels narrow. This can make your heart work too hard and eventually it tires out.2

There are two types of left-sided heart failure. These two types are diagnosed by determining your ejection fraction. This is the amount of blood your left ventricle pushes out with each heartbeat. It’s a percentage. Normal is 50-70%. The two types of left-sided heart failure are:2

  • Diastolic Heart Failure. HF symptoms with an EF greater than 45%
  • Systolic Heart Failure.  HF symptoms with an EF of less than 45%

Right-sided heart failure

This is when the right ventricle becomes a weak pump. The right ventricle pumps blood through your lungs. It’s most likely caused by lung diseases, such as COPD, pulmonary fibrosis, and cystic fibrosis. It happens after years of the right heart working hard to pump blood through diseased lungs.2

High output heart failure

 
The heart is able to pump out more blood as needed and is functioning just fine. But it still is unable to meet the metabolic needs of the body. This is because it does not receive enough blood to pump out. The cause of this is a drop in blood pressure. This is not very common. One condition that can cause this is severe anemia. Anemia means you don’t have enough blood. In cases like this, the heart can pump out all it wants. There is simply not enough blood volume to meet the body’s needs. Other conditions that may cause this are sepsis, hyperthyroidism, and pregnancy. While the heart is functioning fine, symptoms of this type of heart failure are the same as for the other types.1,3,4

Low output heart failure

Another name is low cardiac output heart failure. In these cases, the heart receives enough blood. It is simply not strong enough to put out enough blood volume to meet the demands of the body. Anything that impacts your heart’s ability to pump blood will cause this. Examples include a heart attack, pulmonary embolism (blood clot in artery returning blood to the heart), among other things. The low output may be present during exercise, causing shortness of breath. In some cases, it may be present at rest.1,4,5

Acute heart failure

It is happening right now. You are currently experiencing heart failure symptoms. Symptoms include new or worsening feet or ankle swelling or shortness of breath. This is what happens when heart damage is occurring right now, such as during a heart attack. It can happen if a heart valve ruptures. It can happen if you have too much fluid in your system and your heart can’t work fast enough to pump it through your vessels. It could mean simply that your system has too much fluid, and this can happen after you have surgery and your doctor has given you too much via your IV.2

Acute heart failure can be treated. It will require a trip to the emergency room. Often times, if you feel short of breath, BiPAP can be used. This is a machine that applies pressures to help decrease your work in breathing. It helps to take the edge off until medicines take effect. Medicines a doctor prescribes can make the heart a better pump. Other medicine can help you pee out excess fluid so the heart doesn’t have to work as hard. So, usually, you can get past an episode of acute heart failure. The key is you need to seek medical attention ASAP.

Chronic heart failure

This is heart failure that develops over a long period of time. It is the end result of long-standing coronary artery disease. It is often the end-stage of many chronic diseases of the heart. These patients can be controlled with various medicines. Some medicines make you pee and others can increase the strength of the heart. Many patients benefit from cardiac rehabilitation. There are also other treatments that can help, depending on the specific cause of heart failure.2

People with chronic heart failure need to be closely monitored. They need to be aware of the early warning signs and symptoms, such as new or worsening feet or ankle swelling, shortness of breath, or chest pain. Abnormal heart rhythms or infections may also cause episodes of acute heart failure. So, patients with chronic heart failure must work with their doctors to develop a plan of action for what to do when symptoms are present. As a rule of thumb, the sooner you seek help the easier it is for doctors and nurses to help you get better.2

Key takeaways

The type of heart failure you have is important because the treatment may be different. For instance, the treatment for high output heart failure is different from low output heart failure. How your heart failure is treated may depend on how your heart failure presents. It may depend on your doctor. It may depend on you.

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