Systolic Heart Failure

Not all heart failure is the same. There are a few different types of heart failure and for this article, I will be focusing on systolic heart failure

What is systolic heart failure?

This type of heart failure occurs when the left ventricle (left lower chamber of the heart) can no longer contract normally. Generally, this occurs because the ventricle has become larger than normal, making it more difficult to contract as it should. This means that insufficient blood is being pumped out to the rest of the body. With this type of heart failure, the ejection fraction will be reduced to 40% or less.

Some common causes of systolic heart failure include either having a previous heart attack (myocardial infarction), a history of coronary artery disease, or high blood pressure, among others.

Most common symptoms

The most common symptoms of systolic heart failure include:

  • Fatigue. Feeling weak or tired most of the time and not having the energy to do daily tasks.
  • Shortness of breath. This is often especially bothersome when you are exerting yourself or when you lie down.
  • Edema or Swelling. This is most often noticed in the ankles and feet but can also be seen in other parts of the body. This is due to the excess build-up of fluid from the heart not pumping effectively.
  • Cough. A persistent cough that doesn’t go away that is oftentimes accompanied by wheezing.


Diagnosing systolic heart failure is done by a doctor. They will do a physical exam, take your medical history and run tests that include EKGs, Xrays, a heart echo, blood testing. Exercise treadmill and/or a cardiac catheterization may also be done to diagnose systolic heart failure.

While there is no cure for systolic heart failure, there are treatments that can help your heart contract better and ease symptoms.


Oftentimes, people with systolic heart failure are put on diuretic medications which help reduce the amount of excess fluid in the body. These are often referred to as “water pills.”

ACE (angiotensin-converting enzyme) inhibitors and beta blockers are commonly prescribed as well. Other medications used in the treatment of systolic heart failure include angiotensin II receptor blockers, and digoxin.

Non-medication treatments

Dietary modifications are a relatively easy change to make. Reducing sodium (salt) intake and eating a healthy diet can make a huge difference. Also be sure to stay hydrated, year-round.

Exercise is another great way to help with heart failure. It doesn’t have to be intense cardio or anything like that. Just being active like taking a walk, riding a stationary bike, and swimming are great, lower-impact exercises that most people are able to tolerate.

Other treatment options

Sometimes surgery is warranted to treat systolic heart failure. Heart bypass surgery or even a heart transplant can be done in severe cases if other treatments have been tried and were unsuccessful. Pacemakers can help the coordination between the left and right sides of the heart when they aren’t working as they should on their own. Heart valve repair/replacement is sometimes done to help fix the blood flow through the heart.

The prognosis of systolic heart failure varies depending on the severity and other comorbidities. There is no cure, but there are many treatment options to help improve the pumping power of the heart and keep symptoms at bay.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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