What Are Types of Heart Failure?

Reviewed by: HU Medical Review Board | Last reviewed: November 2023

Heart failure (HF) is when the heart no longer functions properly. It leads to symptoms of chest discomfort, shortness of breath, and body swelling.1-3

The symptoms of HF can severely limit a person’s ability to perform their activities of daily living. They can also decrease a person’s quality of life. But with diagnosis and good management, symptoms and quality of life can be improved.1-3

HF is caused by several different conditions that weaken the heart muscle. It is a result of abnormalities in the structure or function of the heart, among other triggers.1-3

Left-sided versus right-sided HF

The left side of the heart takes oxygenated blood coming back from the lungs and pumps it throughout the body, whereas the right side takes carbon dioxide-rich blood from the body and pumps it to the lungs to be reoxygenated. HF can affect 1 side of your heart or both. But it is more common in the left side of the heart than in the right side.3

If you have left-sided HF, your heart is not good at pumping blood to the rest of your body. Left-sided HF happens when your heart becomes too weak to pump blood or too stiff or thick to fill with blood. If you have right-sided HF, your heart is too weak to pump enough blood to your lungs.3

Left-sided HF

Doctors classify HF based on your symptoms and left ventricular ejection fraction (LVEF). The ejection fraction (EF) is a measure of how much blood the lower chamber of your heart (ventricle) pumps out when it contracts. Your LVEF is assessed through imaging such as an ultrasound or MRI of your heart.1,4

Left-sided HF can be broken down into 2 types:1

  • HF with reduced EF
  • HF with preserved EF

People with reduced EF generally have an LVEF of less than 40 percent. People with preserved EF generally have an LVEF of 50 percent or greater. There are also people with midrange LVEFs between 40 to 50 percent.1

There is no cure for HF. But treatment can help you live longer and with fewer symptoms. The overall goal of HF treatment is to reduce symptoms, increase quality of life, and lower the chance of hospitalization. Treatment consists of:1-3,5,7

  • Lifestyle changes such as physical activity, avoiding excess sodium, and limiting fluid intake
  • Drugs that help improve symptoms and treat your HF
  • Surgery to fix a heart defect or to place a device that may help if the left side of your heart is getting weaker

Right-sided HF

Right-sided HF is usually caused by left-sided HF. But there are other conditions that can lead to right-sided HF, such as:5

  • Pneumonia
  • A blood clot in the lung
  • Severe disease of the heart valves
  • High blood pressure in the arteries of the lungs and right ventricle

People with right-sided HF require more advanced therapies such as a heart transplant.5

Acute versus chronic HF

Acute HF is defined as new-onset or worsening HF. It is used to describe people who have had no previous signs of HF who develop active symptoms. Acute HF is also used to describe people who have a diagnosis of chronic (long-lasting) HF, who are stable, and whose condition worsens. Acute HF is a medical emergency and typically requires hospital admission.2,6

HF symptoms can worsen quickly and without warning. Understanding and managing your HF is essential to slowing its progression and preventing complications. The best approach includes:2

  • Following the treatment plan your doctor recommends
  • Taking all your medicines as prescribed
  • Going to all your follow-up visits with your doctor

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