“Your heart can’t pump as much as it needs to. Acute heart failure can happen without warning.”

“Your heart can’t pump enough blood to meet your demands. This can be a chronic condition. It can be sudden.”

It’s estimated that 64 million people worldwide are living with heart failure. This condition is a major cause of people over age 65 being admitted to the hospital. This may be because people are living longer with heart disease, which can lead to heart failure over time.

Symptoms of acute heart failure can include:

Many of these symptoms can be related to water retention, which is when your body holds on to excess water. This can make you feel heavy or sluggish.

Symptoms can come on suddenly if acute heart failure is involved. Over time, your symptoms can develop into a problem.

Other symptoms of heart failure include:

Heart failure is not the same thing as a heart attack. But, like a heart attack, acute heart failure can be a life threatening event. Someone with acute heart failure will typically need emergency hospital care. If your symptoms are sudden or severe, call 911 or your local emergency services for help.

If not treated, heart failure can lead to serious complications. These complications can include cardiac arrest, which is when your heart stops beating.

Some people with heart failure have other health problems. It can be hard to know what is causing your symptoms.

But when it comes to symptoms of heart failure, it’s best to get them checked by a doctor right away. According to a 2017 study, fast treatment of acute heart failure can lead to better outcomes.

“The chambers where the blood is pumped out of the heart are called ventricles. They may stiffen so that they don’t fill properly. The ventricles can fail to pump hard if your heart muscle is weak.”

Heart failure can begin on either the left or right side of your heart. Sometimes, both sides may fail at the same time. The different types of heart failure correspond to where the heart is failing:

Left-sided heart failure

This occurs when your left ventricle isn’t pumping efficiently. There are two types of left-sided heart failure:

  • Systolic heart failure happens when your left ventricle cannot squeeze (contract) strongly enough. This means it can no longer pump out blood to your body very well. It’s also called heart failure with reduced ejection fraction.
  • Diastolic heart failure happens when your left ventricle becomes stiff. If your ventricle is stiff, it cannot fill up with blood between heartbeats like it should. As a result, your body doesn’t get as much blood as it needs. This is also called heart failure with preserved ejection fraction.

Right-sided heart failure

This happens in people with left-sided heart failure. The change in blood flow can cause damage to the right side of your heart.

The right side of your heart moves blood. Too much blood can stay in your veins if the right side of your heart is not pumping effectively. This can cause swelling in your legs or abdomen.

Other ways to classify heart failure

Sometimes, doctors also identify types of heart failure based on whether you have known (preexisting) heart disease. These types are:

Acute decompensated heart failure

Acute decompensated heart failure happens when you already have heart disease. This is the most common form of acute heart failure.

It can be hard to know the exact cause of heart failure in people with several conditions.

De novo acute heart failure

“Acute heart failure is less common. De novo is a medical term that means for the first time. This type describes heart failure when you don’t have a previous diagnosis.”

The most common cause of de novo heart failure is lack of blood flow to your heart, which can be caused by conditions such as atherosclerosis.

Over time, many conditions can weaken the heart. This can cause heart failure.

“When you have chronic heart failure, your heart tries to adapt to the strain but it just can’t. Acute heart failure happens when that happens.”

It is possible for acute heart failure to happen in people who are otherwise healthy. There are a number of conditions that can cause a sudden strain on your heart.

Acute heart failure can be caused by:

Chronic heart failure can be caused by these same conditions.

Acute heart failure can be caused by conditions.

Risk factors for heart failure

Having one risk factor may be enough to trigger heart failure. And having a combination of risk factors typically means the chance of heart failure happening is higher.

Risk factors include:

Black and Hispanic people in the US get heart failure diagnoses more often than other people. Black people in the US are more likely to die from heart failure.

These trends are related to racism and inequities in healthcare, according to the American College of Cardiology.

Your doctor will run tests to diagnose heart failure. Your doctor can help you find the right treatment for your heart failure.

Tests for acute heart failure

Your doctor will perform a physical exam on you. They will listen to your heart and lungs with a stethoscope to detect any problems. Your doctor can check for fluid in your body, including your legs, neck, and abdomen.

Your doctor might request tests such as these.

  • Blood tests. These could include a BNP test, which measures a hormone related to heart failure.
  • Electrocardiogram (ECG or EKG). During this test, your doctor will attach electrodes to your skin and record your heart’s electrical activity.
  • Stress test. This test measures your heart activity during physical exercise. It’s not typically recommended if you already have signs and symptoms of heart failure.

A doctor can use an image to help diagnose heart failure.

  • Chest X-ray. This test allows your doctor to better examine your heart and lungs.
  • Echocardiogram. This test uses sound waves to form a live, moving image of your heart so your doctor can see which areas of your heart are affected.
  • Angiogram. If your doctor thinks you may have a blocked artery, they will insert a thin tube into your groin or arm and into your coronary arteries. After injecting dye through a catheter, your doctor can see an image of your arteries.

Other tests can be used to look for underlying causes of heart failure.

  • MRI scan. This test produces detailed images of your heart using magnets and radio waves.
  • CT scan. This test allows your doctor to see detailed images of your heart. It involves lying inside a machine while the images are taken using X-rays.

Your doctor can learn about your heart health from your physical exam and test results.

Classes and stages of heart failure

If you receive a heart failure diagnosis, your doctor may use a classification system to tell you what stage of heart failure you have. This can help guide your treatment.

The New York Heart Association classification is a symptom-based scale. It places heart failure in one of four categories:

  • Class 1. You don’t experience any symptoms at any time.
  • Class 2. You can perform daily activities with ease but feel fatigued or short of breath when you exert yourself.
  • Class 3. You have difficulty completing daily activities.
  • Class 4. You have heart failure symptoms like shortness of breath even when you’re at rest.

The American College of Cardiology/American Heart Association classification is a stage-based system. It’s used to identify your risk for or level of heart failure. The letters A to D convey the stage that you’re in:

  • Stage A: At risk of heart failure. You have one or more risk factors for heart failure, but you aren’t experiencing any symptoms.
  • Stage B: Pre-heart failure. Your test results show signs of heart disease, but you don’t have symptoms of heart failure.
  • Stage C: Symptomatic heart failure. You have heart disease, and you’re experiencing symptoms of heart failure.
  • Stage D: Advanced heart failure. You have advanced heart failure that affects your daily life and requires specialized treatments.

Doctors use the two classification systems to determine the best treatment plan for you.

Treatment can help improve your quality of life. Acute heart failure can have long-term effects. Treatment is centered on managing symptoms and preventing future heart failure.

If you experience acute heart failure, you’ll likely stay in the hospital until you’re in stable condition. During this time, you may need oxygen therapy. You might also need supplemental oxygen after you leave the hospital.

The cause of your heart failure will determine your treatment plan. Acute heart failure can be caused by chronic heart failure. Acute and chronic heart failure are treated the same.

Acute heart failure treatment options include medication, medical devices, and surgery.


In many cases, a combination of at least two drugs is needed to manage heart failure.

Some of the medications include:

  • Angiotensin converting enzyme (ACE) inhibitors. These medications help open your blood vessels, which lowers blood pressure and increases blood flow. This makes your heart’s job easier.
  • Angiotensin receptor blockers (ARBs). Much like ACE inhibitors, ARBs help to relax your blood vessels.
  • Beta-blockers. These medications reduce blood pressure and slow your heart rate. They help to normalize the rhythms of your heart.
  • Digoxin (Lanoxin). This drug strengthens the contractions of your heart and makes it beat more slowly.
  • Diuretics. Also known as water pills, these medications prevent fluid from accumulating in your body.
  • Aldosterone antagonists. These are another type of diuretic. They also reduce the amount of fluid in your body.

A doctor may prescribe medication to treat conditions if they are the cause of heart failure.

Surgery and medical devices

Sometimes surgery is used to treat heart failure. Your doctor may use one of the following devices.

  • Biventricular pacemaker. This device helps both sides of your heart beat at the correct speed by sending electrical impulses.
  • Implantable cardioverter defibrillators (ICDs). An ICD is implanted under your skin, like a pacemaker. It monitors your heart rate and uses an electrical signal to correct it when needed.
  • Heart pumps. An implant such as a ventricular assist device can help your heart pump blood more strongly.

Other procedures can be done if you have a good heart health.

  • Heart valve replacement or repair. If your heart fails because of a problematic heart valve, your doctor may repair or replace the valve.
  • Coronary bypass surgery. In this surgery, your surgeon will remove a blood vessel from another part of your body. This blood vessel is fashioned into a new pathway to work around a clogged artery. Sometimes a less invasive alternative, such as angioplasty with stent placement, can be used instead.
  • Heart transplant. If your condition is severe and other treatments aren’t working, your doctor may recommend heart transplant surgery.

Tips for self-management

It is possible to reduce your heart failure symptoms by focusing on certain behaviors. This may reduce your risk for future heart failure.

If you smoke, talk with your doctor about making a plan to quit. Smoking has negative effects on heart hearth, including:

  • Your blood pressure is raised.
  • Making your heart race.
  • The amount of oxygen in your blood is lowered.

Changes to your doctor can be included.

  • making changes to your diet, such as lowering your salt intake
  • If you are overweight or obese, it is a concern.
  • taking steps to reduce and manage stress

Follow your treatment plan with care. This can help you manage your heart failure symptoms.

Palliative and hospice care

Someone living with a serious condition like heart failure can access palliative care at any stage of their condition. Palliative care is intended to support overall wellness and quality of life and can happen alongside other treatments.

With very severe heart failure, people may choose to access hospice care to receive supportive care at the end of life.

Some risk factors, such as aging, can’t be avoided. The key to preventing heart failure is to reduce the risk factors that you can control.

Many of the lifestyle measures recommended for heart failure recovery can also reduce or eliminate conditions that lead to heart failure. These conditions include high blood pressure. and high cholesterol.

If you’re at risk for heart failure, you should consider these measures to promote heart health:

  • If overweight or obese is a concern, maintain a healthy weight.
  • Get regular physical activity.
  • eat a balanced diet that’s low in red meat and sugar
  • If you smoke, quit.
  • find ways to manage stress
  • Get enough sleep.
  • limit your alcohol consumption, if you drink
  • You may have other health conditions.

If you are making changes to your diet or activity levels, you should check with your doctor first.

It is important to get regular medical exams and report any unusual symptoms to your doctor. The quicker you identify your symptoms and begin treatment, the better you will be.

Your outlook depends on a number of factors, including your overall health, the cause of your heart failure, and the degree of your heart failure. The first step to recovery is hospital treatment. Many people can manage their symptoms with implanted medical devices.

It is important to follow your treatment plan after a heart failure diagnosis. If you notice symptoms of heart failure, call your doctor. If you think you might be having a heart failure, you should get help.

Treatment can relieve symptoms and reduce your risk of future incidents.