Heart Failure

The heart is a muscle that pumps blood to the various organs. Heart failure occurs when the heart loses its ability to pump efficiently and fails to meet the needs of the body. As a result, the blood moves through the body at a slower rate which leads to a variety of symptoms.


Heart failure rarely occurs spontaneously. It usually develops as a result of a heart attack (infarction) or hypertension. Other factors can also contribute to heart failure, including:

  • arrhythmia
  • atherosclerosis
  • diabetes
  • drug or alcohol abuse
  • cardiomyopathy
  • valvular heart disease
  • coronary artery disease
  • poor blood circulation


This disease develops slowly and gradually over time. Because the heart adopts certain compensatory measures (e.g. dilating or beating faster), symptoms may develop much later. Symptoms associated with heart failure include:

  • shortness of breath when lying down
  • almost continual shortness of breath, difficulty breathing
  • fatigue and feeling of weakness
  • sudden weight gain
  • swollen legs or ankles
  • loss of appetite
  • coughing or wheezing

These symptoms vary and change over time. They also vary as a function of the seriousness of the disease and are more pronounced when the person is lying down. Those who suffer from heart failure often prefer to sleep in a seated position since lying down is extremely uncomfortable.

Heart failure frequently causes the feet and legs to swell. Since the heart has difficulty pumping blood, it tends to accumulate in the extremities. It may also lead to an accumulation of fluid in the lungs which can develop into pulmonary oedema. In fact, the accumulation of fluid in the lungs is what causes the coughing and shortness of breath. It is recommended that those with heart failure constantly monitor their weight as weight gain could be a result of water retention.


Heart failure is diagnosed by a physician or cardiologist. Patients who present symptoms of heart failure must undergo certain examinations. Blood tests and an echocardiography may also be recommended. A heart ultrasound, or echocardiography, is used to measure cardiac ejection fraction which is the proportion of blood released by the heart available to flow through the blood vessels. This data is used to determine the degree of heart failure. Additional examinations such as chest x-rays or an electrocardiogram (ECG) may also prove useful.


Medications commonly used to treat heart failure act in three ways:

  1. by strengthen the heart and normalizing the heartbeat (beta blockers and digoxin);
  2. by causing the blood vessels to expand allowing blood to flow more easily (ACE inhibitors and vasodilators);
  3. by forcing the kidneys to eliminate fluid to reduce swelling (diuretics).

These drugs relieve heart failure only temporarily. They have to be taken on a regular basis to maintain on-going control of heart disease. Several measures can help control the symptoms associated with heart failure and improve the heart’s efficacy. These measures include:

  • Reducing fluid intake – includes food and beverages
  • Reducing salt and fat intake in diet
  • Reducing stress and anxiety
  • Avoiding alcohol and tobacco
  • Exercising moderately 3 times a week (30 minutes)
  • Losing excess weight
  • Wearing elastic stockings to help blood flow

For more information or for support

The Heart and Stroke Foundation of Canada