Heart failure is when the heart isn’t able to pump blood to the body as well as it used to. This can happen in two ways. One way is that the heart can grow weak and lose its ability to pump. The other is when the walls of the heart become stiff. In both cases, the heart fails to provide enough blood to meet the body’s needs.
Heart failure is a common condition — about 6.5 million Americans have heart failure. It’s also a serious condition.
How a Healthy Heart Works
Your heart has a left and right side. When the heart is healthy and strong, the two sides work together to pump blood to your lungs and to the rest of your body.
The right side of your heart takes in blood that is lacking oxygen. The blood then travels to the lungs, where it becomes “oxygenated.” From there, the oxygen-rich blood moves to the left side of the heart, where it’s pumped out to the rest of the body.
Just as important as the “pump” is the heart’s ability to relax. Each heartbeat comes from the contracting of the heart (and pumping of the blood), followed by the relaxing of the heart. When the heart relaxes, it fills with blood before pumping again.
What Happens When You Have Heart Failure
A healthy heart pumps blood to all the cells in your body. This allows you to be active and to do things like walk your dog or go to the grocery store. When you have heart failure, however, the heart is unable to provide enough blood to meet your body’s needs. This can leave you feeling run down.
Your heart tries to make up for this in a few ways.
- Your heart may grow in size to give it stronger pumping
- Your heart may pump faster to try to get more blood out to your body.
- Your body may restrict where some blood goes. This way, there is enough blood for important organs like your brain and heart.
Your body and your heart will only be able to keep this up for so long. Eventually, you will find yourself feeling tired. You may have trouble breathing.
The Different Types of Heart Failure
There are four types, or classifications, of heart failure. They’re based on something called ejection fraction (EF). Ejection fraction measures how much blood leaves the heart each time it contracts.
The classifications include:
- Heart failure with preserved ejection fraction (HFpEF)
- Heart failure with reduced ejection fraction (HFrEF)
- Heart failure with mid-range ejection fraction (HFmrEF)
- Heart failure with improved ejection fraction (HFimpEF)
Heart failure with preserved ejection fraction
Also known as “diastolic” heart failure, HFpEF is when the walls of your heart become thick and stiff. This makes it hard for your heart to relax. Because of this, your heart isn’t able to properly fill with blood while at rest. With HFpEF, your ejection fraction is greater than or equal to 50%.
You may be on medication to help take care of your symptoms. It’s very important that you manage any other chronic illnesses you may have, like high blood pressure or diabetes.
Heart failure with reduced ejection fraction
Also known as “systolic” heart failure, HFrEF is when your heart has become weak. With HFrEF, your ejection fraction is less than or equal to 40%. The good news is it can be managed with medication.
The meds your doctor prescribes will help improve your heart function. It’s important that you manage any other chronic illnesses you may have, like high blood pressure, kidney disease, or diabetes.
Heart failure with mid-range ejection fraction
With HFmrEF, the heart becomes weak. The ejection fraction range is from 41-49%. This means HFmrEF falls between heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. Because of this, patients with HFmrEF may move between the two, depending on treatment, lifestyle, and overall health.
Heart failure meds may be used in some patients with HFmrEF. It’s also important that you manage any other chronic illnesses you may have, like high blood pressure, kidney disease, or diabetes.
Heart failure with improved ejection fraction
This is also called “recovered” ejection fraction. This is because it starts as HFrEF with an ejection fraction of less than or equal to 40%, but it improves over time.
Medications and treatments may even improve your heart function to normal ejection fraction levels. Continuing these beneficial meds can help ensure you maintain these improvements.