Heart Failure: Causes, Early Signs & Symptoms

Looking for the Area’s Advanced Heart Failure Treatment? Orange County Trusts Hoag for Cardiac Care.

Every day at Hoag’s Jeffrey M. Carlton Heart and Vascular Institute, we’re dedicated to helping our neighbors who need heart failure treatment in Orange County. From patient education about common risk factors to accurate imaging to diagnose heart failure, the multidisciplinary team of cardiologists, cardiothoracic surgeons and cardiac rehabilitation specialists at Hoag is ready to help you get back to doing what you love.

That dedication is why U.S. News & World Report rated Hoag among the best hospitals in the nation for Heart Failure in 2024-2025.

Read on for more information about heart failure from Hoag, including symptoms, types, risk factors and ways to potentially reduce your risk. If you need an appointment or second opinion, contact Hoag today through our online form or by calling 949-764-5384.

What is Heart Failure?

Heart failure is a medical condition in which the heart becomes unable to pump enough oxygen-rich blood to meet the body’s needs. People with heart failure may have a functional heart, but it cannot handle the amount of blood flow it ordinarily should.

A variety of conditions can contribute to the onset of heart failure. Those with a congenital heart defect, certain forms of coronary artery disease and valvular heart disease, for example, may be at increased risk of the condition.

Heart failure is a serious, potentially life-threatening condition which can cause severe symptoms and complications.

What Are the Different Types of Heart Failure?

To understand the different types of heart failure and how they impact the function of the heart, you need to know a little bit about cardiac anatomy.

To maintain normal circulation throughout the body, blood is pumped both in and out of the heart. To accomplish this, the heart includes four hollow spaces called heart chambers. The two upper chambers are called the atria, while the two lower chambers are known as the ventricles.

On the right side of the heart is the right ventricle, while the left ventricle is on the left side. The types of heart failure are categorized by which ventricle of the heart fails. Sometimes, heart failure can affect both sides of the heart.

The types of heart failure can include:

• Left-sided heart failure: left-sided heart failure occurs when the left ventricle fails. The left ventricle is responsible for pumping oxygen-rich blood from the lungs to the rest of the body. Should the left ventricle fail, it can impair the function of all other organs.
  • Systolic heart failure: In patients with systolic heart failure, also known as heart failure with reduced ejection fraction (HFrEF), the left ventricle loses its ability to forcefully and fully contract, which can reduce how much blood is pushed out of the heart (the ejection fraction) each time it beats. The heart’s pumping ability is preserved, but it is weak.
  • Diastolic heart failure: Also known as heart failure with preserved ejection fraction (HFpEF), diastolic heart failure involves the left ventricle gradually losing the ability to fully relax after contracting because the heart muscle has become inflexible and stiff. This can reduce the heart’s ability to completely fill with blood during the resting period between each beat. This can be described as a stiff heart.
• Right-sided heart failure: right-sided heart failure occurs when the right ventricle fails. The right ventricle normally pumps blood that is depleted of oxygen from the heart into the lungs so it can be reoxygenated. If the right-ventricle is impaired, it can lead to a buildup of fluid within tissues, causing swelling in the abdomen, legs or other areas of the body.

What Does “Ejection Fraction” Mean?

Ejection fraction is a medical term that refers to how much oxygen-rich blood the left ventricle pushes into the circulatory system every time the heart contracts.

In a healthy heart, the left ventricle pushes out between 55-70 percent of the blood it contains with every beat. In those with severe systolic heart failure, ejection fraction can be as low as 40 percent, meaning less oxygenated blood makes its way to the organs and tissues.

Visit here to learn more from the American Heart Association about ejection fraction and heart failure.

What Conditions Can Cause Heart Failure?

Heart failure may be caused from a congenital heart disease, due to a birth defect, also known as a congenital heart defect. However, in most cases, heart failure develops in a slow, progressive process that can be caused by a variety of related conditions or lifestyle factors. Some of the conditions which can contribute to heart failure include:

Coronary Artery Disease and Heart Attack

Heart failure most commonly occurs due to the narrowing or blockage of the coronary blood vessels that supply blood to the heart. The buildup of a fatty substance called plaque within the blood vessels can prevent enough blood from reaching the heart muscle, resulting in a condition known as coronary artery disease (CAD). The added strain on the heart muscle caused by coronary artery disease can eventually cause heart failure. Learn more about Hoag’s Coronary Artery Disease Program here. 

High Blood Pressure

Hypertension, commonly referred to as high blood pressure, is a medical condition characterized by elevated blood pressure. High blood pressure can cause blood flow to push excessively hard against the walls of blood vessels. That can force the heart to work harder to pump blood throughout the cardiovascular system.

The strain on the heart caused by high blood pressure can eventually result in a weakened heart, or heart muscle that is thickened and too stiff to pump blood properly. This can eventually lead to heart failure.

Heart Valve Disease

The heart is made up of several open voids known as heart chambers, which are connected by four natural gates known as heart valves. Heart valve disease occurs when the heart valves are not able to function properly or become abnormally narrowed, forcing the heart to work harder to compensate.

Over time, the extra strain placed on the heart can cause it to weaken. In some cases, it can cause the heart to physically enlarge. This enlargement and weakening can eventually cause heart failure. Learn more about Hoag’s Heart Valve Disease program here. 

Myocarditis

Myocarditis occurs when there is an inflammation of the heart muscle. This inflammation can be caused by a variety of factors, including viral or bacterial infections, exposure to radiation or reactions to illegal or prescribed drugs. Myocarditis most commonly occurs due to infection by a virus.

Myocarditis is a serious, though rare, condition. Severe cases of myocarditis can weaken the heart and prevent the body from receiving enough blood, which can culminate in left-sided heart failure.

Congenital Heart Disease

Certain forms of heart disease can be congenital, meaning that they are present at birth. Congenital cardiac conditions can range from mild to severe issues with the structure of the heart that can prevent it from functioning properly. Congenital heart defect (CHD) is the most common type of birth defect and covers a wide range of structural issues.

In cases where a child has a critical CHD, surgery or other procedures may be necessary within the first year of life. However, even with more mild defects, structural problems may force parts of the heart, such as the ventricles, to work harder, eventually leading to heart failure.

Arrhythmias

Arrhythmias are irregular heart rhythms. A rapid heartbeat is normal when a patient is exercising, for example, but a rapid, fluttering, or unusual heartbeat may indicate that there is a problem that may be impacting the ability of the heart to pump enough blood to the body. During an arrhythmia, the heartbeat may be too quick or slow, while in other cases the rhythm of the heartbeat may be abnormal.

If an irregular heart rhythm is left untreated, the condition can sometimes result in damage to the heart muscle, leading to life-threatening conditions such as stroke, cardiac arrest or heart failure. Visit here to learn more about Hoag’s world-class program for diagnosing and treating heart rhythm disorders.

Long-Term Diseases

Long-term diseases, also known as chronic diseases, are medical conditions that are persistent or long-lasting. This term often applies to a disease which lasts more than three months. Some of the chronic diseases that can cause heart failure include diabetes, infection with HIV and hyperthyroidism.

In some cases, the persistent strain on the heart caused by a chronic condition can eventually cause chronic heart failure, which is heart failure that progresses slowly over a long period of time.

What Are the Symptoms of Heart Failure?

The symptoms of heart failure depend in part on why a patient’s heart has become diseased or damaged.

Sometimes, the symptoms of heart failure may develop slowly, with mild symptoms occurring only during periods of strenuous physical activity. This is called chronic heart failure. However, due to the progressive nature of the disease, symptoms may eventually happen even when a patient is at rest.

Other times, particularly in cases involving a major cardiovascular emergency like a heart attack, the onset of heart failure symptoms can begin suddenly, and are called acute heart failure.

Common symptoms of heart failure may include:

• Shortness of breath after laying down, especially when it awakens the patient from sleep after a couple of hours
• Unusual shortness of breath during physical activity
• General fatigue and weakness, which can cause a reduced ability to exercise
• Swelling in the legs, ankles, and feet
• Swelling in the abdomen (or belly)
• Swelling in the liver
• Irregular heartbeat, particularly an irregular heartbeat that is rapid
• Unusual, very rapid weight gain
• Wheezing and coughing, especially when the patient coughs up pink, blood-tinged mucus
• Unusual need to urinate at night
• Nausea and a general lack of appetite
• Difficulty focusing or decreased alertness
• Chest pain, particularly if a patient is convalescing after a heart attack

Heart failure can be a confusing condition, with a variety of symptoms that can be shared by other common conditions.

Always follow your physician’s advice. Hoag offers an easy-to-understand heart failure management tool that can help you recognize the warning signs and understand your symptoms.

What Are the Complications of Heart Failure?

Heart failure can be life-threatening and may lead to severe complications. The severity of these complications can depend on several factors, including the patient’s overall health, the severity of their heart disease and any heart failure treatment measures they may have taken.

Complications of heart failure may include:

• Kidney damage: due to the heart’s reduced ability to pump blood, heart failure can reduce blood flow to the kidneys. This can potentially cause kidney failure or kidney failure, which may cause a person to require dialysis.
• Liver damage: heart failure can cause a buildup of excess fluid within the liver, increasing the strain placed on this vital organ. That can cause scarring of the liver, which can impede liver function.
• Sudden cardiac death: Heart failure can prevent the heart from maintaining a steady, regular heartbeat. In some cases, an irregular heartbeat can increase the risk of sudden death.

What are the Stages of Heart Failure?

Heart failure is classified into four distinct stages: Stage A, Stage B, Stage C, and Stage D. These stages determine the presence and overall severity of the condition.

1. Stage A: Pre-heart failure. While heart failure has not yet been diagnosed, risk factors may cause the patient to develop heart failure in the future.
2. Stage B: Pre-heart failure. Although heart failure symptoms have not been observed, the structure and function of the patient’s heart is impeded in a way that increases the risk of heart failure.
3. Stage C: Heart failure. Heart failure is present, and the patient has or previously had symptoms of the disease.
4. Stage D: End Stage Heart Failure. Stage D is a form of advanced heart failure in which symptoms are not getting better with treatment. Stage D is also called Stage D HFrEF, short for heart failure with reduced ejection fraction.

What are the Risk Factors for Heart Failure?

Heart failure affects hundreds of thousands of Americans annually. Understanding the risk factors of heart failure is important to helping avoid the most serious complications and side effects of the condition.

Individuals most at risk of heart failure include those with:

• Conditions which can damage the heart: These include coronary artery disease, high blood pressure, heart valve disease, or irregular heart beats. These conditions can weaken the heart muscle over time, culminating in heart failure.
• Diabetes: Diabetes can increase the risk of other conditions which damage the heart, such as coronary artery disease and high blood pressure.
• Heart attack: The damage from a heart attack can weaken the heart muscle, hampering the ability of the heart to pump blood like it should.
• Congenital heart disease: Congenital heart disease occurs when a patient is born with an abnormal heart. Symptoms of a congenital heart issue may require treatment at a young age, or they may induce complications later in life, such as heart failure.
• Viral infections: Infections may viruses can lead to the inflammation of the lining of the heart, weakening it and contributing to heart failure.
• Lifestyle factors: Obesity, smoking, or excessive alcohol use are all lifestyle factors which may contribute to heart failure.

Are There Any Ways to Reduce the Risk of Developing Heart Failure?

Considering the severity of heart failure and the potential intrusiveness of the treatments sometimes needed to combat it, changes in lifestyle can be a good way to head off heart failure before a formal diagnosis. These changes may include:

• Maintaining a healthy weight
• Exercising regularly
• Managing stress
• Limiting salt intake
• Stopping tobacco use and avoiding alcohol
• Taking care of other medical conditions that can increase your risk

Visit our heart failure treatment page or heart failure diagnosis and testing page to learn more.

For Advanced Heart Failure Diagnosis and Treatment in Orange County, There’s No Place Like Hoag.

At Hoag’s Jeffrey M. Carlton Heart and Vascular Institute, we’re changing the way heart failure symptoms are recognized, diagnosed and treated, with a commitment to utilizing the most advanced tools and techniques and a constant focus on delivering the best in compassionate, patient centered care.

That’s cardiac care at Hoag. Need Orange County’s caring, advanced heart failure treatment? Contact Hoag today through our online form or by calling 949-764-5384.