Overview
In heart failure, the heart muscle is either too weak to squeeze well or too stiff to fill well between beats. Either way, less blood gets pumped out, and fluid backs up into the lungs, belly, and legs.
It usually develops over time after the heart is damaged by a heart attack, high blood pressure, or other problems. It can also get worse suddenly, which is an emergency.
Symptoms
Symptoms often start slowly and get worse as the heart gets weaker.
- Getting winded easily with activity or stairs
- Short of breath lying flat or waking up breathless
- Swollen ankles, feet, or legs
- Feeling tired and weak
Less common
- Fast weight gain from fluid
- A cough that won't go away
- Swollen belly
- Needing to pee at night
- Confusion in older adults
When to get medical care
Causes
Heart attacks and coronary artery disease are the most common causes. High blood pressure, diabetes, heart valve problems, irregular heartbeats, heavy alcohol use, and some infections and cancer treatments can also weaken the heart.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Past heart attack
- High blood pressure
- Diabetes
- Obesity
- Older age
- Heart valve disease or AFib
Possible complications
- Heart rhythm problems: Can be dangerous
- Kidney problems: From low blood flow
- Fluid in the lungs: Can come on suddenly
Diagnosis
No single test shows heart failure. Doctors use your symptoms, an exam, and tests.
Questions you may be asked
- How far you can walk before getting short of breath
- Whether you wake up breathless or need extra pillows
- Past heart attacks, high blood pressure, or diabetes
The exam
They'll listen to your heart and lungs and look for swelling in your legs, belly, and neck veins.
Tests
Common tests:
- Echocardiogram: An ultrasound that shows how well your heart pumps (ejection fraction).
- BNP blood test: This level goes up when the heart is under strain.
- Chest X-ray and ECG: Look for fluid in the lungs and heart rhythm problems.
Treatment
Treatment eases symptoms, keeps you out of the hospital, and helps you live longer.
Self-care
- Weigh yourself every morning and write it down
- Limit salt, and limit fluids if your care team tells you to
- Take your medicines every day
- Stay active as your care team suggests; ask about cardiac rehab
- Don't smoke, and avoid alcohol
Medicines
Several medicines work together. Many help you live longer, not just feel better.
| Medicine | Helps with | Good to know |
|---|---|---|
| Diuretics (water pills) | Removing extra fluid and easing swelling and breathing | Can lower potassium. You'll pee more. |
| Heart-protecting medicines | Helping a weak heart work better and live longer | Can lower blood pressure; get up slowly. |
| Spironolactone | Helping the heart and removing fluid | Can raise potassium. |
| SGLT2 medicines | Fewer hospital stays, with or without diabetes |
OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.
Some people need a device, like a defibrillator (ICD) or a special pacemaker. Severe heart failure may be treated with a heart pump or a heart transplant.
Prevention
To lower your risk, or keep heart failure from getting worse:
- Control blood pressure and diabetes
- Don't smoke
- Limit alcohol and salt
- Stay active and at a healthy weight
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a cardiologist (heart doctor) if it's hard to control.
Living with it
- Weigh yourself every morning. Call if you gain 2 to 3 pounds in a day or 5 in a week.
- Limit salt as advised.
- Long-term illness can affect mood. Tell your doctor if you feel down or anxious.
Support groups and helplines
- American Heart Association: Plain-language heart information and a support network for patients.
Back to school, work, or sports
- Most people can keep working or going to school.
- Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.
Children, pregnancy, and older adults
- Older adults: May feel tired or confused instead of short of breath.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
For caregivers
- Go to visits when you can and take notes.
- Keep a list of medicines, allergies, and doctors in one place.
- Learn the warning signs that need fast care.
- Take breaks and ask for help. Caregivers need care too.
Outlook
Heart failure is a lifelong condition, but today's medicines help many people feel better, stay out of the hospital, and live longer.
Getting ready for your visit
Bring your weight log.
What to bring
- Your daily weights
- All your medicines
- Your blood pressure readings
Questions to ask
- What's my ejection fraction?
- How much salt and fluid can I have?
- When should I call about weight gain?
- Would cardiac rehab help me?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
Last updated 2026-11-12.