Heart Failure: Understand How it Happens, Types, Symptoms and Risk Factors

Has been reviewed and approved by dr. Beny Hartono, Sp.JP, Subsp. KI (K), FIHA, FAPSC

Have you ever heard the term heart failure? This condition may sound scary, but understanding more about heart failure will help you recognize the early symptoms and how to take steps to prevent it. Let's look at the complete review below.

What is Heart Failure?

Heart failure is a condition where the heart is unable to pump enough blood throughout the body. Even though the name is "failure", this condition does not mean the heart stops working altogether. The reason is, a healthy heart pumps oxygen-rich blood throughout the body and brings blood and oxygen back to the lungs. When the heart experiences problems, this process is hampered, so that the body's organs do not get enough oxygen and nutrients. 

How the Heart Works?

Before discussing heart failure further, it is important to understand how the heart works normally. The heart consists of four main chambers, namely: right atrium, right ventricle, left atrium and left ventricle. The atrium functions as a blood receiving chamber, while the ventricle functions as a pumping chamber. Heart valves ensure blood flows in the right direction. 

Types of Heart Failure

There are several types of heart failure, but in general they can be divided into:

Left Side Heart Failure

When a person experiences left-sided heart failure, the left ventricle has to work extra hard to pump the same amount of blood. The heart's ability to pump blood is measured by ejection fraction (EF). The higher the EF value, the better the heart's performance. Under normal conditions, the EF value ranges from 55% to 60%. If a person's EF value is low, it means the heart is having difficulty pumping blood. Two types of left-sided heart failure:

• Systolic Failure: In left-sided heart failure, the lower left side of the heart muscle (left ventricle) weakens, so it cannot contract as strongly as usual. As a result, the heart is unable to pump blood throughout the body with sufficient pressure. This condition is often referred to as heart failure with low ejection fraction (HFrEF) with the heart's ability to pump blood less than or equal to 40%.

• Diastolic Failure: In this type of heart failure, the lower left side of the heart muscle (left ventricle) becomes stiff making it difficult to relax. As a result, the heart cannot be completely filled with blood between each beat. This condition is called heart failure with preserved ejection fraction (HFpEF) with its ability to pump blood still quite good, namely more than or equal to 50%. In addition, there is also an intermediate condition called heart failure with mid-range ejection fraction (HFmrEF). In this condition, the ability to pump blood is between HFpEF and other types of heart failure which have a weaker blood pumping ability (HFrEF), namely between 41% to 49%.

Right Side Heart Failure

Right-sided heart failure is usually the result of problems on the left side of the heart. If the left side cannot pump blood properly, blood pressure will increase and burden the right side. This causes the right side to also have difficulty pumping blood to the lungs. As a result, the right side also weakens and is unable to pump blood effectively, so blood accumulates in blood vessels throughout the body.

Congestive Heart Failure

When blood flow out of the heart is obstructed, blood will accumulate in the body and cause swelling or edema. This condition is often referred to as congestive heart failure (CHF). Edema most often occurs in the legs, but can also occur in other parts of the body. If fluid builds up in the lungs, this condition is called pulmonary edema and can cause difficulty breathing.

Heart Failure Symptoms

Symptoms of heart failure can vary depending on the severity and type of heart failure. Some common symptoms that may appear include:

• Shortness of breath, especially when doing activities or lying down

• Get tired easily

• Swelling in the legs, ankles, or abdomen

• Dry cough

• Irregular heartbeat

• Decreased appetite

• Sudden weight gain or loss

Risk Factors for Heart Failure

Some factors that can increase a person's risk of experiencing heart failure include:

• Coronary heart disease: Occurs when cholesterol and fat accumulate in the heart arteries and cause blockage of the coronary arteries that supply blood to the heart. 

• High blood pressure: Occurs when blood pressure is consistently high, which can weaken the heart's function.

• Type 2 diabetes: Diabetics tend to experience high blood pressure, which can damage blood vessels. 

• Syndrome metabolic: The five metabolic risk factors are large waist circumference (abdominal obesity), high fasting triglycerides, low HDL (good) cholesterol, high blood pressure, and high fasting blood sugar. These risk factors affect the heart. 

• Overactive thyroid problems: This condition can cause an increase in heart rate and thickening of the heart muscle.

• Aging: People over 65 years of age are more likely to experience heart failure due to weakening of the heart or the heart becoming stiff due to age.

If you experience the symptoms above, immediately consult a Heart Specialist doctor Premier Bintaro Hospital. Cardiologist at our hospital tasked with diagnosing and providing treatment for congenital heart defects, coronary artery disease, heart failure, valvular heart disease, and electrophysiology, so that it can help patients to overcome various complaints and prevent heart problems.

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