Heart Failure


© Morium Howlader, Association of Medical Illustrators

Heart Failure

Heart failure is when the heart is unable to pump blood around the body well enough to meet the needs of the body. This is usually because the heart has become too weak or too stiff. There are many causes for this, which include heart disease and high blood pressure. It does not mean the heart has stopped working, but that it is not working as well as it should be, and may need some support.

As the heart cannot pump blood as well as it should, it can cause fluid to build up in the lungs and lower legs, causing breathlessness (dyspnoea), swelling of the lower legs (lower limb edema), and orthopnoea (breathlessness when lying flat). Heart failure is a long-term condition. Treatment for heart failure aims to control the symptoms, and varies depending on what is the cause of heart failure.

Paroxysmal Nocturnal Dyspnoea
This causes sudden shortness of breath or gasping during sleeping and feeling the urgent need to sit up. This sensation is due to a buildup of fluid in the lungs, caused by heart failure.
Jugular Venous Distension
A common sign of heart failure is prominent bulging of the major vessels in the neck. This is caused by a back up of blood in the veins due to the heart being unable to pump as efficiently as it should.
Prominent right internal jugular vein
Left Ventricular Hypertrophy (LVH)
This is when the walls of the heart’s main chamber, the left ventricle, is thickened. This makes it harder for the heart to pump blood efficiently around the body.
Thickened left ventricular wall
Pulmonary Edema
Heart failure causes too much fluid to back up in the lungs, which is called pulmonary edema. This excess fluid collects in the air sacs of the lungs (alveoli), causing breathlessness.
Fluid in the alveoli
Peripheral Edema
This is swelling in the lower legs caused by a buildup of fluid due to the heart being unable to pump as efficiently as it should.
Pitting edema (pressing on the swollen area leaves an indentation)

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