Symptoms and causes
Typical signs are getting winded on stairs, fatigue, swollen ankles and legs, and shortness of breath when lying flat or waking up gasping. A weight gain of 2–3 pounds in a day or 5 in a week can signal fluid buildup. Long-standing high blood pressure, coronary artery disease and angina, valve problems, and atrial fibrillation are common causes.
Testing and treatment
A BNP blood test and an echocardiogram confirm it; an ejection fraction of 40% or lower means HFrEF. For HFrEF, the "four pillars", an ARNI (or ACE inhibitor/ARB), a beta-blocker, an MRA, and an SGLT2 inhibitor, improve survival. Diuretics relieve swelling. Limiting sodium, weighing yourself every morning, avoiding tobacco and heavy drinking, and cardiac rehab reduce hospital visits.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Does heart failure mean the heart stops?
- No. The heart is still beating but can't keep up with the body's demands.
- Is exercise safe with heart failure?
- For stable patients, supervised regular activity such as cardiac rehab is recommended.
Sources reviewed: 2026-10-26
References
- Heidenreich, P. A., et al. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation, 145(18), e895–e1032.
- McDonagh, T. A., et al. (2021). 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 42(36), 3599–3726.
- National Heart, Lung, and Blood Institute. Heart Failure. NHLBI.