Acute Heart Failure
Overview
What is acute heart failure?
Heart failure is a life-threatening condition. When it occurs, your heart is still working, but it cannot deliver oxygen-rich blood throughout your body. With acute heart failure, you experience a sudden, rapid decline in heart functioning and the amount of blood your heart can pump to the rest of your body.
Who experiences acute heart failure?
Acute heart failure occurs in people with or without previous heart issues:
- Acute decompensated heart failure (ADHF) occurs in people with heart conditions, such as coronary artery disease.
- De novo acute heart failure occurs in people with no history of heart disease. They have ongoing health conditions, like diabetes, that damage their heart.
How do these issues cause acute heart failure?
Heart disease and certain medical conditions can make your heart work harder than usual.
This extra effort leads to physical changes that can include:
- Enlarged heart.
- Decreased blood flow.
- Narrow blood vessels.
- Rapid or irregular heartbeat.
- Stiff heart muscles.
The changes are small at first. They start long before you experience acute heart failure symptoms. Over time, the changes get worse, making your heart work harder than it should. When your heart is no longer able to keep up, acute heart failure occurs.
Symptoms and Causes
Acute heart failure symptoms
One of the most common symptoms is shortness of breath (dyspnea). You may experience:
- Heavy breathing.
- Sensation like suffocating.
- Struggling to breathe while lying down.
- Tight chest.
Other acute heart failure symptoms may include:
- Arrhythmia.
- Chest pain.
- Cough.
- Fluid retention (edema) in the arms or legs.
- Loss of consciousness.
What should I do if I experience these symptoms?
If you notice any of these symptoms, seek emergency medical care as quickly as possible. The sooner you receive treatment, the better your chances of recovery.
What causes acute heart failure?
Health issues that strain the heart increase your risk of heart failure:
- Advanced kidney disease.
- Alcoholism.
- Blood clot in the lung (pulmonary embolism).
- Diabetes.
- High blood pressure (hypertension).
- Overactive thyroid (hyperthyroidism).
- Sleep apnea.
- Stroke.
- Viral infections affecting the heart.
Existing heart problems that cause ADHF include:
- Heart rhythm problems (arrhythmia).
- Coronary artery disease.
- Heart valve disease.
Diagnosis and Tests
How is acute heart failure diagnosed?
Healthcare providers perform a rapid assessment that includes:
- Your health history, including your personal or family history of heart disease. They’ll want to know about other health conditions like whether you use tobacco products and any medications you take.
- A physical exam to learn more about your symptoms and how severe they are. This includes listening to your heart and checking for signs of edema.
What tests will I need?
Healthcare providers use a variety of tests to assess your symptoms, such as:
- Electrocardiogram (EKG) to record and assess the heart’s electrical activity.
- Chest X-ray to check for fluid build-up in the heart or lungs.
- Echocardiogram to show heart movement and blood flow.
- Angiography or heart catheterization to examine the heart’s blood vessels.
You may also need lab tests that include:
- BNP (biomarker) blood test to check for hormones that occur when pressures change inside the heart.
- Basic metabolic panel which shows signs of kidney or thyroid issues.
Management and Treatment
What does acute heart failure treatment look like?
Emergency treatment for acute heart failure restores blood flow and oxygen levels. Care often includes:
- Supplemental oxygen delivers extra oxygen you breathe in through a mask.
- Vasodilators, medications that open narrowed blood vessels.
- Water pills (diuretics) help the body get rid of excess fluid.
Will I need other treatments?
After you leave the hospital, you may need medications, like beta blockers or water pills, to maximize heart health. Other treatments may be necessary to prevent future episodes of acute heart failure.
These treatments may include surgery to:
- Stent placement or coronary bypass surgery for coronary artery disease.
- Repair or replace worn-out heart valves (heart valve surgery).
- Implant a pacemaker or implantable cardioverter defibrillator (ICD) to help you maintain a regular heartbeat and help treat dangerous heart rhythms.
- Replace your heart with a healthy one from a donor (heart transplant).
- Give your heart extra help with a ventricular assist device until you can have a transplant.
Prevention
How can I prevent acute heart failure?
Living a heart-healthy lifestyle can lower your risk of acute heart failure.
This includes:
- Maintaining a healthy weight with a diet that includes plenty of fruits and vegetables.
- Quitting tobacco if you use it and avoiding secondhand smoke.
- Getting regular physical activity and restful sleep.
- Managing stress with deep breathing or relaxation techniques.
Following care instructions for chronic conditions like sleep apnea or diabetes.
Outlook / Prognosis
What is the prognosis for people with heart failure?
The prognosis for heart failure varies widely and depends on the underlying cause and whether it can be treated.
Your outlook depends on a variety of factors, including:
- Heart failure cause and severity.
- How quickly you receive care.
- Your overall health and response to treatment.
- Commitment to heart-healthy living.
Living With
How will my life be different after acute heart failure?
Life after acute heart failure often includes changes, like getting more physical activity. You may also need to avoid certain foods and limit salt and fat intake.
It's important to pay careful attention to your body. This can help you detect the early signs of heart failure that come back after treatment. Your daily routine may include weighing yourself to check for fluid retention. Ongoing medical care can help you feel your best.
A note from Cleveland Clinic
Acute heart failure is a sudden, life-threatening condition that occurs when your heart can no longer do its job. ADHF occurs in people with a history of heart disease. De novo heart failure is due to other medical conditions affecting the heart. You should seek emergency medical treatment if you experience heart failure symptoms. Timely care can save your life. And ongoing therapies lower the risk of future heart issues.