Heart Failure

This information explains heart failure, including causes, symptoms, diagnosis, and treatment.

Heart failure is a condition in which your heart does not pump well or fill with enough blood. Your heart delivers blood to your body’s cells. If you have heart failure, your heart does not do this well. Fluid can build up in your body causing shortness of breath or swelling in your lower extremities (edema).


  • High blood pressure, which makes your heart work harder to pump blood. This causes your heart to become enlarged and not pump well.
  • Coronary artery disease (damage in your heart’s blood vessels).
  • Smoking.
  • Heart attacks, which cause parts of your heart to be without oxygen and can cause permanent damage to your heart.
  • Valvular heart disease (see Figure 1), which develops when one of the valves in your heart is damaged. This interferes with blood flow through the valve and increases pressure in your heart.
  • Congenital heart disease (a problem with your heart that is present at birth).
  • Hyperthyroidism (overactive thyroid).
  • An enlarged, poorly pumping heart (cardiomyopathy).
  • An infection in your heart.
  • Irregular and poorly controlled heart beats.
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  • Shortness of breath when active or when lying down
  • Swelling (edema) in your feet, ankles, legs, or abdomen
  • Fatigue, weakness, dizziness, or lightheadedness
  • Needing to sleep with several pillows or upright to improve breathing
  • Racing or irregular heartbeat
  • Dry cough, which may be accompanied by white or pink mucus
  • Sudden weight gain
  • Chest pain
  • Difficulty concentrating or decreased alertness
  • Decreased appetite and nausea
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Your doctor may do several tests to diagnose heart failure, including:

  • A chest x-ray to see if there is fluid in your lungs and if your heart is enlarged.
  • Blood tests to check for a hormone called brain natriuretic peptide (BNP) that is released when you have heart failure.
  • An echocardiogram (echo), which uses ultrasound to produce images of your heart. It shows how your heart is beating and pumping blood and can show abnormalities in your heart muscle and heart valves. 
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There are several types of medication for treating heart failure that work in different ways. A few examples of each type are listed but there are others.

  • ACE inhibitors and angiotensin II receptor blockers (ARBs), which relax your blood vessels and lower blood pressure. This makes it easier for your heart to pump. Some examples are lisinopril (Prinivil®) and losartan (Cozaar®).
  • Beta blockers, which slow your heart rate and lower your blood pressure. This helps to reduce the amount of work your heart has to do. Examples are carvedilol (Coreg®) and metoprolol (Lopressor®).
  • Diuretics (water pills), which help your body remove extra salt and fluid and improve shortness of breath and swelling. One example is furosemide (Lasix®).
  • Aldosterone receptor antagonists, which are similar to diuretics. They help to remove extra fluid from your body, but they also help you keep potassium. One example is spironolactone (Aldactone®).
  • Nitrates, which widen your coronary arteries. This causes more blood to be brought to your heart muscle and can also reduce chest pain. Some examples of nitrates are nitroglycerin and isosorbide dinitrate.
  • Digoxin (Lanoxin®), which helps your heart pump with more force.
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Caring for Yourself When You Have Heart Failure

  • Make changes to your diet and lifestyle.
    • Decrease how much salt you eat. Most people should eat no more than 2 grams of sodium every day, but talk with your doctor about the amount that is right for you. Avoid processed foods, such as canned soups, frozen meals, and cold cuts, Ask your nurse for the resource 2-Gram Sodium Diet
    • Decrease how much liquids you drink. Most people should drink no more than 1 liter of liquids daily. Talk with your doctor about the amount that is right for you.
    • Lose weight, if you need to.
    • Ask your doctor if you need to lower your cholesterol.
  • Weigh yourself daily. If your weight increases by 2 pounds in 1 day or 4 pounds in 1 week, call your doctor.
  • Quit smoking if you are a smoker. If you want to quit, call our Tobacco Treatment Program at 212-610-0507. You can also ask your nurse about the program.
  • Decrease your alcohol intake to no more than 1 drink a day if you are a woman and 2 drinks a day if you are a man.
  • Participate in physical exercise on a daily basis. Ask your doctor if you need a referral to a physical therapist.
  • Speak with your primary care doctor or cardiologist (heart doctor) about how to manage other health problems, such as high blood pressure, high cholesterol, and diabetes.
  • Join a cardiac rehabilitation program, which is a program that helps improve the health and well-being of people who have heart problems. The program includes exercise, ways to reduce your risk of other heart problems, and counseling.
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