Heart failure may seem like a disease of advanced age, but it can develop at any time in life. And, in many cases, it can be prevented or treated. In this expert alert, Gosia Wamil, M.D., Ph.D., a cardiologist at Mayo Clinic Healthcare in London, explains risk factors, symptoms that people may not be aware of and how heart failure is treated. 

Risk factors:

Heart failure means that the heart is unable to pump blood as efficiently as it should. It is a result of the heart becoming too weak or too stiff. In heart failure, the heart can no longer keep up with the demands placed on it to pump blood to the rest of the body.

Coronary artery disease is the main cause of heart failure. Stiffening of the heart muscle is mostly a result of poorly controlled hypertension or diabetes. There are rarer causes of heart failure such as myocarditis, which can be caused by a viral infection, and cardiomyopathies, Dr. Wamil says. 

There are also lifestyle-related risk factors.

“Maintaining a healthy diet, treating obesity, avoiding tobacco use and secondhand smoke, and avoiding alcohol can help prevent heart failure,” Dr. Wamil says. 

Other risk factors for heart failure include sleep apnea, some medications used to treat cancers, and viral infections that damage the heart muscle, Dr. Wamil says.

Symptoms:

Some heart failure warning signs are intuitive, such as ankle swelling, breathlessness, chest pain, a heartbeat that feels rapid or irregular and fatigue while exercising, Dr. Wamil says.

“There are other symptoms that people may not associate with heart failure. Those include a persistent cough, abdominal swelling, rapid weight gain, nausea and a lack of appetite,” Dr. Wamil says. ''People who experience any of these symptoms should contact their health care provider.”

Treatment:

It is important to identify the cause of heart failure because treatments may differ. In most cases heart failure cannot be cured, but the symptoms can often be controlled for many years.

“After heart failure is diagnosed, patients will need to manage the condition for the rest of their lives, usually through care at specialized heart failure clinics,” Dr. Wamil says.

There are several treatment options. Those include medication, surgically implanted devices, and in advanced cases, heart transplant. Physicians and researchers are collaborating to discover new treatments, Dr. Wamil says.

“Over the last few years we have observed significant advances with the introduction of new classes of medications to manage heart failure,” she says. Those include drugs called SGLT2 inhibitors, initially developed to lower glucose levels in patients with diabetes. 

Dr. Wamil’s heart failure research includes studies aimed at understanding and breaking the connection between diabetes and heart disease and using novel medical imaging techniques to identify heart failure early, when serious consequences can be prevented.