What is heart failure?

Heart failure is a condition in which the heart doesn't pump enough blood to meet the needs of the body. It "fails" at what it is supposed to do, but this does not mean it has stopped beating.

Heart failure can be left or right side, or both. The two types are:

  • Systolic—referring to the lack of pressure or force of the heart to pump sufficient amounts of oxygen-rich blood throughout the body
  • Diastolic—referring to the lack of stiffness or lack of "relaxation" of the ventricles (lower heart chambers), thus preventing blood from entering the heart during normal contractions

If heart failure causes blood to get backed up (congested) in the liver, legs, lungs and abdomen, this is called congestive heart failure.

The most common causes of heart failure are other conditions, such as coronary artery disease (CAD), diabetes, high blood pressure, and obesity, all of which put strain on and may contribute to weakening or stiffening of the heart.

Symptoms of heart failure

Many of the symptoms are similar to those of other conditions, such as fatigue and weakness, shortness of breath, fluid retention in the legs, ankles or feet, and loss of appetite and nausea. However, there are some symptoms that require immediate medical attention, including:

  • Chest pain
  • Coughing up pink, foamy mucus
  • Rapid or irregular heartbeat that accompanies shortness of breath, fainting or chest pain
  • Sudden, severe shortness of breath

If you have any of these emergency symptoms, please call 911 immediately.

Diagnosis and testing for heart failure

If you are at risk, your doctor may already be monitoring your condition. To get an accurate diagnosis, your doctor will review your medical history and perform a physical exam. He or she may also recommend a blood test, chest X-ray, CT scan or MRI.

You may also undergo additional testing, such as:

At Lankenau Heart Institute in the suburbs of Philadelphia, we treat patients with heart failure, or congestive heart failure (CHF), by taking a comprehensive approach that emphasizes lifestyle changes along with advanced treatments and management of contributing conditions such as diabetes and hypertension. Changes in diet and lifestyle can include quitting smoking, reducing blood pressure and managing your weight.

Heart failure is also treated with medication, such as angiotensin-converting enzyme (ACE) inhibitors and beta blockers, as well as with implantable cardioverter-defibrillators (ICD), similar to a pacemaker.

Along with medication management and preventive measures, heart failure interventions may include:

When surgery is required to manage heart failure, our board-certified heart failure specialists bring expertise in a wide range of procedures, including heart valve repair and replacement, coronary artery bypass (CABG) surgery, and ventricular-assist device implantation. Our experienced team comprises surgeons who have extensive experience with left ventricular assist device (LVAD) implantation as well as a dedicated LVAD nurse practitioner and physician assistant specializing in heart failure.

Heart failure is a lifelong condition that requires long-term care. Our goal is to effectively manage your symptoms and dramatically reduce the rate of hospitalization and readmission associated with your disease.


If you have severe heart failure, a mechanical assist device may be an option for you. This device can serve as either a "bridge-to-transplant" if you are waiting for a donor heart or if you're not eligible or well enough to undergo transplant surgery.

If you're a candidate for heart transplant, this procedure can significantly improve your quality of life and chances of survival. At Lankenau Heart Institute we partner with prominent transplant programs throughout the Philadelphia region to help heart failure patients have access to transplant services.

Angiotensin-Converting Enzyme Inhibitors

A type of vasodilator, these drugs widen blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart.

Aldosterone Antagonists

Aldosterone antagonists are primarily potassium-sparing diuretics, but they have additional properties that help the heart work better.

Beta Blockers

These drugs reduce signs and symptoms of heart failure, improve heart function and help extend patients’ lives.

Cardiac Resynchronization Therapy

CRT involves the use of a special (biventricular) pacemaker to reset, or resynchronize the beat of the heart by causing the ventricles to contract normally.

Heart Transplantation

People with end-stage heart failure for whom other treatments and medications have not helped, and who are otherwise healthy, may be eligible for heart transplant.

Implantable Cardioverter Defibrillator (ICD)

An ICD may be recommended if you have a life-threatening arrhythmia or if you have had a heart attack or survived sudden cardiac arrest.

Left Ventricular Assist Device

An LVAD is a heart pump that helps the left ventricle, the heart's main pumping chamber, pump blood more effectively to other parts of the body.

Heart failure clinical trials

Main Line Health uses clinical trials to help prevent, diagnose and treat the full range of heart and vascular conditions. Learn more about the cardiovascular clinical trials currently being offered by our renowned cardiologists and heart and vascular surgeons.

U.S. News & World Report has rated Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital as High Performing for heart failure for 2022-2023.


Genetics and Risk Assessment

Genetic evaluation is becoming an important part of personalized care, as many health conditions have a genetic basis and genetic test results can help to guide medical decisions. Our genetic counselors provide consultations related to cancer genetics, cardiovascular genetics and prenatal genetics.