Pulmonary edema Heart failure

Photo of author

By nclexnursing

Pulmonary edema heart failure is a condition in which the heart is unable to keep up with the body’s needs, resulting in diminished blood flow, blood back-up (congestion) in the veins and lungs, and/or other alterations that may weaken or stiffen the heart further.

Heart failure occurs when the heart’s contracting or relaxing motion is insufficient, usually due to a weak, stiff, or both heart muscle. Heart failure can be caused by a variety of heart conditions.

Shortness of breath and exhaustion develop progressively over days to months for the majority of persons.

Fluid can build up in the lungs, the belly, or the legs.

Doctors typically suspect heart failure based on symptoms, although procedures such as echocardiography (heart ultrasound) are commonly used to assess heart function.

The goal of treatment is to address the underlying cause of heart failure, make lifestyle changes, and treat heart failure using medicines, surgery, or other procedures.

Heart failure can strike anyone at any age, including children (especially those born with a heart defect). It is, however, considerably more prevalent in the elderly, because they are more likely to have illnesses that predispose to heart failure (such as coronary artery disease, which destroys the heart muscle) or heart valve abnormalities. Changes in the heart caused by aging tend to make the heart perform less efficiently.

The goal of treatment is to address the underlying cause of heart failure, make lifestyle changes, and treat heart failure using medicines, surgery, or other procedures.

Heart failure can strike anyone at any age, including children (especially those born with a heart defect). It is, however, considerably more prevalent in the elderly, because they are more likely to have illnesses that predispose to heart failure (such as coronary artery disease, which destroys the heart muscle) or heart valve abnormalities. Changes in the heart caused by aging tend to make the heart perform less efficiently.

Heart failure affects roughly 6.5 million people in the United States, with 960,000 new cases diagnosed each year. Around 26 million people are affected globally. Because people are living longer and because certain risk factors for heart disease (such as obesity, diabetes, smoking, and high blood pressure) are affecting more individuals in some nations, the problem is anticipated to become more widespread.

The term “heart failure” does not imply that the heart has stopped beating. It indicates that the heart is unable to keep up with the task of pumping enough blood to all parts of the body (its workload). This definition, however, is oversimplified. Heart failure has various origins, characteristics, forms, and consequences, and there is no one term that can capture them all.

  • The heart’s job is to pump blood around the body. A pump is a device that transfers fluid from one location to another.
  • Blood is pumped from the veins into the lungs by the right side of the heart.
  • The left side of the heart pumps blood from the lungs to the rest of the body via the arteries.
  • Blood leaves the heart when the heart muscle contracts (systole) and returns when the heart muscle relaxes (diastole) (called diastole). Heart failure occurs when the heart’s contracting or relaxing motion is insufficient, usually due to a weak, stiff, or both heart muscle. As a result, blood may not flow as freely as it should. Blood may also accumulate in the tissues, resulting in congestion. As a result, congestive heart failure is a term used to describe heart failure.

The heart normally extends as it fills with blood (diastole), then contracts to push the blood out (during systole). The ventricles are the heart’s major pumping chambers.

Heart failure owing to systolic dysfunction occurs when the heart is unable to contract properly. It may fill with blood, but because the muscle is weaker or a heart valve fails, the heart cannot pump out as much of the blood it holds. The amount of blood pumped to the body and lungs is reduced as a result, and the ventricle normally expands.

Diastolic dysfunction causes heart failure because the heart muscle stiffens (especially in the left ventricle) and thickens, preventing the heart from filling with blood correctly. As a result, blood accumulates in the left atrium and pulmonary blood veins, causing congestion. The heart may, however, be able to pump out a normal percentage of the blood it receives.


The heart chambers always contain some blood, but the thickness of the arrows represents how much blood enters and leaves the chambers with each heartbeat.

Heart Failure Types

The ejection fraction (EF), which is the percentage of blood pumped out by the heart with each beat and is a measure of how well the heart pumps, is used to classify the different forms of heart failure. A healthy left ventricle ejects roughly 55 to 60% of the blood it contains.

HFrEF (also known as systolic heart failure) is a kind of heart failure with a decreased ejection fraction.

The heart contracts with less force and pumps out a lower percentage of the blood it receives. As a result, the heart retains more blood. After then, blood builds up in the lungs, veins, or both.

In patients with heart failure with preserved ejection fraction (HFpEF—also known as diastolic heart failure).

Because the heart is rigid and does not relax normally after contracting, it has trouble filling with blood. The heart can pump a normal proportion of blood out of the ventricles when it contracts regularly, but the overall amount pumped with each contraction may be less. When the heart is stiff, it compensates for its poor filling by pumping out a bigger amount of blood than usual. However, like with systolic heart failure, blood returning to the heart eventually builds up in the lungs or veins.


The term “heart failure with mid-range ejection fraction” (HFmrEF) refers to persons who have an ejection fraction that is midway between preserved and diminished.

Causes of Heart Failure

Heart failure is commonly divided into three categories by doctors. Disorders that have a direct impact on the heart (cardiac causes). Other body system disorders have an indirect impact on the heart (non-cardiac causes).

Heart failure can be caused by any condition that directly affects the heart, as well as several disorders that affect the heart indirectly. Heart failure can occur fast in some cases. Other illnesses only lead to cardiac failure after a long period of time. Systolic heart failure is caused by some conditions, whereas diastolic heart failure is caused by others. Some disorders, such as high blood pressure and some heart valve problems, can induce both types of heart failure.

One of the most common causes of heart failure is coronary artery disease.

Coronary artery disease (CAD) is a condition that affects because coronary artery disease lowers the flow of oxygen-rich blood to the heart muscle, which requires oxygen for optimal contraction, it can affect huge portions of the heart muscle. A heart attack occurs when a coronary artery is blocked, destroying a section of the heart muscle. As a result, that area no longer has the ability to contract regularly.

  • Myocarditis is a disease that affects the heart (inflammation of heart muscle)
  • Some medications (for example, some chemotherapy drugs)
  • Toxic substances (for example, alcohol)
  • Valve problems in the heart
  • A link between the heart chambers that is abnormal (for example, ventricular septal defect)
  • Affects the electrical conduction system of the heart, resulting in an aberrant cardiac rhythm.
  • Some genetic conditions
  • Heart conditions can cause the heart to stiffen

Heart failure can be caused by a variety of non-cardiac factors.

Because the heart must pump blood more vigorously than usual to expel blood into the arteries against the higher pressure, high blood pressure puts a strain on the heart. The heart’s walls thicken (hypertrophy) and/or stiffen over time. Because the stiff heart does not fill fast or sufficiently, the heart pumps less blood with each contraction than it should. Changes in the walls of the ventricle are also caused by diabetes and fat.

The heart’s walls thicken as people get older. Heart failure is more common in older persons due to a combination of high blood pressure, obesity, and diabetes, all of which are common among the elderly, as well as age-related stiffness.

Non-cardiac causes of heart failure are less common.

  • High blood pressure in the lungs’ arteries (pulmonary hypertension, sometimes caused by pulmonary embolism)
  • Anemia
  • Thyroid gland dysfunction
  • Failure of the kidneys
  • Some medications

Symptoms of Heart failure

Heart failure symptoms can appear rapidly, especially if the cause is a heart attack. When the heart initially starts to malfunction, however, most people have no symptoms. The symptoms then appear gradually over a period of days, months, or years. Heart failure can be stable for a while, although it usually advances slowly and insidiously.

Some of the most prevalent signs and symptoms are:

  • Breathing problems
  • Edema (fluid accumulation) in the legs causes fatigue.
  • Inability to exercise or engage in other strenuous activities
  • Heart failure can induce a variety of symptoms in older persons, including tiredness, confusion, and disorientation.

The severity of heart failure is usually determined by how effectively a person is able to carry out daily activities. The New York Heart Association (NYHA) categorization is still a useful tool for people and their carers to understand the severity of their condition and how it affects their lives.

Severe heart failure symptoms

Cheyne-Stokes respiration (periodic breathing) may develop as heart failure progresses. In this uncommon breathing pattern, a person stops breathing for a few seconds before starting to breathe quicker and deeper, then slower and shallower, until they briefly stop breathing again and continue the cycle over and over. Cheyne-Stokes respiration occurs when blood supply to the brain is diminished, resulting in a lack of oxygen in the parts of the brain that control breathing. Central sleep apnea is characterized by Cheyne-Stokes respiration.

A different and more common breathing issue that can occur in persons with heart failure is obstructive sleep apnea (in which airway obstruction interrupts sleep, resulting in daytime sleepiness). Heart failure can be exacerbated by severe obstructive sleep apnea.

Acute pulmonary edema is the buildup of a substantial amount of fluid in the lungs in a short period of time. It causes extreme difficulty breathing, rapid breathing, bluish skin, restlessness, anxiety, and suffocation, as well as symptoms of agitation, anxiety, and suffocation. Bronchospasms (airway spasms) and wheezing are common in some people. Acute pulmonary edema is a life-threatening condition that can develop when people with heart failure get extremely high blood pressure, have a heart attack, or simply stop taking their heart failure medications or eat salty foods.

When the heart is significantly injured, blood clots can form in the chambers. Because blood flow within the chambers is sluggish, blood clots can form. Clots can become emboli, which move through the bloodstream and partially or fully block an artery elsewhere in the body. A stroke can occur when a clot stops an artery leading to the brain.

People with severe heart failure, particularly the elderly, are prone to depression and mental decline, which necessitates thorough assessment and treatment.

Heart Failure (HF) Diagnosis

  • X-ray of the chest
  • Electrocardiography (ECG)
  • Other imaging tests, such as echocardiography, are sometimes used.
  • Tests on the blood

Symptoms alone are generally enough for doctors to suspect heart failure. A physical examination reveals a weak, often rapid pulse, low blood pressure, abnormal heart sounds and murmurs, as well as fluid accumulation in the lungs, all of which can be heard through a stethoscope, as well as an enlarged heart, swollen neck veins, an enlarged liver, and swelling in the abdomen or legs.

Read pneumonia vaccine (pneumococcal)