Heart Failure

Many people think heart failure means the heart has suddenly stopped beating. Instead, heart failure means the heart has become weak and has trouble pumping oxygen and blood throughout the body.

It is often called congestive heart failure because inefficient pumping can cause fluid to build up throughout the body, including the lungs, liver and gastrointestinal tract. Typically, it is a serious, long-term condition. Millions of Americans are affected by heart failure, which causes about 300,000 deaths each year.

Causes of Heart Failure
Diagnosing Heart Failure
Treating Heart Failure
Heart Failure Clinic at Virginia Mason

Causes of Heart Failure 

Heart failure typically occurs after something weakens the heart muscle over time.

Common causes of injury include:

  • Coronary artery disease
  • High blood pressure
  • Heart valve disease
  • Viral illnesses
  • Obesity
  • Sleep apnea
  • Alcohol abuse
  • Some cancer therapies
  • Genetic heart muscle disease (familial cardiomyopathy)

While it is far more common among the elderly, young people who have had these types of injuries can have heart failure as well.

Diagnosing Heart Failure

Symptoms of heart failure include shortness of breath, fatigue, cough and waking up with a sense of panic. Blood flow backing up in the veins can cause swelling in the legs and abdomen.  

Tests to diagnose heart failure include:

  • Electrocardiogram (ECG) — measures the heart's electrical activity
  • Echocardiogram — uses ultrasound waves to produce a video image of the heart beating
  • Stress echocardiogram — uses ultrasound waves to provide a video image of the heart beating before and after exercise
  • Nuclear perfusion stress test — uses a radioactive isotope to track blood flow to the heart muscle before and during exercise (or after taking a stress medication)
  • Coronary angiogram — allows doctors to track dye as it flows through the coronary arteries
  • Right heart catheterization — a procedure in which a catheter is placed into the heart to directly measure pressure and blood flow in the heart and lungs

Treating Heart Failure

At the Virginia Mason Heart Institute in Seattle, treatment is first geared toward reducing symptoms to help you live a more comfortable life.

To keep symptoms at a minimum, heart failure patients should:

  • Reduce salt and sodium intake
  • Weigh themselves every day to monitor fluid buildup
  • Maintain a regular activity schedule, such as walking every day
  • Take medications exactly as prescribed
  • Call their doctors if symptoms become worse


Medications such as diuretics and Angiotensin-Converting Enzyme (ACE) inhibitors or Angiotensin Receptor Blockers (ARBs) help treat symptoms and improve exercise capacity.

Other medications are used for slowing the progression of disease and improving heart muscle function. These include beta-blockers and aldosterone-blockers.

Treating Underlying Causes of Heart Failure

Interventional procedures or surgery is sometimes appropriate for patients who have heart failure due to:

The only cure for heart failure is a heart transplant. But heart failure can almost always be managed with appropriate medications or medical procedures.

Heart Failure Clinic at Virginia Mason

The Heart Failure Clinic at Virginia Mason is an integrated program that includes specially-trained cardiologists, electrophysiologists, nurses, pharmacists and a dietitian. Working together they provide comprehensive care, with attention to appropriate treatments and underlying causes of heart failure.

This integrated team also provides:

  • Extensive patient and family education about medications, diet, activity, warning signs and treatment options
  • Help with strategies focusing on exercise, diet, weight loss and tobacco cessation
  • Continuous, supportive and regular follow-up appointments to maintain heart health

If you have questions or would like to schedule an appointment in the Heart Failure Clinic, please call (206) 341-1111. Our staff will be happy to assist you.