Behind the Diagnosis: Understanding Heart Failure

There’s more to heart failure than meets the eye. It’s often thought of as a single diagnosis, but it’s actually a complex set of diagnoses with multiple types and stages.

There are many causes that can lead to heart failure. Your cardiology healthcare provider needs to evaluate and treat you continually over a long period of time to navigate heart failure.

Heart failure can be caused by heart artery disease, such as prior heart attacks, but it can also be caused by viral illnesses, uncontrolled blood pressure, genetics (inherited conditions) among many other causes.

Understanding the classifications of heart failure can help patients better understand what’s happening in their bodies, and how to work with their care team to manage the condition effectively.

Read More: 7 Tips for Managing a Family History of Heart Disease

What’s Your Type?

“The condition isn't a one-size-fits-all,” says triple board-certified interventional cardiologist Stuart Smalheiser of Beaufort Memorial Heart Specialists. “Classification helps determine how the condition affects a patient’s everyday life, and helps guide us to the most appropriate course of treatment.”

In many cases, heart failure affects the left ventricle, the heart’s largest and most powerful chamber. The left ventricle can be too weak; this is called systolic heart failure. The ventricle can also be too stiff; this is called diastolic heart failure. People can often have both at the same time.

Congestive heart failure (CHF) is the technical term for heart failure. However, CHF has a distinct meaning. It refers to heart failure that causes tissue congestion. Swelling in the legs and ankles and/or difficulty breathing due to fluid in the lungs are common with CHF.

Read More: Coronary Artery Disease Symptoms and What They Mean for Your Heart

How Heart Failure is Classified

To better understand the severity of a patient’s heart failure, a cardiology specialist relies on established classification systems.

One of the most widely used is the New York Heart Association (NYHA) Functional Classification, which focuses on how heart failure symptoms affect daily life:

• Class I — No symptoms during normal physical activity
• Class II — Mild symptoms during everyday activities
• Class III — Noticeable limitations, and even mild exertion causes symptoms
• Class IV — Symptoms occur at rest and with any level of physical activity

The American College of Cardiology (ACC) and American Heart Association (AHA) developed stages of heart failure to classify patients. This classification system complements the NYHA system. The ACC/AHA stages include:

• Stage A — You have risk factors for heart failure, such as coronary artery disease — a type of heart disease — but not structural heart disease or heart failure symptoms. Structural heart diseases, such as aortic stenosis and mitral valve disease, affect the heart’s valves, muscles and other structures.
• Stage B — Structural heart disease is present, but not heart failure symptoms.
• Stage C — You have heart failure symptoms and structural heart disease.
• Stage D — You have advanced heart failure, which means the symptoms are difficult to manage and disrupt your daily life.

Read More: 10 Essential Heart Tests to Safeguard Your Health

Why Early Detection Matters

Heart failure is a progressive condition, but early diagnosis and treatment can slow or even reverse its advancement and improve overall quality of life. Treatment for the condition varies based on the type and severity.

"For many patients, care begins with important lifestyle changes like increasing physical activity, reducing alcohol and tobacco, maintaining a healthy weight and cutting back on sodium intake," said Dr. Smalheiser.

Medication can also play a role in a patient’s treatment plan, including:

• Beta-blockers to slow heart rate and lower blood pressure
• Diuretics to reduce fluid buildup
• Diabetic medications like SGLT2 inhibitors
• ACE inhibitors and Angiotensin receptor blockers to ease strain on the heart

In advanced cases of heart failure, additional therapies like cardiac rehabilitation or implantable devices may be considered.

The cardiac rehabilitation program at Beaufort Memorial offers help for patients managing a heart failure diagnosis. The program includes personalized education, medication monitoring, ongoing evaluations and coordination with a patient’s care team.

Understanding heart failure causes, treatment and classification are valuable tools that can empower patients to take an active role in their care. With the right education, support and treatment plan, many people living with heart failure can continue leading active and fulfilling lives.

Need an expert’s help managing heart failure? Find a cardiologist who can help you control symptoms and maintain your quality of life.