Heart failure is a medical condition where the heart struggles to pump enough blood to meet the body’s demands. This can lead to symptoms as organs and tissues do not receive adequate oxygen and nutrients. Systolic heart failure is a common form. This condition involves a problem with the heart’s pumping action, impacting its ability to circulate blood effectively.
The Mechanics of Systolic Heart Failure
Systolic heart failure, also known as heart failure with reduced ejection fraction (HFrEF), occurs when the heart’s main pumping chamber, the left ventricle, becomes weakened and enlarged. The term “systolic” refers to the phase of the heartbeat when the heart contracts to push blood out to the body. In this condition, the weakened left ventricle cannot contract forcefully enough, leading to a reduced amount of blood being pumped with each beat.
This means less oxygen-rich blood circulates to the body’s organs and tissues. This reduced pumping action directly affects the “ejection fraction” (EF), a measurement indicating the percentage of blood pumped out of the left ventricle with each contraction. A normal ejection fraction typically ranges from 55% to 70%; in systolic heart failure, it is usually 40% or less, signifying impaired pumping ability.
While systolic heart failure involves a problem with the heart’s contraction, another type, diastolic heart failure, involves the heart muscle becoming stiff and unable to relax properly to fill with blood between beats. Both conditions affect the left ventricle, but systolic heart failure specifically targets the pumping dysfunction.
Common Causes and Contributing Factors
Systolic heart failure often develops from underlying cardiovascular conditions that weaken the heart muscle. Coronary artery disease (CAD), where heart arteries narrow, is a frequent cause. Previous heart attacks, resulting from blocked blood flow to the heart muscle, can also damage the heart and lead to systolic heart failure. High blood pressure, or hypertension, forces the heart to work harder to circulate blood, which over time can weaken the heart muscle.
Heart valve diseases, where valves do not open or close properly, can also increase the heart’s workload. Irregular heart rhythms, known as arrhythmias, can impair heart efficiency. Conditions affecting the heart muscle, termed cardiomyopathy, can lead to systolic heart failure. Lifestyle factors such as long-term alcohol or drug abuse can also damage the heart muscle. Chronic conditions like diabetes and certain infections may also contribute to heart weakening.
Identifying Symptoms and Diagnostic Methods
Individuals with systolic heart failure often experience symptoms that can progress over time. Shortness of breath (dyspnea) is a common indicator, especially during physical activity or when lying flat. Fatigue and weakness are also reported, as the body’s tissues do not receive enough oxygenated blood.
Fluid retention can lead to swelling (edema) in the legs, ankles, feet, and sometimes the abdomen. A persistent cough or wheezing, occasionally producing pink-tinged mucus, may occur due to fluid buildup in the lungs. Some individuals might experience a rapid or irregular heartbeat, dizziness, or difficulty concentrating.
Diagnosis typically begins with a physical examination and medical history review. Blood tests, such as B-type natriuretic peptide (BNP) levels, can indicate heart strain. An electrocardiogram (ECG or EKG) assesses the heart’s electrical activity, while a chest X-ray can reveal an enlarged heart or fluid in the lungs. An echocardiogram, using sound waves, creates heart images and precisely measures the ejection fraction, confirming reduced pumping function.
Management and Treatment Strategies
Management of systolic heart failure involves a multifaceted approach aimed at improving heart function, alleviating symptoms, and slowing disease progression. Lifestyle adjustments are a fundamental component of treatment. These include adopting a heart-healthy diet, often emphasizing reduced sodium intake, engaging in regular physical activity as guided by a healthcare provider, managing body weight, and stopping smoking.
Medications play a significant role in treating systolic heart failure. Various categories of drugs are prescribed to help the heart pump more effectively, reduce fluid buildup, lower blood pressure, and control heart rate. These drugs ease the heart’s workload and improve efficiency. For some, implantable devices may be considered, such as pacemakers to coordinate contractions or implantable cardioverter-defibrillators (ICDs) for dangerous irregularities.
In severe cases, surgical options like valve repair or replacement may be performed. A heart transplant can be considered for advanced heart failure. Ongoing management includes consistent follow-up appointments and strict adherence to the treatment plan.