Introduction

Click the icon to see an image of the valves of the heart.

• The very mechanisms that the body uses to compensate for inefficient heart pumping can, over time, change the architecture of the heart (called remodeling) and finally lead to irreversible problems.

The specific effects of heart failure on the body depend on whether it occurs on the left or right side. Over time, however, in either form of heart failure, the organs in the body do not receive enough oxygen and nutrients, and the body's wastes are removed slowly. Eventually, vital systems break down.

Failure on the Left Side (Systolic Failure). Failure on the left side of the heart is the more common event. The failure can be a result of abnormal systolic (contraction) or diastolic (relaxation) action.

• This failure is often caused by a systolic abnormality (called systolic failure). In such cases, the heart muscles weaken and cannot keep up with the demands of the body. The left ventricle is usually dilated. Fluid backs up and accumulates in the lungs. Systolic heart failure typically occurs in men between the ages of 50 and 70 years who have had a heart attack.
• Between 20 - 50% of heart failure cases have abnormal diastolic actions, in which there is an abnormality in the way the heart relaxes. Most often in failure on the right side, the heart muscles thicken so that the muscles relax abnormally. In this case, fluid entering the heart backs up. This causes the veins in the body and tissues surrounding the heart to swell. It is often a precursor to systolic failure. Patients with diastolic failure are typically women, overweight, and elderly, and have high blood pressure and diabetes.

In both cases, with the weakened pump, fluid builds up in the lungs, and from there it builds up in tissues throughout the body, causing congestion.

Failure on the Right Side. Failure on the right side of the heart is most often a result of failure on the left. Because the right heart receives blood from the veins, failure here causes the blood to back up. As a result, the veins in the body and tissues surrounding the heart to swell. This causes swelling in the legs.