Types of Heart Failure

Systolic versus Diastolic  

Ejection Fraction or EF is the most common parameter for the assessment of the efficiency of the  heart. The normal EF is 55-65 percent.  

EF less than 40 percent is considered as low ejection fraction.  

EF more than 50 percent is considered as normal ejection fraction. 

Heart failure with low Ejection Fraction is also known as Systolic heart failure. In this condition the  heart muscle gets thinned, the heart chambers get enlarged leading to a reduction in the heart  pumping efficiency. In this condition the heart is thin and enlarged.  

On the contrary the heart function might be normal but still the heart failure can happen if the heart  muscle gets thick and there is a inability to expand because of stiff heart. So, a thick and stiff heart is  called heart failure with preserved Ejection Fraction. In this condition the heart gets thick and stiff. 

Both types of heart failure present with identical symptoms whether it results from either a  

• Thin, weak and enlarged heart (or) 
• Thick, stiff and small heart 

(add image of stiff and thick versus thin and weak heart) 

If both entities present with similar symptoms – Is it relevant to differentiate these two types of  heart failure? 

It is very important to differentiate because the treatments are completely different for both  conditions.  

Left versus Right heart failure (add image of right and left heart failure) 

If the efficiency of the left heart is reduced that is called left heart failure. This is commonly due to a  heart attack or abnormal heart rhythm or valvular diseases affecting the left side of the heart. In this  condition there is fluid logging in the lungs predominantly because the fluid accumulates within the  lungs. This causes breathlessness predominantly either on walking or even at rest.  

On the contrary if the right side of the heart is damaged because of lung problem or blood clots in  the lungs or commonly due to left heart problem there will be fluid logging in the other organs of the  body notably the legs, face and abdomen. Fluid accumulation in the liver causes pain in upper part of  the abdomen on the right side and loss of appetite. Patients also observe and complain about the  neck veins engorgement and abnormal pulsations.  

What is Congestive heart failure? 

Congestive heart failure is an older term to describe heart failure where there is a failure of both the  right as well as the left side of the heart. In this condition, there is fluid accumulation both in the  lungs and the other organs of the body leading to the term “congestion” in congestive heart failure. 

Types of heart failure-Acute Vs Chronic Heart failure 

Acute heart failure means person who was completely normal previously suddenly develops  symptoms of heart failure such as breathlessness or fluid logging in the other organs of the body.  This usually happens over a period of few hours to days or at the maximum a week to 10 days.  

On the contrary, chronic heart failure is a condition where the heart pumping efficiency is reduced gradually over weeks to months or may be years. Patients with chronic heart failure despite having a  low pumping efficiency might remain without symptoms.  

In acute heart failure because of the suddeness of the insult the symptoms are florid. In chronic  heart failure because it is a gradually developing process the symptoms are very subtle.