Medical Encyclopaedia › Heart failure (short definition)
In brief: In heart failure, the heart can no longer pump enough blood through the body to meet its needs. It is one of the most common reasons for hospital admission in older people, but can be treated much better today than in the past.
Causes
The most common causes are coronary heart disease with or without a previous heart attack and long-standing high blood pressure. Other causes are heart valve defects, heart muscle diseases, heart rhythm disorders such as atrial fibrillation, myocarditis, alcohol and some cancer medicines.
Symptoms
Typical symptoms are shortness of breath on exertion and, at an advanced stage, also at rest or when lying down, rapid exhaustion, fluid retention in the ankles and legs, night-time urination and rapid weight gain due to retained fluid. Severity is often classified according to the NYHA classification.
Diagnosis
Cardiac ultrasound (echocardiography), ECG and the blood value NT-proBNP are important. Based on pumping capacity (ejection fraction), forms with reduced, mildly reduced and preserved pump function are distinguished, some of which are treated differently.
Treatment
In reduced pump function, four groups of medicines form the basis: ACE inhibitors, sartans or ARNI (sacubitril/valsartan), beta-blockers, mineralocorticoid receptor antagonists and SGLT2 inhibitors. Diuretics relieve fluid retention. Depending on the situation, an implantable defibrillator, cardiac resynchronisation therapy, valve procedures or, in severe cases, ventricular assist devices and transplantation may be considered. Regular, appropriately adapted exercise is recommended.
Self-monitoring and warning signs
Weighing yourself daily helps to notice fluid retention early: a gain of more than about one kilogram in a day or two kilograms in a few days should be discussed with a doctor. Sudden severe shortness of breath, chest pain or fainting is an emergency.
Related terms in the encyclopaedia
Heart, Echocardiography, NT-proBNP, ACE inhibitors, Beta-blockers, SGLT2 inhibitors, Diuretic, Cardiomyopathy, Pulmonary oedema
Sources
- Bundesärztekammer, KBV, AWMF: Nationale VersorgungsLeitlinie Chronische Herzinsuffizienz, leitlinien.de
- European Society of Cardiology (ESC): Leitlinie Herzinsuffizienz 2021 mit Aktualisierung 2023
- IQWiG: gesundheitsinformation.de – Gesundheitsinformationen des Instituts für Qualität und Wirtschaftlichkeit im Gesundheitswesen
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor or pharmacist. Last updated: October 2026.