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Acute Heart Failure: Everything You Need to Know

Acute Heart Failure: Everything You Need to Know

What is Acute Heart Failure?

Acute Heart Failure (AHF) is a dangerous condition where the heart is unable to adequately pump blood throughout the body. It is a condition that predominantly affects male patients 70 years old and above. These patients typically present with pre-existing cardiac conditions, such as ischemic heart disease or congestive heart failure. A majority of these patients will have a history of a previous heart failure.

The development of acute heart failure is usually a worsening of their pre-existing condition rather than a sudden onset of acute heart failure with no prior heart disease or risk factors.

It should be noted that AHF is not limited to patients with pre-existing heart conditions. There are also cases where patients may develop sudden signs and symptoms of heart failure as well.

What’s the Difference Between Acute and Chronic Heart Failure?

Acute heart failure is a clinical syndrome that comes about due to the failure of the heart to pump blood throughout a person’s body. The term “acute” refers to the rapid development of new symptoms or worsening of pre-existing symptoms of heart failure.

Patients who develop heart failure aren’t usually able to return to their previous baseline heart condition. This is because the damage that is done to the heart is usually permanent.

Heart failure is considered “chronic” if a patient has been suffering from heart failure for an extended period of time. Additionally, if the patient is treated and their condition does not deteriorate for at least a month, they are considered “stable.”

Heart failure is considered acute if the onset of symptoms occur suddenly. For instance, this occurs in the case of acute myocardial infarction (AMI), where the coronary arteries which supply blood to the heart are affected, causing ischemic injury to the heart.

What Causes Heart Failure?

Heart failure is caused by a disease or condition that damages the heart. The most common causes of heart failure include: high blood pressure, coronary artery / heart disease, cardiomyopathy, and heart valve disease.

This condition comes about when there are structural and/ or functional abnormalities within the heart, causing:

  • A decrease in the amount of blood the heart is able to pump out per beat. This causes symptoms such as lower limb swelling, difficulty breathing, and tiredness.
  • Places stress on the heart as it tries to compensate (increased cardiac pressures). As the heart continues to compensate, the cells of the heart may experience ischemic injury, causing chest pain.

What are Signs and Symptoms of Acute Heart Failures

With acute heart failure, the amount of blood pumped by the heart (i.e. the cardiac output) decreases. AHF typically presents with the following signs and symptoms:
  • Chest pain or discomfort that may radiate to one or both arms, the neck, jaw, back, and stomach. This pain can be described as pressure, tightness, or fullness.
  • Dyspnea (shortness of breath/ difficulty breathing)
  • Easily tired
  • Dizziness or lightheadedness
  • Nausea
  • Diaphoresis (sweating)

When Should You Seek Help?

Patients should seek medical attention upon experiencing the symptoms mentioned above, especially chest pain and difficulty breathing.

Patients should also seek medical attention if they experience any of the more subtler signs:

  • An unexplained change in weight by at least 4 pounds
  • Increased lower limb swelling
  • Worsening of dyspnea
  • Respiratory infections that worsen in severity
  • A worsening cough, especially at night
  • Changes in sleeping pattern (difficulty sleeping)
  • A decrease in the amount of urine produced
  • Dark color of the urine
  • Easy fatigability
  • Unusually tired/sleepy
  • Restlessness or confusion
  • Nausea and vomiting
  • Poor appetite
  • Chest pain or discomfort during activities, but relieved at rest
  • A heart rate greater than or equal to 120 beats per minute while at rest

Certain symptoms can be more foretelling of the severity of a patient’s condition. If a patient experiences any of the symptoms listed below, they should seek emergency medical care as soon as possible:

  • Severe burning chest pain that is accompanied by dyspnea, sweating, weakness, and/ or nausea. This chest pain may be described as burning, lasts longer than 15 minutes and is not relieved by resting or taking nitroglycerin.
  • Tachycardia or fast heart beat (at around 120-150 bpm) even while at rest.
  • Difficulty breathing that doesn’t go away after resting
  • Inability to move arms and/ or legs, or weakness
  • A headache that is severe and occurs suddenly
  • An alteration in your level of consciousness

Key Takeaway

Acute Heart Failure is a serious condition that typically presents as sudden chest pain or difficulty breathing associated with easy fatigability, nausea, and sweating. It is caused by deteriorating heart function due to ischemic injury, structural abnormality, or dysfunction of the heart.

Learn more about Heart Failure here.


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Heart Failure: When to Call your Doctor or Nurse About Symptoms, https://my.clevelandclinic.org/health/treatments/17640-heart-failure-when-to-call-your-doctor-or-nurse-about-symptoms

Accessed on March 27, 2021

Acute Coronary Syndrome, https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/acute-coronary-syndrome

Accessed on March 27, 2021

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, https://pubmed.ncbi.nlm.nih.gov/27206819/

Accessed on March 27, 2021

Acute Heart Failure: Definition, Classification, and Epidemiology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597697/

Accessed on March 27, 2021

Types of Heart Failure, https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/types-of-heart-failure

Accessed on March 27, 2021

Acute Heart Failure: Epidemiology, Classification and Pathophysiology, https://www.escardio.org/static-file/Escardio/Subspecialty/ACCA/Documents/Acute%20CVDays/Textbook%20pdf/IACC-Textbook-Acute%20heart%20failure-Epidemiology.pdf

Accessed on March 27, 2021

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Written by Gerard Tamayo Updated Jul 01
Medically reviewed by Mike-Kenneth Go Doratan, M.D.