Heart Failure

Basic Facts

Heart failure is often caused by certain heart and blood circulation problems that are more common with age. It can be caused by more than one condition.

Types of Heart Failure

There are two main types of heart failure. The types depend upon how much force the heart has when it pumps blood from the left ventricle (a chamber in the heart) to the rest of the body. This force is called the ejection fraction.

Heart failure can involve the right or left side of the heart or may sometimes involve both sides.

  1. Heart failure with reduced ejection fraction [HFrEF) happens when the heart pumps with less effort due to weakness of the wall. Ejection fraction of left ventricle (lower chamber) is less than 40 percent in this condition.
  2. Heart failure with preserved ejection fraction [HFpEF] happens when the heart walls get stiff and are unable to relax enough to accommodate extra volume of blood. Often the  left ventricle’s ejection fracture is normal at  50 percent or higher in this condition.

How Common is Heart Failure

Heart failure affects more than 6 million Americans, with more than one million new cases each year. Approximately 14 percent of men and 13 percent of women over 80 years old have heart failure.

Among older adults with heart failure, 60 percent have at least 5 other long-term health conditions. More than half have disability.

Heart failure is the leading cause of a hospital stay for people at age 65 and over. About 20 percent of those who go to the hospital for heart failure have to go back again within 30 days of leaving the hospital due to not feeling better or feeling worse. Up to 50 percent go again within 6 months for same problem.

End of Life Considerations

Healthcare professionals should begin discussions about symptom relief and end-of-life care early in the treatment of people with heart failure, to understand what matters most to individuals with this condition and be able to honor their wishes and preferences in life. Discussions should occur regularly as the person’s condition changes.


Last Updated February 2023

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