Table of ContentsView AllTable of ContentsDefinitionSymptomsCausesDiagnosisTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Definition
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Coping
Systolicheart failure, also known as heart failure with reduced ejection fraction (HFrEF), is a type ofheart failurein which the main chamber of theheartdoes not pump as effectively as it should. This can lead to symptoms such asfatigue, leg swelling, and shortness of breath.This article discusses systolic heart failure and its symptoms, causes, and treatment.SDI Productions / Getty ImagesUnderstanding Systolic Heart FailureThe heart acts as a pump to supply oxygen and nutrients throughout the body. The leftventricleis the main chamber of the heart that pumps blood to the body. Normally, the left ventricle pumps more than half of the blood it receives in each heartbeat.Ejection FractionThe ejection fraction (EF) is a measure of the left ventricle’s pumping efficiency and is the proportion of blood pumped out of the heart. An ejection fraction of 55%–60% or higher is normal, and means that 55%–60% of the blood in the left ventricle is pumped out with each heartbeat.Although an ejection fraction below 55% is abnormal, an ejection fraction ≤40% is considered heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure.A low EF can cause reduced cardiac output. Cardiac output is the amount of blood the heart is able to pump out each minute.Our organs require a certain amount of cardiac output in order to function, and a low cardiac output has negative effects on organs such as thekidneysandbrain.Systolic Heart Failure SymptomsSymptoms of systolic heart failureare a result of low cardiac output, as well as the backup of blood in thelungsand body. They include:Shortness of breathExercise intoleranceFatigueInability to lay flat due to difficulty breathingWaking up at night with spells of breathlessnessRapid heartbeat (palpitations)Decreased appetite andnauseaLeg and ankle swellingAbdominal fullness (bloating)What Causes Systolic Heart Failure?Systolic heart failure has many causes, including:Coronary artery diseaseHigh blood pressureAlcohol or cocaine useChemotherapyorradiation therapyGenetic inheritanceInfectionsHeart valve disorders, likemitral regurgitationArrhythmias(heart rate or rhythm problem)Metabolic issues, such as thyroid disordersNutritional deficiency, such asthiamine(Vitamin B1) deficiencyStresscardiomyopathy, also known asTakotsubo(heart muscle becomes suddenly weakened)Peripartum cardiomyopathy(heart muscle weakness that starts around the final month of pregnancy through several months after delivery)Sometimes, the cause of heart failure is not known. This is consideredidiopathic.Diagnosing Systolic Heart FailureSystolic heart failure is diagnosed with a noninvasive test calledtransthoracic echocardiography. This test involves an ultrasound that can generate pictures of the heart and evaluate the heart’s pumping function (EF), as well as the valves and flow of blood.Other tests to help determine the cause and complications of heart failure include:Blood tests, including blood counts,electrolytes, and kidney, liver, and thyroid functionElectrocardiogram(records electrical signals in your heart)Stress testing such as anuclear stress testCardiac MRI(magnetic resonance imaging of the heart)Coronaryangiography(X-ray imaging of blood vessels in the heart)TreatmentManaging systolic heart failure requires lifestyle changes and medications. Sometimes implantable devices can help.Lifestyle ChangesIn addition to medications, people with systolic heart failure should follow a low-salt diet and monitor their fluid intake. Weighing yourself daily can help you keep track of fluid overload.Those with systolic heart failure should avoid excessive alcohol intake and stay away from other substances.10 Self-Care Tips for Heart FailureMedicationsSystolic heart failure is a well-studied condition, and several medications have been shown to improve prognosis in people with this condition. Sometimes, the weakened heart muscle can even improve with medication.The following are medications commonly used to treat systolic heart failure:Diureticslike Lasix (furosemide) or torsemideBeta-blockers, specifically Toprol XL (metoprolol succinate), Coreg (carvedilol), and bisoprololAce-inhibitorsorangiotensinreceptor blockers (ARBs)Neprolysin inhibitors, like in the combination pill Entresto (sacubitril and valsartan)Aldosterone antagonistlike Aldactone (spironolactone)Vasodilatorslike Bidil (isosorbide dinitrate and hydralazine)Sodium-glucose co-transporter-2 (SGLT2) inhibitors like Farxiga (dapagliflozin) and Jardiance (empagliflozin)Procoralan (ivabradine)Note that treatment is individualized and some medications may not be tolerated in certain people.Implantable Device TherapyAnimplantable cardioverter defibrillator(ICD) is recommended for some people with low EF.An ICD is a small device placed under the skin in the chest, with wires that sit in the heart’s chambers. ICDs monitor the heart’s rhythm and deliver a “shock” of electricity to stop life-threatening arrhythmias.Some people who have abnormal electrocardiogram and systolic heart failure can benefit fromcardiac resynchronization therapy(CRT). CRT is a special type of ICD with an additional lead that helps it optimize the timing of the heart’s contraction. CRT can help improve symptoms, and some people even see an improvement in their EF with this therapy.Prognosis of Systolic Heart FailureIn general, a diagnosis of heart failure is serious, since it can cause life-threatening arrhythmias and organ failure.Taking medications as prescribed, monitoring fluid status, and close follow-up with a healthcare provider can help people with heart failure stay out of the hospital and improve quality of life.Advanced treatments and heart transplant are also options for those with very severe heart failure.Coping With Heart FailureDealing with heart failure symptoms can be difficult, particularly when it impacts daily life. Exercise ability may be significantly limited, with some people having shortness of breath with minimal activity or even while at rest. In addition, leg swelling can become painful, and it can be hard to find shoes that fit.Staying organized is very important. Consider investing in a pill sorter to keep track of all of the medications you are prescribed. Each morning, write down your weight, blood pressure, and any symptoms on a calendar and bring this to your healthcare provider visits.For some, cutting back on salt can be a big help. Using other spices can help keep flavor in meals without the added salt.As with any chronic condition, support from loved ones can help you cope. Many hospitals also offer support groups for people with heart failure.SummarySystolic heart failure is a serious condition in which the heart’s main chamber is not pumping as effectively as it should. This causes symptoms of shortness of breath, fatigue, and leg swelling, and increases the risk of arrhythmias and organ failure. Several medications and devices can improve survival of people with systolic heart failure.A Word From VerywellA diagnosis of systolic heart failure is life-changing. It requires monitoring of your diet and remembering to take a handful of medications. Managing the symptoms of heart failure and side effects of medications can be overwhelming. Support from loved ones and healthcare providers can help you cope and live with the condition.
Systolicheart failure, also known as heart failure with reduced ejection fraction (HFrEF), is a type ofheart failurein which the main chamber of theheartdoes not pump as effectively as it should. This can lead to symptoms such asfatigue, leg swelling, and shortness of breath.
This article discusses systolic heart failure and its symptoms, causes, and treatment.
SDI Productions / Getty Images
Understanding Systolic Heart Failure
The heart acts as a pump to supply oxygen and nutrients throughout the body. The leftventricleis the main chamber of the heart that pumps blood to the body. Normally, the left ventricle pumps more than half of the blood it receives in each heartbeat.
Ejection FractionThe ejection fraction (EF) is a measure of the left ventricle’s pumping efficiency and is the proportion of blood pumped out of the heart. An ejection fraction of 55%–60% or higher is normal, and means that 55%–60% of the blood in the left ventricle is pumped out with each heartbeat.Although an ejection fraction below 55% is abnormal, an ejection fraction ≤40% is considered heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure.
Ejection Fraction
The ejection fraction (EF) is a measure of the left ventricle’s pumping efficiency and is the proportion of blood pumped out of the heart. An ejection fraction of 55%–60% or higher is normal, and means that 55%–60% of the blood in the left ventricle is pumped out with each heartbeat.Although an ejection fraction below 55% is abnormal, an ejection fraction ≤40% is considered heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure.
The ejection fraction (EF) is a measure of the left ventricle’s pumping efficiency and is the proportion of blood pumped out of the heart. An ejection fraction of 55%–60% or higher is normal, and means that 55%–60% of the blood in the left ventricle is pumped out with each heartbeat.
Although an ejection fraction below 55% is abnormal, an ejection fraction ≤40% is considered heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure.
A low EF can cause reduced cardiac output. Cardiac output is the amount of blood the heart is able to pump out each minute.
Our organs require a certain amount of cardiac output in order to function, and a low cardiac output has negative effects on organs such as thekidneysandbrain.
Systolic Heart Failure Symptoms
Symptoms of systolic heart failureare a result of low cardiac output, as well as the backup of blood in thelungsand body. They include:
What Causes Systolic Heart Failure?
Systolic heart failure has many causes, including:
Sometimes, the cause of heart failure is not known. This is consideredidiopathic.
Diagnosing Systolic Heart Failure
Systolic heart failure is diagnosed with a noninvasive test calledtransthoracic echocardiography. This test involves an ultrasound that can generate pictures of the heart and evaluate the heart’s pumping function (EF), as well as the valves and flow of blood.
Other tests to help determine the cause and complications of heart failure include:
Managing systolic heart failure requires lifestyle changes and medications. Sometimes implantable devices can help.
Lifestyle Changes
In addition to medications, people with systolic heart failure should follow a low-salt diet and monitor their fluid intake. Weighing yourself daily can help you keep track of fluid overload.
Those with systolic heart failure should avoid excessive alcohol intake and stay away from other substances.
10 Self-Care Tips for Heart Failure
Medications
Systolic heart failure is a well-studied condition, and several medications have been shown to improve prognosis in people with this condition. Sometimes, the weakened heart muscle can even improve with medication.
The following are medications commonly used to treat systolic heart failure:
Note that treatment is individualized and some medications may not be tolerated in certain people.
Implantable Device Therapy
Animplantable cardioverter defibrillator(ICD) is recommended for some people with low EF.An ICD is a small device placed under the skin in the chest, with wires that sit in the heart’s chambers. ICDs monitor the heart’s rhythm and deliver a “shock” of electricity to stop life-threatening arrhythmias.
Some people who have abnormal electrocardiogram and systolic heart failure can benefit fromcardiac resynchronization therapy(CRT). CRT is a special type of ICD with an additional lead that helps it optimize the timing of the heart’s contraction. CRT can help improve symptoms, and some people even see an improvement in their EF with this therapy.
Prognosis of Systolic Heart Failure
In general, a diagnosis of heart failure is serious, since it can cause life-threatening arrhythmias and organ failure.
Taking medications as prescribed, monitoring fluid status, and close follow-up with a healthcare provider can help people with heart failure stay out of the hospital and improve quality of life.
Advanced treatments and heart transplant are also options for those with very severe heart failure.
Coping With Heart Failure
Dealing with heart failure symptoms can be difficult, particularly when it impacts daily life. Exercise ability may be significantly limited, with some people having shortness of breath with minimal activity or even while at rest. In addition, leg swelling can become painful, and it can be hard to find shoes that fit.
Staying organized is very important. Consider investing in a pill sorter to keep track of all of the medications you are prescribed. Each morning, write down your weight, blood pressure, and any symptoms on a calendar and bring this to your healthcare provider visits.
For some, cutting back on salt can be a big help. Using other spices can help keep flavor in meals without the added salt.
As with any chronic condition, support from loved ones can help you cope. Many hospitals also offer support groups for people with heart failure.
Summary
Systolic heart failure is a serious condition in which the heart’s main chamber is not pumping as effectively as it should. This causes symptoms of shortness of breath, fatigue, and leg swelling, and increases the risk of arrhythmias and organ failure. Several medications and devices can improve survival of people with systolic heart failure.
A Word From Verywell
A diagnosis of systolic heart failure is life-changing. It requires monitoring of your diet and remembering to take a handful of medications. Managing the symptoms of heart failure and side effects of medications can be overwhelming. Support from loved ones and healthcare providers can help you cope and live with the condition.
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSAGuideline for the Management of Heart Failure: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical PracticeGuidelines. J Am Coll Cardiol. 2022;79(17):e263-e421.doi:10.1016/j.jacc.2021.12.012Cleveland Clinic.Heart failure.American Heart Association.Implantable cardioverter defibrillator.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSAGuideline for the Management of Heart Failure: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical PracticeGuidelines. J Am Coll Cardiol. 2022;79(17):e263-e421.doi:10.1016/j.jacc.2021.12.012Cleveland Clinic.Heart failure.American Heart Association.Implantable cardioverter defibrillator.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSAGuideline for the Management of Heart Failure: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical PracticeGuidelines. J Am Coll Cardiol. 2022;79(17):e263-e421.doi:10.1016/j.jacc.2021.12.012Cleveland Clinic.Heart failure.American Heart Association.Implantable cardioverter defibrillator.
Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSAGuideline for the Management of Heart Failure: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical PracticeGuidelines. J Am Coll Cardiol. 2022;79(17):e263-e421.doi:10.1016/j.jacc.2021.12.012
Cleveland Clinic.Heart failure.
American Heart Association.Implantable cardioverter defibrillator.
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