The Subtle Signs Your Heart May Need Help

Heart failure sounds frightening, and many people assume it means the heart has stopped working. In reality, heart failure means the heart cannot pump blood effectively enough to meet the body’s needs.

It’s a common condition that affects millions of Americans, but with early recognition and proper treatment, many people can manage heart failure and continue to live active lives.

“When we talk about heart failure, what we’re really talking about is the heart not being able to either fill with blood properly or pump blood out effectively,” explains Sean P. Javaheri, DO.

Understanding the causes, symptoms, and treatment options can help people recognize problems early and take steps to protect their heart health.

What Causes Heart Failure?

Heart failure typically develops when the heart muscle becomes weakened or stiff, making it harder to pump blood efficiently.

• Heart failure with normal pumping function (diastolic heart failure). In this case, the heart muscle becomes stiff and cannot fill with enough blood between beats. This can cause blood to back up into the lungs, leading to shortness of breath.
• Heart failure with reduced pumping function. Here, the heart becomes enlarged and weakened, making it difficult to pump blood out to the rest of the body.

In both situations, fluid can build up in the lungs, which is why breathing problems are one of the most common symptoms.

“The two biggest risk factors we see for heart failure are high blood pressure and coronary artery disease,” says Dr. Javaheri.

Other factors, such as high cholesterol, diabetes, and a family history of heart disease, can also increase risk.

Recognizing the Symptoms

The most common symptom of heart failure is shortness of breath, also called dyspnea. This may occur during activity, while resting, or when lying flat at night. Some people notice they need to sleep propped up on multiple pillows to breathe comfortably.

Other warning signs may include:

• Getting tired more easily than usual
• Difficulty walking long distances
• Trouble climbing hills or stairs
• Reduced activity levels over time
• Waking up suddenly at night, feeling short of breath

Symptoms can develop gradually, sometimes so slowly that people don’t realize anything is wrong.

“Sometimes patients don’t notice the symptoms themselves — it’s often a family member who realizes they’re slowing down or becoming short of breath more easily,” Dr. Javaheri says. If these symptoms appear, it’s important to talk with a healthcare provider. Early evaluation can help identify heart problems before they become more serious.

The Stages of Heart Failure

Doctors often describe heart failure in stages based on risk and symptoms.

Stage D – Advanced heart failure

This stage involves severe symptoms that often require hospitalization and advanced therapies.

“The earlier we identify risk factors and start treatment, the better chance we have of preventing heart failure from progressing,” Dr. Javaheri says.

How Heart Failure Is Treated

Treatment for heart failure depends on the underlying cause. Doctors first focus on addressing conditions that may have damaged the heart.

For example:

• Controlling high blood pressure
• Treating coronary artery disease
• Improving cholesterol levels
• Using medications that strengthen heart function

In some cases, procedures may be needed. Patients with blocked arteries may benefit from a stent or bypass surgery to improve blood flow to the heart.

Doctors also closely monitor a measurement called ejection fraction, which indicates how well the heart pumps blood.

A normal heart pumps about 50–55% of the blood it fills with. If the number drops significantly, patients may face a higher risk of dangerous heart rhythm problems.

For some people with severely reduced heart function, a specialized implanted device called a defibrillator can monitor the heart and deliver a life-saving shock if a dangerous rhythm occurs.

How to Lower Your Risk

While some risk factors cannot be changed, many steps can help protect your heart.

Dr. Javaheri recommends focusing on overall heart health, including:

• Eating a low-sodium, low-fat diet
• Limiting sugar intake
• Exercising regularly
• Monitoring and controlling blood pressure
• Checking cholesterol levels
• Seeing your doctor regularly
• Knowing your family history of heart disease

Family history is particularly important. Heart failure can run in families, which is why doctors often review several generations of family health history when evaluating risk.

When to Talk to Your Doctor

Shortness of breath, fatigue or reduced activity levels shouldn’t simply be dismissed as part of getting older. These symptoms can sometimes signal heart failure or another heart condition.

Early evaluation can make a major difference. With today’s treatments, many people with heart failure can manage their condition successfully — especially when it’s caught early and treated promptly.

Sean P. Javaheri, MD, Lexington Health Heart and Vascular Center