What is Systolic Heart Failure?

Systolic heart failure is one of two main types of heart failure. It is a problem with how the left ventricle pumps blood to the rest of the body effectively or how it improperly fills with blood. Systolic heart failure can be caused by heart conditions or chronic diseases. The two types of systolic heart failure include:

Acute Systolic Heart Failure

Acute systolic heart failure occurs more suddenly and often is considered a medical emergency.

Chronic Systolic Heart Failure

Chronic systolic heart failure occurs over a period of time, typically caused by other heart conditions such as high blood pressure, a damaged heart, or coronary artery disease.

Baptist Health is known for advanced, superior care for patients with heart disease and the diagnosis, management and treatment of systolic heart failure. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Systolic Heart Failure Signs and Symptoms

Systolic heart failure symptoms may come on gradually or start suddenly. Systolic heart failure signs and symptoms of systolic heart failure may include:

• Chest pain
• Persistent cough  with blood-tinged or pink, foamy mucus
• Decreased alertness or difficulty concentrating
• Fatigue and/or weakness
• Lack of appetite and nausea
• Rapid or irregular heartbeat
• Reduced exercise tolerance
• Shortness of breath during exertion or which causes you to wake up (dyspnea)
• Sudden weight gain from fluid retention
• Swelling (edema) of the abdomen 
• Swelling (edema) in your legs, ankles, and feet

Causes of Systolic Heart Failure

Systolic heart failure causes can include:

• Alcohol abuse
• Drug abuse
• High blood pressure

Risk Factors

Outside of what causes systolic heart failure, there are several risk factors that could contribute, including:

• Arrhythmias: Abnormal heart rhythms – too fast, slow or irregular – can create extra work for the heart.
• Cardiomyopathy: An abnormality in the structure of the heart muscle.
• Chemotherapy: Certain chemotherapy drugs can damage the heart muscle.
• Chronic diseases: Certain conditions – like HIV, thyroid disease, diabetes, or a build-up of iron or protein can damage the heart and lead to failure.
• Congenital heart disease: Present from birth, malformations of the heart’s chambers or valves can lead to failure.
• Coronary artery disease: This condition occurs when the blood vessels that supply the heart muscle become narrow.
• Heart valve disease: This problem could be congenital or caused by coronary artery disease or infection. Narrow or leaky heart valves force the heart to work harder, which can eventually weaken it.
• Myocarditis: This inflammation can be caused by a viral infection.
• Sleep apnea: Untreated sleep apnea increases the heart’s workload.

Prevention

While some risk factors cannot be controlled, there are ways you can help to prevent some cases of systolic heart failure:

• Practice good heart health: Watch what you eat, exercise, stop smoking, avoid non-prescription drugs, limit alcohol use and maintain a healthy weight.
• Take your medications as prescribed: If you have high blood pressure, high cholesterol, diabetes or another chronic condition, be certain to take your prescribed medications as directed.
• Get regular check-ups: Discussing your symptoms as soon as they appear can lead to earlier diagnosis and treatment.

Systolic Heart Failure Diagnosis

Early diagnosis is critical to manage systolic heart failure. To determine if someone has systolic heart failure, we use advanced technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

• Blood Test: Blood tests gauge kidney, liver and thyroid function and look for indicators of other diseases that affect the heart. One specific test (NT-proBNP) helps show if heart failure is present.
• Chest X-ray: A common imaging test of the heart, this can show enlargement of the heart or fluid build-up in the lungs.
• Coronary angiography: This procedure is done with cardiac catheterization. During the procedure, dye that can be seen on an X-ray is injected into the heart chambers or coronary arteries. The dye lets a physician study blood flow through the heart and blood vessels to detect any blockages.
• Echocardiogram: An ultrasound exam that uses soundwaves to take moving pictures of the heart’s chambers and valves.
• Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.
• Stress Testing: This test is conducted during exercise. If a person can’t exercise, medicine is given to increase heart rate. Used along with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure. Exercise makes the heart work hard and beat fast while heart tests are administered.

In certain situations, other imaging tests like computerized tomography (CT), magnetic resonance imaging (MRI) or nuclear scanning may be used to look at the heart muscle or blood vessels.

Systolic Heart Failure Prognosis

Prognosis for systolic heart failure, and left-sided heart failure in general, varies depending on the cause of the condition, severity of symptoms and presence of co-existing medical problems. Some may improve with medication and lifestyle changes. For others, severe symptoms can be life-threatening and require an implanted device, surgical heart repair or a heart transplant.

Treatment and Recovery

For most people, systolic heart failure is a chronic condition. It is generally treatable with medications and life-style changes, but rarely goes away completely.

Medication

Depending on your symptoms and the cause of your systolic heart failure, you may be prescribed one or more medications, including:

• Aldosterone antagonists
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers
• Angiotensin receptor-neprilysin inhibitor
• Beta blockers
• Digoxin
• Diuretics
• F-channel blocker
• Inotropes

Surgery and Medical Devices

In some cases, surgery is needed to control systolic heart failure symptoms and prevent further damage. Procedures may include:

• Cardiac resynchronization therapy: Insertion of a specialized pacemaker to restore normal, coordinated pumping of the right and left sides of the heart.
• Coronary bypass surgery: In this procedure, blood vessels from the leg, arm or chest are used to bypass a blocked artery in your heart so blood can flow through the heart more freely.
• Heart pumps: Mechanical devices, such as ventricular assist devices (VADs), are implanted into the abdomen or chest and attached to a weakened heart to help it pump blood to the rest of the body.
• Heart transplant: Replacing a diseased heart with a healthy donor heart can improve survival and quality of life for those with severe systolic heart failure. However, candidates may need to wait a long time for a donor heart, must be treated with immunosuppressing drugs to prevent rejection and face risks associated with open-heart surgery.
• Heart valve repair or replacement: Surgeons can modify original valves to correct blood flow, repair valves by reconnecting valve leaflets or removing excess valve tissue, or tighten or replace rings around valves. Valve replacement is performed when valve repair isn’t possible, and the damaged valve is replaced by an artificial one. Certain types of heart valve repair or replacement can now be done without open heart surgery, using minimally invasive surgical or cardiac catheterization techniques.
• Implantable cardioverter-defibrillators: An ICD is a device similar to a pacemaker, surgically implanted under the skin in the chest with wires leading through the veins and into the heart. The ICD monitors heart rhythm and tries to pace the heart or shock it back into normal rhythm if a dangerous rhythm arises.

Complications

Systolic heart failure complications may include:

• Impaired kidney function: Decreased kidney function is common in patients with systolic heart failure. Kidney disease can also make heart failure worse. In severe cases, dialysis may be required.
• Liver damage: Fluid backing up from the heart puts pressure on the liver that can cause scarring, which makes it harder for the liver to function properly.