Acute Heart Failure: Types, Symptoms & Treatments

Heart failure is a condition in which the heart is unable to pump enough blood to meet the body's needs to function optimally. This can be caused by various factors, including coronary artery disease, high blood pressure, heart disease, and diabetes. Heart failure can appear suddenly or may appear gradually over a long period of time.

Sudden heart failure, also known as acute heart failure, is a condition in which the heart’s ability to pump blood has diminished significantly in a relatively short time. Below is a closer look at what acute heart failure is, how it can present, and how heart failure patients can manage their symptoms.

What Is Acute Heart Failure?

Acute heart failure typically occurs after a cardiac event or other condition that causes cardiomyopathy or suddenly diminished heart function. The diminished function can lead to a reduced ejection fraction which means less blood being pumped with every beat.

Some common causes of acute heart failure include heart attacks or myocardial infarctions, fluid build-up in the body, and the worsening of chronic heart failure. Acute heart failure often requires hospitalization and can be managed through medications, lifestyle changes, and other treatments.

How Are Left-Sided and Right-Sided Heart Failure Different?

Your heart is divided into two separate pumping systems, the right side and the left side. The right side of the heart is responsible for receiving unoxygenated blood from the body and forcing it into the lungs to be reoxygenated. The left side of the heart is responsible for receiving oxygenated blood from the lungs and forcing it with enough pressure and force to reach the body's tissues.

Heart dysfunction and failure can affect either the left or right side of the heart. Left-sided heart failure occurs when the left ventricle, which is the main pumping chamber of the heart, is unable to pump enough blood to the body. This can lead to fluid build-up in the lungs and difficulty breathing.

Right-sided heart failure occurs when the right ventricle, which pumps blood to the lungs, cannot pump enough blood to the left side of the heart. This can lead to a build-up of fluid in the body and swelling in the legs and abdomen.

What Causes Acute Heart Failure?

While acute heart failure and the associated heart insufficiencies occur in a short time frame, the underlying causes can occur as a result of other health conditions. Several risk factors can contribute to the development of acute heart failure. Below is a closer look at these factors and how they can contribute to acute heart failure.

Heart Attacks From Heart Disease

Coronary artery disease falls under the umbrella of heart diseases, and describes an individual with poor cardiovascular health that has plaque building up in their arteries. Over time this plaque buildup can stiffen arteries and increase your likelihood of experiencing a heart attack.

A heart attack occurs when a clot in the coronary artery cuts off the blood supply to the heart muscle. The clot can form is a piece of plaque breaks off from the wall of the arteries. If the blockage of the blood supply to the heart goes on for too long, it can cause heart tissue to die, which can drastically reduce its efficiency in pumping blood.

Fluid Imbalance

A build-up of fluid in the body can also cause acute heart failure. Fluid buildup can be caused by a malfunction of organs like the kidneys, and if this imbalance becomes significant enough, it can cause a condition known as fluid overload.

In this scenario, there is too much fluid within the body and blood. More blood volume means that the heart must work harder, which places it under undue stress. This can quickly lead to acute heart failure if not addressed.

Acute Decompensated Heart Failure

Chronic heart failure is a long-term condition in which the heart cannot pump enough blood to meet the body's needs. A heart that is experiencing heart failure can typically compensate to a certain degree, but over time, the heart can become stiffer and may stop being able to compensate for its inefficiency.

When heart failure suddenly becomes much worse, it can turn into a type of acute heart failure known as acute decompensated heart failure (ADHF).

What Are the Symptoms of Acute Heart Failure?

The symptoms of acute and chronic heart failure are fairly similar, and the main difference is that the onset of symptoms in acute heart failure tends to be quicker than that of chronic heart failure and slightly more severe in nature.

Below is a closer look at some common symptoms of acute heart failure and how they may present themselves.

Shortness of Breath

One of the most common symptoms of acute heart failure is shortness of breath, which can occur even with mild activity. This is often caused by a build-up of fluid in the lungs, known as pulmonary edema, which makes it difficult to breathe and get enough blood oxygenated to support the body. In the case of acute heart failure, the difficulty in breathing may even extend to when no physical activity is being performed.

Coughing or Wheezing

When the heart begins to fail, the lungs can often feel the effects quickly, as it is directly connected to the heart via the pulmonary circuit. Inefficiencies in the heart can cause fluid to pool in the lungs, causing inflammation. This inflammation can then restrict airways and cause coughing and wheezing.


Acute heart failure can also cause fatigue due to the heart's inability to pump enough blood to the body. Without an optimal supply of oxygen and nutrients, it makes sense that the body is likely not feeling energized.

Sudden onset fatigue, alongside other symptoms of heart failure, can be suggestive of acute heart failure. Without good blood flow to the body, it will start to slow down, causing you to feel fatigued.

Irregular Heartbeat

Another symptom of acute heart failure is an irregular heartbeat, which can cause the heart to beat too fast or too slow. This can be caused by damage to the heart muscle or a build-up of fluid in the body.

These symptoms are typically the heart's way of compensating for an injury. A heart attack or myocardial infarction, for example, can damage a part of the heart muscle. In response, the heart will try and beat faster to help compensate for the reduced output due to heart damage.

What Does Treatment of Acute Heart Failure Entail?

Addressing heart failure can be complicated and tends to involve a multidisciplinary team of healthcare professionals to achieve the best results. The outlook for acute heart failure isn’t ideal, but several steps can be taken to mitigate the chances of developing acute heart failure.

Some of the things a physician of cardiology may be able to provide include:

  • The implantation of a ventricular assist device
  • The prescription of diuretics to avoid fluid retention
  • The prescription of beta-blocker hypertension medication, like β-adrenergic receptor blockers, or ACE inhibitors
  • Medications to help treat arrhythmias (abnormal heart rhythm or heart rate)
  • Chest X-rays to check for fluid in the lungs
  • Echocardiograms to examine heart health

These interventions can help in the short-term treatment of heart failure and are typically paired with complementary cardiac rehabilitation to help improve cardiovascular health to help slow the progression of heart failure.

What Is Cardiac Rehab?

Cardiac rehabilitation is a program designed to help people support heart health following a heart attack, heart surgery (like a heart valve procedure or heart transplant), or diagnosis of heart failure. It can help improve physical fitness, reduce the risk of future heart problems, and improve quality of life.

Cardiac rehab typically includes exercise, education, and counseling. The exercise component typically involves supervised workouts tailored to the individual's needs and fitness level.

The education component includes information on heart-healthy lifestyle changes, such as quitting smoking and eating a healthy diet. The counseling component can help individuals cope with the emotional aspects of heart disease and make positive lifestyle changes.

Traditionally cardiac rehab was only available at physical rehab clinics, but now, thanks to Carda Health, it is as easy as getting on your computer, signing up, and setting up a few health monitoring devices. Our easy process allows you to take full advantage of cardiac rehab virtually from the comfort of your home.

The Bottom Line

Acute heart failure is a serious and potentially life-threatening condition that requires immediate medical attention. It can be caused by heart attacks, fluid build-up in the body, or the worsening of chronic heart failure. The symptoms of acute heart failure can include shortness of breath, fatigue, irregular heartbeat, and coughing or wheezing.

Cardiac rehabilitation can be an important part of managing heart failure and avoiding acute cardiac failure, as it can help improve heart function, reduce the risk of future heart problems, and may improve your quality of life.


Types of Heart Failure | American Heart Association

Fluid Volume Overload and Congestion in Heart Failure | American Heart Association (AHA)

2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology | American Heart Association

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