Understanding Heart Failure in the Elderly


When a person has heart failure, it means that their heart is unable to pump enough blood throughout their body. Heart failure develops over time and as the heart weakens, it either cannot fill with enough blood, pump with enough force or both. While this cardiovascular condition sounds scary, heart failure does not imply that the heart has stopped working or is about to stop working.

Types of Heart Failure

There are a few different types of heart failure and each has its own unique symptoms, depending on which areas of the organ are affected. In normal hearts, blood vessels called veins bring oxygen-poor blood from the body to the right side of the heart. It is then pumped through the pulmonary artery to the lungs, where it becomes re-oxygenated. From there, the blood returns to the left side of the heart and is pumped through a large artery called the aorta that distributes it throughout the body.

Heart failure is a chronic, progressive condition, meaning it is persistent and worsens over time. Cardiac conditions like heart attack and high blood pressure, as well as conditions like diabetes and kidney disease can cause cumulative damage to the heart. At first the organ finds ways to compensate, but over time these methods of keeping up with an increasing workload cause more damage to the heart muscle. The heart’s chambers may compensate by stretching to pump more strongly, which causes the walls to thin, or they may thicken as the muscles of the heart build up to provide more force.

Left-Sided Heart Failure

In most cases, heart failure affects the left side of the heart, causing a deficit in oxygen-rich blood sent to the rest of the body. The left ventricle is the largest chamber of the heart and provides most of the power for pumping blood around the cardiovascular system. Two things can happen to the left ventricle to cause it to pump less effectively. When the chamber walls stretch out and thin, they eventually lose their ability to contract and pump blood. This is called systolic heart failure. When the walls thicken, the chambers become inflexible and shrink, preventing the heart from filling with enough blood. This is called diastolic heart failure.

Right-Sided Heart Failure

When heart failure affects the right side, the heart cannot pump enough blood to the lungs, where it picks up oxygen. Weakness on the right side usually occurs as an effect of left-sided heart failure. When both pumping mechanisms of the heart are compromised, unoxygenated blood tends to back up throughout the body, causing swelling in the extremities and abdomen.

Congestive Heart Failure

While the terms heart failure and congestive heart failure (CHF) are often used interchangeably, there is a difference between these two conditions. When the heart is weakened significantly, blood and fluid can back up and collect not only in the feet, ankles and legs but also in the lungs. This excess fluid “congests” tissues and can put dangerous amounts of pressure on vital organs. This problematic fluid build-up is called edema. In addition to inhibiting proper blood flow, CHF can interfere with the kidneys’ ability to balance water and sodium in the body as well.

Who Is at Risk for Heart Failure?

Scientists estimate that 5.7 million people in the U.S. have heart failure and that number is growing. This condition contributes to approximately one in nine deaths each year. Heart failure is most common in men, African Americans, and those who are age 65 years and older. It is the number one reason older people are hospitalized.

Although heart failure tends to be more common in men than women, the condition affects more women in their 70s and 80s because women typically enjoy longer lifespans.

Symptoms of Heart Failure

The most common symptoms of heart failure include:

  • Shortness of breath or difficulty breathing
  • Chronic coughing and/or wheezing
  • Fatigue
  • Light-headedness
  • Swelling, especially of the feet, ankles and legs
  • Nausea
  • Loss of appetite
  • Elevated heart rate
  • Confusion or disorientation
  • Unexplained weight gain

If someone is experiencing more than one of these symptoms, it is crucial to make a doctor’s appointment for evaluation. Tracking symptoms is also important for helping those who have already been diagnosed with heart failure to manage their condition.

How to Prevent Heart Failure and Manage Symptoms

Heart failure is caused by other diseases or conditions that damage the heart muscle, such as coronary artery disease, heart attack, diabetes and high blood pressure. Taking steps to maintain a healthy cardiovascular system and prevent heart disease will significantly minimize the risk of developing heart failure.

Maintaining desirable cholesterol levels and blood pressure is crucial for heart health. Clogged arteries can contribute to high blood pressure, causing the heart to work harder and raising the risk of heart failure. Talk to a doctor about ways to reduce cholesterol levels and lower blood pressure.

Read: High Blood Pressure: Guidelines and Treatments for Seniors

Diabetes, obesity, smoking cigarettes and excess alcohol consumption all have negative impacts on heart health. Lifestyle changes such as eating a healthy diet and exercising regularly can be beneficial at any age. However, starting these healthy habits early on is vital because the damage caused by heart disease can be permanent. It is important to discuss diet and/or exercise changes with a physician before beginning a new regimen.

For more information on treatments for heart failure, how it progresses and tips on managing symptoms of this condition, read “Caring for a Loved One with Heart Failure.”

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My grandpa is 82 years old and has Dementia. He has a history of 1 heart attack and has a defibulator. He also has a history of blood clot in lung and since then has been on oxygen at home at night and when needed due to low oxygen, Today I have noticed he is short of breath, seems to be congested (1st thought nasal congestion) So I put some nasal strips on his nose to help open airway, gave him albuterol treatment, mucinex (incase chest congestion) and some Cold medicine. I checked vitals they were b/p 153/87, pulse 79 and pulse ox was 90% (normally 93-98%) and blood sugar was 138. I just went in laid him down for bed put his oxygen on him set at 2.5. I noticed with oxygen on he seems to still be breathing heavy and having trouble breathing. and his left ankle/foot is swelled with fluid. His right foot was pretty much normal. ............................I don't have car and not only have him but 3 kids. ages 3, 4 and 5. should I call a squad? or he also has a doctor that sees him in home Idk if he does night calls but was gonna give a shot because I cant drive him to hospital, I can call squad but I also don't have way to go with him I cant ride due to having 3 kids with me. and all our family lives hours away. what Im worried about s if his severe dementia will causes issues with doctor even knowing whats wrong n why he is there because in past he can never explain to doctors what he is experiencing its usually always based off what I see, n what he may tell me which he is telling me hes having trouble catching breathe what should I do?
quite well written ,particularly for lay people. as always drawings would be helpful.

My mother has CHF , my poor mom is soooo weak ,today we met a new Dr.who specializes in CHF ,he has such a wonderful way with his patients, and seems EXTREAMLY concerned...tomorrow we will make a appointment with a special CHF clinic .I did not even know about all this help that is out there,I am so glad they are takeing such great care of my mom.I believe there are many people who do not know how many different opportunities there is for a heart patient I'm amazed how did all of these specialties pass me up I feel so stupid that I did not even know about all this help that is out there ....maybe if I had of done more research and got my mother involved in this heart care program I could of stopped mom's heart from getting so bad or prolonged this BAD CHF episode...I guess we can't change the past....at least mom is getting the best care EVER! At this time.I guess I answered my own question ...I'm really sad and worried I think all I can do now is keep doing what we are and PRAY ,PRAY .THANK YOU FOR LETTING ME VENT .