Heart failure is usually a chronic disease. That means it’s a long-term condition that tends to become worse gradually. By the time someone is diagnosed, chances are that the heart has been losing pumping capacity little by little for quite a while. At first the heart tries to make up for this by:
- Enlarging. When the heart chamber enlarges, it stretches more and can contract more strongly, so it pumps more blood.
- Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This allows the heart to pump more forcefully, at least initially.
- Pumping faster. This helps to increase the heart’s output.
The body also tries to compensate in other ways. The blood vessels narrow to keep blood pressure up, trying to make up for the heart’s loss of power. The body diverts blood away from less important tissues and organs to maintain flow to the most vital organs, the heart and brain. These temporary measures mask the problem of heart failure, but they don’t solve it. This helps explain why some people may not become aware of their condition until years after their heart begins its decline. (It’s also a good reason to have regular checkups with your doctor.) Eventually the heart and body just can’t keep up and the person experiences the fatigue, breathing problems, or other symptoms that usually prompt a trip to the doctor.
Victoria’s comment: My cardiologist told me years before I was first diagnosed that I would develop heart failure if I didn’t control my weight and blood pressure. I had high blood pressure for 22 years before I first noticed that I was getting short of breath.