What are the types of heart failure?

Heart failure may affect different patients very differently – the affected parts of the heart, the resulting symptoms and the time course of heart failure onset can vary widely. For this reason, different medical terms are used to exactly describe the different types of heart failure. It’s very important to define the type and cause of heart failure because it determines treatment. Exact diagnosis may be difficult since symptoms may be very similar, for example, all types of heart failure cause shortness of breath, fatigue and some degree of congestion, usually in the lungs but also in other parts of the body such as the liver, intestines, kidneys and lower limbs.

Acute heart failure develops suddenly and symptoms are initially severe. Acute heart failure may follow a heart attack, which has caused damage to an area of your heart. It may also be caused by a sudden lack of ability by the body to compensate for chronic heart failure. If you develop acute heart failure, it may be severe initially, but may only last for a short period of time and improve rapidly. It usually requires treatment and medication to be administered by injection (intravenously).

Chronic heart failure is very common. Symptoms appear slowly over time and gradually get worse.

If symptoms, such as shortness of breath, get worse within a very short period of time in a patient with chronic heart failure, we call this an episode of acute decompensation. These episodes often need to be treated in hospital and should therefore be avoided. Heartfailurematters.org can help you to avoid hospitalisations.

Please note that heart failure may be caused or worsened by irregular heart rhythm or a fast heartbeat because this impedes proper filling of the ventricles. It’s important to detect such trigger factors in order to treat them and to avoid them in the future.

Left-sided heart failure means that the power of the left heart chamber, which pumps blood throughout the body, is reduced; thus, the left chamber must work harder to pump the same amount of blood.

There are two types of left-sided heart failure:

  • Systolic failure: The left chamber lacks the force to push enough blood into circulation.
  • Diastolic failure: The left chamber fails to relax normally because the muscle has become stiffer and filling is impaired.

The term ejection fraction is used to describe the chambers’ strength and ability to empty with each beat. It can be measured in many ways but usually with echocardiography. If the pumping ability of the main pumping chamber is reduced, it’s often referred to as HFrEF or Heart Failure with reduced Ejection Fraction. If the primary problem is abnormal relaxation during diastole, which impairs filling, the term HFpEF, or Heart Failure with preserved Ejection Fraction is often used. There is often overlap between these conditions with both reduced emptying and filling.

In right-sided heart failure, the right pumping chamber or ventricle, which pumps blood to the lungs, is compromised. This may be due to muscle injury, such as a heart attack localised to the right ventricle, damage to the valves in the right side of the heart or elevated pressure in the lungs.

However, heart failure commonly affects both sides of the heart and is then called biventricular heart failure.

Overview

Cardiomyopathy (kahr-dee-o-my-OP-uh-thee) is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body. Cardiomyopathy can lead to heart failure.

The main types of cardiomyopathy include dilated, hypertrophic and restrictive cardiomyopathy. Treatment — which might include medications, surgically implanted devices, heart surgery or, in severe cases, a heart transplant — depends on the type of cardiomyopathy and how serious it is.

Types

  1. Dilated cardiomyopathy
  2. Hypertrophic cardiomyopathy

Symptoms

There might be no signs or symptoms in the early stages of cardiomyopathy. But as the condition advances, signs and symptoms usually appear, including:

  • Breathlessness with activity or even at rest
  • Swelling of the legs, ankles and feet
  • Bloating of the abdomen due to fluid buildup
  • Cough while lying down
  • Difficulty lying flat to sleep
  • Fatigue
  • Heartbeats that feel rapid, pounding or fluttering
  • Chest discomfort or pressure
  • Dizziness, lightheadedness and fainting

Signs and symptoms tend to get worse unless treated. In some people, the condition worsens quickly; in others, it might not worsen for a long time.

When to see a doctor

See your health care provider if you have one or more signs or symptoms associated with cardiomyopathy. Call 911 or your local emergency number if you have severe difficulty breathing, fainting or chest pain that lasts for more than a few minutes.

Some types of cardiomyopathy can be passed down through families (inherited). If you have the condition, your health care provider might recommend that your family members be checked.

Sign up for free, and receive heart transplant and heart failure content, plus expertise on heart health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

Often the cause of the cardiomyopathy is unknown. In some people, however, it's the result of another condition (acquired) or passed on from a parent (inherited).

Certain health conditions or behaviors that can lead to acquired cardiomyopathy include:

  • Long-term high blood pressure
  • Heart tissue damage from a heart attack
  • Long-term rapid heart rate
  • Heart valve problems
  • COVID-19 infection
  • Certain infections, especially those that cause inflammation of the heart
  • Metabolic disorders, such as obesity, thyroid disease or diabetes
  • Lack of essential vitamins or minerals in the diet, such as thiamin (vitamin B-1)
  • Pregnancy complications
  • Iron buildup in the heart muscle (hemochromatosis)
  • The growth of tiny lumps of inflammatory cells (granulomas) in any part of the body, including the heart and lungs (sarcoidosis)
  • The buildup of abnormal proteins in the organs (amyloidosis)
  • Connective tissue disorders
  • Drinking too much alcohol over many years
  • Use of cocaine, amphetamines or anabolic steroids
  • Use of some chemotherapy drugs and radiation to treat cancer

Types of cardiomyopathy include:

  • Dilated cardiomyopathy. In this type of cardiomyopathy, the heart's main pumping chamber — the left ventricle — becomes enlarged (dilated) and can't effectively pump blood out of the heart.

    Although this type can affect people of all ages, it occurs most often in middle-aged people and is more likely to affect men. The most common cause is coronary artery disease or heart attack. However, it can also be caused by genetic changes.

  • Hypertrophic cardiomyopathy. This type involves abnormal thickening of the heart muscle, which makes it harder for the heart to work. It mostly affects the muscle of the heart's main pumping chamber (left ventricle).

    Hypertrophic cardiomyopathy can develop at any age, but the condition tends to be more severe if it occurs during childhood. Most people with this type of cardiomyopathy have a family history of the disease. Some genetic changes have been linked to hypertrophic cardiomyopathy.

  • Restrictive cardiomyopathy. In this type, the heart muscle becomes stiff and less flexible, so it can't expand and fill with blood between heartbeats. This least common type of cardiomyopathy can occur at any age, but it most often affects older people.

    Restrictive cardiomyopathy can occur for no known reason (idiopathic), or it can by caused by a disease elsewhere in the body that affects the heart, such as amyloidosis.

  • Arrhythmogenic right ventricular dysplasia. In this rare type of cardiomyopathy, the muscle in the lower right heart chamber (right ventricle) is replaced by scar tissue, which can lead to heart rhythm problems. It's often caused by genetic changes.
  • Unclassified cardiomyopathy. Other types of cardiomyopathy fall into this category.

Risk factors

There are a number of things that can increase your risk of cardiomyopathy, including:

  • Family history of cardiomyopathy, heart failure and sudden cardiac arrest
  • Long-term high blood pressure
  • Conditions that affect the heart, including a past heart attack, coronary artery disease or an infection in the heart (ischemic cardiomyopathy)
  • Obesity, which makes the heart work harder
  • Long-term alcohol misuse
  • Illicit drug use, such as cocaine, amphetamines and anabolic steroids
  • Treatment with certain chemotherapy drugs and radiation for cancer

Many diseases also raise your risk of cardiomyopathy, including:

  • Diabetes
  • Thyroid disease
  • Storage of excess iron in the body (hemochromatosis)
  • Amyloidosis
  • Sarcoidosis
  • Connective tissue disorders

Complications

Cardiomyopathy can lead to serious complications, including:

  • Heart failure. The heart can't pump enough blood to meet the body's needs. Untreated, heart failure can be life-threatening.
  • Blood clots. Because the heart can't pump effectively, blood clots might form in the heart. If clots enter the bloodstream, they can block the blood flow to other organs, including the heart and brain.
  • Heart valve problems. Because cardiomyopathy causes the heart to enlarge, the heart valves might not close properly. This can cause blood to flow backward in the valve.
  • Cardiac arrest and sudden death. Cardiomyopathy can trigger irregular heart rhythms that cause fainting or, in some cases, sudden death if the heart stops beating effectively.

Prevention

In many cases, there's no prevention for cardiomyopathy. Let your health care provider know if you have a family history of the condition.

You can help reduce your risk of cardiomyopathy and other types of heart disease by living a heart-healthy lifestyle, including:

  • Avoiding the use of alcohol or cocaine
  • Controlling high blood pressure, high cholesterol and diabetes
  • Eating a healthy diet
  • Getting regular exercise
  • Getting enough sleep
  • Reducing your stress

The Mayo Clinic experience and patient stories

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients.

  1. What are the types of heart failure?

    Celebrating 10-years with a new heart - just like her big sister

    Linsey Rippy was 16 weeks pregnant with her second child when she learned her daughter, Madi, had dilated cardiomyopathy. She was just two-and-a-half years old. “Our hospital in the Twin Cities ran every genetic test on Madi, but nothing came up,” Linsey said. “She’d had a virus a few weeks before, so they figured that’s what caused her to develop the condition.” Doctors also figured that meant there was little risk of the baby Linsey…

  2. What are the types of heart failure?

    Joelle's journey to a new heart

    Cardiomyopathy is a medical term for a number of genetic and nongenetic diseases involving the heart muscle that adversely affect the heart's mechanical pumping function and its electrical system. It can occur in people of all ages, races or genders, and it is a frequent cause of sudden cardiac arrest and sudden cardiac death. For [...]

What are the 4 types of heart failure?

What are the different types of heart failure?.
Left-sided heart failure. Left-sided heart failure is the most common type of heart failure. ... .
Right-sided heart failure. The right heart ventricle is responsible for pumping blood to your lungs to collect oxygen. ... .
Diastolic heart failure. ... .
Systolic heart failure..

Is there different types of heart failure?

Types of Heart Failure Systolic heart failure happens when your heart muscle doesn't squeeze with enough force. When that's the case, it pumps less oxygen-rich blood through your body. With diastolic heart failure, your heart squeezes normally, but the ventricle -- the main pumping chamber -- doesn't relax properly.

What are the 2 types of congestive heart failure?

Systolic CHF - Systolic CHF occurs when the left ventricle is unable to contract with enough force to circulate blood properly. Diastolic CHF - Diastolic CHF occurs when the heart muscle becomes stiff.

How many different heart failures are there?

There are four heart failure stages (Stage A, B, C and D). The stages range from "high risk of developing heart failure" to "advanced heart failure."