Health Conditions / Cardiovascular Health / Hypertension

It’s important to protect our hearts, and we’re not talking in the metaphorical sense. The heart is the lifeblood of the body—the reason why your brain gets oxygen to think, your hands are warm enough to hold, and you get to live another day. Yet heart disease is the leading cause of death in the United States, and two major conditions that fall under that umbrella—heart attack and heart failure—are no joke. But if both conditions are a form of heart disease, what makes them so different? Let’s start with the basics: A heart attack happens when a sudden blockage occurs in one of the arteries of the heart. This prevents oxygenated blood from flowing and eventually causes tissue to die, April Stempien-Otero, MD, a cardiologist and associate professor of medicine at UW Medicine Heart Institute, tells SELF. Heart failure, on the other hand, develops when the heart doesn’t pump enough blood for the body’s needs, which can cause fluid to back up into the lungs and other areas of the body, per the National Heart, Lung, and Blood Institute (NHLBI).Here’s what you should know about heart attack vs. heart failure, including the symptoms, causes, treatments, and what you can do to lower your risk so that your heart will go on.Heart attack symptoms vs. heart failure symptomsThe most common heart attack symptoms are pretty different from typical heart failure symptoms. When it comes to a heart attack, you’ve probably got an image in your head of a person clutching their chest before they stumble over. While chest pain—especially chest pressure, tightness, aching, or a squeezing sensation that radiates through the left arm or into the jaw—is a common sign of a heart attack, per the NHLBI, the potential symptoms can be subtler. That’s especially true for women, who are more likely to experience nausea or indigestion, cold sweats, and profound, unexplained fatigue, Dr. Stempien-Otero says. Shortness of breath and lightheadedness or sudden dizziness can be red flags too. Meanwhile, the most common symptom of heart failure is shortness of breath, especially during activity, Dr. Stempien-Otero says. Activity in this sense isn’t about your workouts so much as your day-to-day activity; getting up from the couch, walking up the stairs, or other basic movements shouldn’t leave you wheezing or feeling exhausted. This can be a sign of heart failure because when the heart stops pumping efficiently, fluid collects around the lungs; in turn, you may feel breathless and, in later stages, experience swelling in the legs, ankles, or feet. Other potential heart failure symptoms include a persistent cough; swelling in the abdomen; rapid, unexplained weight gain from fluid build-up; nausea; lack of appetite; trouble concentrating; and a rapid or irregular heartbeat, according to the Mayo Clinic. Back to topWhat are the causes of a heart attack vs. heart failure?Several factors have been linked to a higher risk of both heart attack and heart failure, Jeffrey Teuteberg, MD, a cardiologist and the section chief of heart failure, cardiac transplantation, and mechanical circulatory support at Stanford Medicine, tells SELF. This includes metabolic factors, like high blood pressure, high cholesterol, high blood sugar, and larger body size. Using substances that can damage the heart, such as tobacco, has been linked to both conditions as well. Family history and genetic conditions can also play a role in either.According to the Mayo Clinic, the biggest heart attack risk factors include:Age (45 years or older)Lack of physical activity A diet high in sodium or trans fatsTobacco use or excessive alcohol intakeHigh blood sugar or diabetesHigh blood pressure or cholesterolFamily history of heart attacksExtreme stressAutoimmune conditionsPreeclampsia (a high blood pressure disorder during pregnancy)

Red flags pregnant people should watch out for include vision changes, upper abdominal pain, and persistent or unusual headache, Dr. Penfield says. The CDC also notes that swelling of the hands or face, trouble breathing, heavy vaginal bleeding or discharge, and overwhelming tiredness are signs that you should see your doctor ASAP.A number of health conditions can be caught and addressed through blood pressure screenings throughout the pregnancy and postpartum periods, Dr. Goje says, explaining that monitoring blood pressure can alert doctors to gestational hypertension, which occurs when you only have high blood pressure during pregnancy; preeclampsia, which occurs when a pregnant person’s blood pressure suddenly spikes; and eclampsia, which is a potential consequence of preeclampsia and can cause seizures. Making regular blood pressure screenings the standard of care may help reduce the disparity between Black and white maternal deaths, Dr. Goje says. This is because routine blood pressure measurements wouldn’t be dismissed by doctors, whereas health complaints from Black pregnant people are sometimes ignored due to their doctors’ racist biases. “Depending on the setting, some patients feel unheard, but when you have your blood pressure measured, this is an objective measurement” of one aspect of your health, she explains. “A provider should see the measurements and act on [them].”The new recommendations also draw attention to the prevalence of telehealth appointments, which, Dr. Goje explains, is an important topic, given how popular virtual visits became during the pandemic. Some people at major hospitals may be able to take blood pressure cuffs home with them to use throughout their pregnancies and after giving birth, including during telehealth appointments, she  says. In these cases, telehealth visits may work, since the provider can watch their patient take their blood pressure and assess whether it’s getting higher. But if a person doesn’t have access to a blood pressure cuff they can use at home, telehealth visits may not cut it, Dr. Goje says. The new recommendations say more research needs to be done to determine how pregnant people and their doctors can utilize telehealth technology without skipping over vital screenings, like blood pressure checks.What else needs to be done to address the maternal mortality crisis?Regular blood pressure checks aren’t the only interventions that need to be instituted to keep pregnant people safe. Addressing the maternal mortality crisis—and the fact that it disproportionately affects Black people—would mean making significant changes to our current health care system, Dr. Goje says.For starters, it would help if all health care personnel who come into contact with pregnant people receive implicit bias training. According to the American Academy of Family Physicians (AAFP), implicit bias is “pervasive” in the health care industry, and it often harms patients.In addition to training programs that address implicit bias, making sure Black people have access to other community care workers, such as doulas—trained professionals who provide educational, physical, and emotional support and care during pregnancy and childbirth—could also help. That way, if a person feels their voice isn’t heard, their doula (or someone in a similar role) could help them create a birth plan, serve as an advocate, and communicate their concerns to the doctor. “Health care systems are adding more levels of care to our [pregnant] patients [because] evidence supports having a multilevel approach,” Dr. Goje says.Ultimately, she explains, the new screenings are one step forward within a complex systemic problem that requires our attention: People who work in health care, alongside our lawmakers, need to do much more work to truly reduce Black maternal mortality. This includes collecting more data, providing resources for maternal mental health, and extending Medicaid services to ensure that pregnant people get the support they need during and after childbirth. “There are a lot of racial disparities,” Dr. Goje stresses, “and bringing back [the conversation around] blood pressure in pregnancy is important.”Related:

Your heart may be relatively small, but it has a big job to do. Each day, the fist-sized organ pumps about 2,000 gallons of blood throughout your body, according to the American Heart Association (AHA). That is, of course, when it’s operating as it should be.The heart is a critical part of your cardiovascular system, and it has two main roles: send blood to the lungs so it can be oxygenated, and then pump that fresh, oxygen- and nutrient-rich blood back out to the rest of the body, David N. Smith, MD, a cardiologist at Premier Cardiovascular Care in Charlotte, North Carolina, and a clinical assistant professor at Yale School of Medicine, tells SELF. When the heart isn’t pumping well enough to perform these functions properly, that’s considered heart failure. With heart failure, “the heart doesn’t circulate the blood adequately enough to allow the person to do normal activities,” Keith C. Ferdinand, MD, Gerald S. Berenson Endowed Chair in preventive cardiology and professor of medicine at Tulane University School of Medicine, tells SELF. You may have trouble walking up the stairs or carrying groceries, for example. (Generally, though, the symptoms of heart failure can be wide-ranging.)According to the Centers for Disease Control and Prevention (CDC), roughly 6.2 million adults in the United States are living with heart failure. By 2030, that number is estimated to rise by 46%, affecting more than 8 million people.1Talking with your doctor to understand your risk and doing your best to adopt lifestyle habits that keep your heart strong will help you mount the best defense. Here’s what you should know to keep heart failure out of your future.How to reduce your heart failure riskThere are several factors that can increase your risk of heart failure; genetics, a history of cardiovascular disease, certain infections, certain underlying conditions, access to reliable health care, and your overall lifestyle can all play a role in your chances of developing the condition. So how do you minimize your chances? Consider starting with these three changes:1. Keep tabs on your blood pressure.There’s a reason this is always part of your annual physical. High blood pressure (a.k.a. hypertension) is a well-established marker for heart disease, including heart failure.2 When you have high blood pressure, the heart becomes thicker and stiffer, and the cells inside the arteries—which transport blood away from the heart—are damaged. So, your heart will have a pretty tough time pumping the proper amount of blood, Dr. Ferdinand explains. Eventually, the heart can become strained and weakened, leading to heart failure.To keep your blood pressure in the optimal range—which is less than 120/80mm Hg—you’ll want to prioritize exercise; eat nutritious meals you enjoy; get quality sleep; drink less alcohol; avoid smoking (or make a plan to quit if you do); and keep your stress levels in check (we know, easier said than done, but these tips may help).2. Make small changes to your meals.Eating a heart-healthy diet doesn’t mean eating a restrictive diet. Making small changes to your daily meals over time can make a big impact. The biggest tweak to consider: Reduce your sodium intake. Of course, some sodium in the diet is essential—and salt makes your meals taste good, too.

It’s pretty well-known that chest pain is a possible sign of heart trouble—but it’s far from the only sign. Shortness of breath—which can feel like you’re exerting yourself more than you’re used to—is another big one to pay attention to, because it can signal heart valve disease, heart attack, and heart failure, among other cardiovascular issues.Shortness of breath, also called dyspnea, can be characterized in a bunch of different ways: You may have difficulty breathing, or feel “air hunger” (a.k.a. severe breathlessness), a sensation of suffocation, or intense tightening in your chest. According to the Mayo Clinic, most cases of shortness of breath can be linked to either a heart or lung issue. This is because the heart and lungs help carry oxygenated blood to tissues throughout the body, and also help remove carbon dioxide from your system. Problems with either function can impact your ability to breathe.Someone who’s generally healthy might feel short of breath while exercising or when spending time in extreme temperatures or high altitudes, especially if you haven’t been exercising much lately. Shortness of breath isn’t a symptom you should ignore, especially if it feels intense and comes on suddenly. Here’s what you should know.First, what types of heart problems cause shortness of breath?Heart valve diseaseThe heart has four valves, which help blood flow in the right direction within the heart and onward to other parts of the body. If one or more of the valves doesn’t work properly, this can cause problems with blood flow, per the US National Library of Medicine.Heart valve issues typically appear in one of two ways: one or more valves stiffen up and they don’t open correctly, or they don’t close correctly, Hal Skopicki, MD, PhD, chief of cardiology and co-director of the Stony Brook Heart Institute in New York, tells SELF. When the valves don’t operate as they should, blood can back up against the lungs and trigger shortness of breath. Over time, this puts strain on the heart, and can ultimately lead to heart failure, a condition in which the heart cannot pump a sufficient amount of blood to other vital organs.Heart muscle problems“Another way that the heart can cause a person to be short of breath is when the muscle itself is having problems ejecting blood out in the forward direction,” Dr. Skopicki says. People with heart muscle dysfunction, also known as cardiomyopathy, may experience a thickening, weakening, or stiffening of the heart muscle that can affect the organ’s ability to pump blood. A variety of health issues can set the stage for heart muscle problems, including heart disease, endocrine diseases, alcohol addiction, viral infections, and certain types of chemotherapy and radiation, among other factors, per the Centers for Disease Control and Prevention (CDC).Some pregnant people who are otherwise healthy may develop cardiomyopathy during or after pregnancy. “It’s important to not just assume that breathlessness is normal for pregnancy,” Stacy Rosen, MD, cardiologist and vice president of women’s health at the Katz Institute for Women’s Health at North Shore-LIJ Health System, tells SELF. Pre-existing heart issues can also become apparent for the first time during pregnancy, Dr. Rosen says.Issues with the heart’s electrical systemNormally, electrical signals help regulate your heartbeat. When these signals don’t fire properly, it can cause the heart to beat irregularly (arrhythmia), really quickly (tachycardia), or too slowly (bradycardia) without explanation, per the Mayo Clinic. Sometimes, an irregular heartbeat doesn’t cause any noticeable symptoms. Other times, it can make you feel short of breath, Dr. Skopicki says.Blockages in the arteriesCoronary artery disease, also known as coronary heart disease or ischemic disease, develops when the arteries—the major blood vessels that flow oxygen-rich blood to your whole body—can’t send enough blood, oxygen, and essential nutrients to your heart. It’s the most common form of heart disease in the US, per the CDC.

We’ve all been there: The nurse places a blood pressure cuff around your upper arm, squeezes that little bulb that makes the cuff inflate, and voilà—you get a reading. A normal blood pressure measurement is less than 120/80 mmHg; it’s considered elevated when it’s greater than 130/81. Doctors make a big fuss about this number because high blood pressure, or hypertension, can set the stage for various forms of heart disease, including heart failure.Blood pressure (BP) refers to the pressure of circulating blood against the walls of your blood vessels, like your veins and arteries. BP is broken down into two readings: the pressure when the ventricles pump blood out of the heart (systolic pressure) and the pressure between heartbeats when the heart is filling with blood (diastolic pressure). High blood pressure is extremely common. In fact, about half of American adults are saddled with this condition and only about one in four have it under control. As if that isn’t bad enough, more than 670,000 deaths in the United States in 2020 had hypertension as a “primary or contributing cause,” per the Centers for Disease Control and Prevention (CDC).The good news: There are many ways to get high blood pressure back into a normal range. Here’s what you need to know about the connection between high BP and heart failure and what you can do to keep your ticker in tip-top shape.What causes high blood pressure?For many people, there’s no identifiable cause of high blood pressure, which is known as primary hypertension, per the Mayo Clinic. But there are some known factors that increase a person’s risk of developing it.Aging is a big one: “It’s very common as we get older for the [blood] vessels to get thicker,” Keith C. Ferdinand, MD, FACC, the Gerald S. Berenson Endowed Chair in preventive cardiology and a professor of medicine at Tulane University School of Medicine in New Orleans, tells SELF. When this happens, the vessels become more rigid and don’t expand as they should when blood flows through them, he explains.There are so many other things that can increase your chances of developing high blood pressure over time, including your diet, lack of exercise, drinking alcohol excessively, tobacco use, stress or anxiety, and various chronic conditions—including pregnancy, diabetes, and sleep apnea, among others. When high blood pressure is caused by an underlying condition or medication, it’s known as secondary hypertension. Hypertension also tends to run in families and disproportionately impacts Black people, who also face a higher risk of heart failure due to various systemic barriers.What’s the connection between high blood pressure and heart failure?Heart failure develops when the heart is unable to pump enough blood to supply the body with what it needs. Over time, high blood pressure can cause damage to the arteries and muscle that affect the heart’s pumping powers, potentially leading to failure.With chronic high blood pressure, the cells inside the arteries, which carry vital oxygenated blood away from the heart, become damaged. This makes it difficult for the proper amount of blood to circulate, which can lead to chest pain, irregular heart rhythms (arrhythmias), heart attack, and heart failure, per the CDC.

Because of this, race itself isn’t the end all be all when it comes to heart failure risk. It is in no way as simple as “heart failure is passed on genetically in certain groups,” says Dr. Morris. Here’s why: Since some genetic mutations that are linked to heart failure—such as transthyretin amyloidosis, which can cause a buildup of proteins in the body that can lead to heart failure—are most commonly found in people of African ancestry, it follows that this mutation may be more prevalent in people who self-identify as Black, she explains. But there are many other complex factors at play, including generations of social dynamics, like racism and segregation. “As an African American, I am more likely to have inherited certain traits,” Dr. Morris explains, but that is, in part, because society “kept races apart from each other—intentionally.”There are also “traditional” risk factors to consider.“Traditional” risk factors refer to the more common things we know contribute to the risk of heart failure, thanks to evidence gathered in research, says Dr. Khan. For example, we know that high blood pressure is a key risk factor for heart failure—your heart has to work harder if your blood pressure is high, which can stiffen it or weaken it over time, according to the Mayo Clinic. And about 55% of Black Americans have high blood pressure, per the American Heart Association (AHA).Other conditions and risk factors that fall into this category include having type 2 diabetes; carrying extra weight; not eating enough fruits, vegetables, and whole grains; and being sedentary. These factors can help your doctor evaluate whether you’re at an increased risk of heart failure, Dr. Khan says. And nearly all of them also disproportionately affect communities of color, per the AHA.Of course, there isn’t a simple explanation as to why high blood pressure, diabetes, and obesity, for example, are so prevalent in Black communities. “It’s very hard to separate the reasons out because they are very interconnected,” says Dr. Khan. Again, some of it may come down to genetics. Additionally, these so-called traditional risk factors are prevalent in communities of color because of societal factors.Social determinants of health are a big deal.The term social determinants of health refers to “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” per the US Department of Health and Human Services.Social determinants of health include things like someone’s financial stability, their access to and quality of health care, their ability to find nutritious foods and exercise opportunities in their community, as well as the likelihood of facing racism, discrimination, and violence in their everyday life. In a 2022 paper coauthored by Dr. Khan and published in Clinical Cardiology, researchers note that a variety of social determinants of health have been associated with heart failure risk, including things like a lack of quality education, living in a low-income household or community, living in a region with a poor public health infrastructure, and a lack of health insurance, among others.2

Andre Romelle Young, better known as Dr. Dre, revealed that his doctors feared he wouldn’t survive the brain aneurysm he was diagnosed with in January 2021. In a recent interview clip shared on Diverse Mentality’s Instagram, the 57-year-old rapper and producer shared more about his experience, explaining he didn’t know how serious it was until after the fact.“I’m at Cedars-Sinai Hospital, and they weren’t allowing anybody to come up, meaning visitors or family or anything like that, because of COVID,” Dr. Dre said. “But they allowed my family to come in. I found out later they called them up so they could say their last goodbyes because they thought I was out of here.”Instagram contentThis content can also be viewed on the site it originates from.He went on to share what his recovery process was like, explaining: “I was in the ICU for two weeks because of what was going on in my brain. They had to wake me up every hour on the hour for two weeks to do these tests, [which were] basically sobriety tests—touch your nose, rub your heel on your calf. So every hour for two weeks I had to wake up and do that.” The testing routine to monitor his recovery was exhausting. “As soon as they leave, I would try to go to sleep because I knew they were coming back in the next hour,” Dr. Dre said. He also didn’t eat regularly for two weeks during this time, adding, “I was hungry.”His family and his medical team never told him the reason he was allowed to have visitors. “I didn’t know it was that serious. Seeing my mom and sister, everybody coming in the room—nobody told me. I had no idea,” Dr. Dre said. In fact, he was thinking of home while in the hospital. “I never felt like I was in trouble,” he said. “I felt like I’m just going through procedure, and I’m ready to go home.”

Sprinting through the final minutes of your run, the stressful seconds leading up to a big presentation, or watching Stranger Things alone in the dark: These are all times when you might feel like your heart rate won’t go down. But just going about your daily life shouldn’t lead to a racing heartbeat. Typically, your heart is part of a fine-tuned system that keeps the essential organ beating at a certain rhythm. So when the beats unexpectedly speed up, it’s understandable to feel concerned that something more serious might be happening to you.Your heart performs an incredible daily balancing act that’s crucial to keeping you alive and healthy. “The heart beats because of electricity,” Shephal Doshi, MD, director of cardiac electrophysiology at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. No, not the type that keeps your lights on, although that would be interesting. Instead, these are electrical impulses from a group of cells in your heart’s right atrium (chamber) that act like your own internal pacemaker. These cells, known as your sinoatrial (SA) node, tell your heart when and how to beat in order to send oxygen-rich blood throughout your body.Sometimes, your body can signal your heart to beat faster, and the SA node responds. Other times, signals start coming from other parts of the heart, causing it to speed up. Whatever the reason, a racing heart rate, or heart palpitations, can make you feel anxious, among other unpleasant symptoms.A racing heart rate has many potential causes, very few of which signal something life-threatening like a heart attack or heart failure. What is important, however, is how your racing heart makes you feel and how often this switch in pace happens. Here are the most common reasons it feels like your heart rate won’t go down—and when you should consider seeing a doctor.What is a “healthy” resting heart rate? | Common causes of a fast heart rate | When to see a doctorFirst, how do experts typically define a “healthy” heart rate?A “normal” or healthy resting heart rate for most adults ranges from 60 to 100 beats per minute, according to the US National Library of Medicine. Between these rates, your heart can pump the oxygen-rich blood it needs to your vital organs. If you’re very physically active—say, you’re an avid runner—you may find your resting heart rate is much lower (sometimes as low as 40 beats per minute). This is because exercise, especially cardiovascular exercise, helps your heart work more efficiently, meaning it can squeeze out more blood at a slower rate, per the Mayo Clinic.A resting heart rate that’s consistently higher than 100 beats per minute or lower than 60 beats per minute (if you’re not an athlete) can signal an underlying health issue, according to the Mayo Clinic.Back to topWhat are the most common causes of a fast heart rate?Normally, your body’s systems run on autopilot, thanks to your autonomic nervous system, which regulates all the vital functions you don’t really need to think about. “This includes things like your heart rate, blood pressure, sweating, urination, and various gastrointestinal functions,” Brent Goodman, MD, a board-certified neurologist at the Mayo Clinic in Phoenix, tells SELF.Sometimes, though, certain lifestyle habits, situations, or even health conditions can cause your heart to start beating very rapidly or irregularly. Here are a few common culprits to keep on your radar.1. You’re feeling very stressed.Let’s be real: With everything going on in the world, there’s an extremely good chance you’re stressed right now. When you encounter something stressful, your body releases a surge of norepinephrine, also known as adrenaline, Camille Frazier-Mills, MD, a cardiologist at Duke Electrophysiology Clinic, tells SELF. Receptors in your heart respond to this trigger and can make your heart rate pick up.1If you can’t immediately solve whatever’s making you stressed (which is hard to do on a good day, let alone in the chaotic reality we live in), try deep breathing exercises to at least help you feel better in the moment. The Mayo Clinic suggests taking deep breaths through your nose so that you feel your stomach rise instead of your chest, and exhaling through your nose as well. Focus on your breath and the rise and fall of your abdomen throughout. (If you’re looking for a more detailed exercise to try, check out these relaxing deep breathing videos.)2. You’ve had a lot of caffeine.While most people can handle a certain level of caffeine just fine, overdoing it can make your heart rate speed up. “A bunch of patients come to see me with an elevated heart rate, then they tell me they drink multiple highly caffeinated beverages daily,” Dr. Mills-Frazier says. “They’re revving themselves up.” This is most likely to happen if you’ve had too much caffeine, but it could also happen in response to small amounts if you’re just sensitive to this stimulant.According to the US Food and Drug Administration (FDA), it’s technically safe for adults to have up to 400 milligrams of caffeine a day, or around the amount in four or five cups of coffee. If that sounds like a lot to you, it may be, since there is a wide range in how sensitive certain people are to the effects of caffeine and in how fast it gets broken down in the body. Certain medications and health conditions may also make you more sensitive to caffeine, including being pregnant. Try cutting back on caffeine gradually to see if it reduces your racing heart (just don’t try to cut it out cold turkey if you rather not deal with the unpleasant side effects of caffeine withdrawal). If that doesn’t help, get in touch with your doctor.3. You smoke.Smokers (tobacco, cannabis, marijuana, you name it) tend to have higher resting heart rates than those who don’t smoke, according to a 2015 study published in Circulation: Cardiovascular Genetics. Although doctors don’t exactly know why this happens, an increase in heart rate from smoking could come with other cardiovascular complications, including a heart attack.24. You have cold- or flu-like symptoms, like a fever.If your pounding heart is accompanied by typical cold- or flu-like symptoms, such as a fever, coughing, and sneezing, a viral illness might be the likely culprit. Battling any type of infection requires your body to work harder than usual, and that includes making your heart beat faster in order to fight for homeostasis (its usual stable condition) and kick the infection to the curb, Dr. Mills-Frazier says.

Tiara Johnson, 32, was diagnosed with heart failure when she was just 26 years old. At first, her doctors wrote off her symptoms and told her it was nothing to worry about.Those symptoms—high blood pressure, shortness of breath, and fatigue—set in toward the end of her pregnancy. She was put on blood pressure medication and sent home after her daughter was born. When she went back to the hospital with persistent symptoms, she was told they were normal for someone who was postpartum. So Johnson just kept pushing through, hoping things would improve with time.Instead, everything just got worse. After passing out in the parking lot at work and being sent to the ER, she learned the true cause of her symptoms: end-stage congestive heart failure. Here’s her story, as told to health writer Korin Miller.It all started at the end of my pregnancy with my second child. I had a completely normal experience—until the last week. My blood pressure skyrocketed out of nowhere and my fingers became so puffy that I couldn’t wear my wedding ring. I was diagnosed with preeclampsia, a serious complication of pregnancy that causes high blood pressure and signs of liver or kidney damage; I was given medication to control hypertension—it didn’t work. A few days later, my doctor decided to induce me, but during labor I felt like something still wasn’t right and I couldn’t catch my breath properly. I expressed my concerns to the medical staff, but I was repeatedly told that everything was fine. So I assumed I was just overreacting, even though I truly felt like something was off.I had my daughter on July 31, 2015. When we went home, I still felt like I couldn’t breathe and it didn’t get better when I laid down or sat up. A few days later, I was in the shower and I felt like I was drowning, so I went back to the hospital. There, I was told I was fine and that this was a normal feeling after you have a baby due to fluid buildup in the body.I felt a little bit better when I went home, but I kept dealing with shortness of breath. I couldn’t lift my baby, I felt exhausted all the time, and I was sleeping a lot. I couldn’t walk for any long periods of time. But, because I was told that this was normal, I just dealt with it.Things changed on October 9, 2015. I passed out in the parking lot where I worked and was sent in an ambulance to a different hospital’s ER. There, I was given a series of tests and finally found out why I had been feeling unwell for the past three months: I had congestive heart failure and it was end-stage, meaning my heart was barely functioning. In fact, it was functioning at just 10% of its normal capacity.

Heart failure is one of those conditions that you rarely (or ever) think about—until it personally affects you. Maybe someone you love was recently diagnosed with heart failure or your doctor warned you about it during a recent physical. Whatever the reason is for it to be on your radar, heart failure sounds pretty scary. You might think it means that your heart suddenly stops working, but heart failure is actually a gradual process in which your heart doesn’t work as efficiently as it should, and it affects roughly 6.2 million people in the U.S., according to the Centers for Disease Control and Prevention (CDC). Here’s everything you need to know about this condition, including what causes heart failure in the first place.What is heart failure? | What are the risk factors for heart failure? | Who is at risk for heart failure? | What are the heart failure stages?What is heart failure?Your heart is tasked with a big job: pumping oxygen and nutrients to all of your organs. Heart failure happens when your heart muscle can’t keep up with the demands of its role, and the rest of the body starts failing, Tariq Ahmad, MD, MPH, associate professor of medicine at Yale Medical School and medical director of advanced heart failure at Yale Medicine, tells SELF.Heart failure can involve the left, right, or both sides of a person’s heart. Left-sided heart failure happens when things go wrong in the left ventricle, which is the muscle’s main pumping chamber. There are two types of left-sided heart failure: systolic heart failure, which means the left ventricle can’t push blood out very well, and diastolic heart failure, which is when the heart is stiff so it can’t relax and fill with enough blood in between beats, according to the National Heart, Lung, and Blood Institute (NHLBI). When blood doesn’t pump in and out of the heart effectively enough, “congestion” can happen. (That’s why heart failure is also sometimes called congestive heart failure.)Right-sided heart failure usually occurs as the result of left-sided heart failure. When both sides are affected the condition is called biventricular heart failure. That said, right-sided heart failure can happen on its own if you have a condition that affects the lungs, such as chronic obstructive pulmonary disease, which causes lung damage.1As the heart gets weaker, people who have developed heart failure may experience the following symptoms, per the National Library of Medicine (NLM):Swelling in your feet, ankles, legs, or abdomen: This can happen because poor circulation causes water and other fluids to build up in the body.Wheezing or coughing: Fluid may build up in the lungs when the heart doesn’t contract properly, causing coughing fits.Shortness of breath: You may be huffing and puffing more than usual when doing everyday activities like walking. This can result from fluid build-up in the lungs or from a lack of oxygen-filled blood.General fatigue: Being robbed of oxygen can really deplete your body.2 “It’s like going from an 800-horsepower engine to one with 100 horsepower,” Dr. Ahmad says.Because heart failure can affect different parts of the heart, symptoms may vary from person to person. Some people might not have any symptoms at all. Heart failure happens in stages, so symptoms can change or worsen over time, according to the Cleveland Clinic.Back to topWhat are the main causes and risk factors of heart failure?Heart failure can happen any time the heart is severely strained or damaged. And that can happen in numerous ways:Coronary artery diseaseThis is the most common form of heart disease, and it occurs when cholesterol, which is a type of fat, builds up in the arteries. As cholesterol continues to accumulate, the coronary arteries narrow and start to inhibit blood flow, according to the CDC.DiabetesDiabetes happens when a person’s blood-glucose (or sugar) levels are higher than the recommended range. This occurs when your body doesn’t make enough insulin (a hormone that regulates blood sugar) or when your body can’t use the hormone efficiently, according to the CDC. Over time, high blood sugar can lead to complications such as high blood pressure and heart disease.High blood pressureMedically known as hypertension, high blood pressure is used to describe the force of blood against artery walls. Hypertension is one of the most common causes of heart failure because it makes the heart work so much harder than it should need to, according to the NLM.Heart attackA heart attack occurs when the heart doesn’t get enough blood or oxygen. “The heart muscle needs oxygen to live,” Dr. Ahmad explains. “If the heart doesn’t get that blood flow, the muscle will die and it won’t be able to come back.” After a heart attack, some people’s hearts may be working at a reduced capacity, which can lead to heart failure.Congenital heart defects (CHD)Sometimes, a person’s heart doesn’t develop properly before birth, resulting in a congenital heart defect, according to the CDC. There are numerous types of CHD, and some may be minor, while others can negatively affect blood flow.InfectionsThe immune system fends off viruses by triggering inflammation throughout the body. In rare cases, that inflammation can damage the heart, according to the Mayo Clinic. This is called myocarditis, and it most often leads to left-sided heart failure.Infection can also affect the heart more directly. For example, bacterial infections may cause germs to stick to and ultimately damage the heart valve, which is known as endocarditis, according to the Mayo Clinic. Generally, this happens when people already have heart damage.Heart valve diseaseSometimes, the heart valves have a hard time opening and closing. This can happen for a variety of reasons, such as being born with a heart defect or getting a severe infection like the flu, which can lead to heart inflammation.ArrhythmiasAbnormal heart rhythms, medically known as arrhythmias, simply mean the heart beats very quickly or slowly at rest. According to the Mayo Clinic, a fast resting heart rate is defined as greater than 100 beats per minute, while a slow resting heart rate is below 60 beats per minute. Everyone experiences a fast or slow heart rate at some point. For example, heart rate generally declines during sleep. But sudden consistent changes in heart rate can indicate an underlying issue, like diabetes or coronary artery disease, which can potentially cause arrhythmias.Sleep apneaSleep apnea (when you stop breathing periodically throughout the night) deprives the body of oxygen, which can eventually lead to heart failure, according to the NHLBI. There are three types of sleep apnea, and they can all contribute to developing high blood pressure and structural heart changes due to oxygen deprivation, according to the Cleveland Clinic. Sleep apnea can often cause right-sided heart failure, but it can worsen left-sided heart failure as well.Metabolic SyndromeMetabolic syndrome refers to several conditions, including high blood pressure, excess body fat around your stomach, elevated blood sugar, high triglycerides (a fat found in the blood), and low HDL cholesterol levels. Together, these issues can increase your risk of developing medical conditions, such as heart disease and diabetes, according to the NHLBI.Peripartum cardiomyopathyAlso known as postpartum cardiomyopathy, this is a rare form of heart failure that can impact people who are pregnant during their last month of pregnancy and up to several months after giving birth, according to the American Heart Association. The heart chambers get bigger and the heart gets weaker, decreasing blood flow and oxygen to other organs. People with elevated blood pressure, Black people, and people who are medically considered overweight have a higher risk of developing this form of heart failure.MedicationsCertain medications can potentially damage the heart muscle, Sanjiv J. Shah, MD, director of the Heart Failure with Preserved Ejection Fraction Program at Northwestern University Feinberg School of Medicine, tells SELF. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can cause water retention, which interferes with blood flow, increasing your risk of heart failure, heart attack, and stroke. Even certain meds to treat high blood pressure can actually increase the risk of heart failure, as can some chemotherapy drugs. Talk to your doctor to understand the risks versus the benefits of taking these medications.