By Katherine Knapp, Shay Seibert, Kelcy Cullison

BSN Students

University of Southern Indiana

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Over 1 million patients admitted to the hospital have a primary diagnosis of heart failure. After years of health promotion regarding heart failure, the incidence and mortality rate have changed very little (Vaduganathan & Gheorghiade, 2014). There are more than 550,000 new cases each year, and survival rates decrease as a patient ages (Roger, 2013). This article will discuss heart failure, signs and symptoms, prevention, and risk factors for this chronic disease.


What is Heart Failure?


            Heart failure is a chronic disease that may cause many hospitalizations. Simply defined, it is a malfunction of the heart, causing impairments in the circulation of blood. It may be caused by a structural or functional deviation in the heart (Gilmour, Strong, Hawkins, Broadbent, & Huntington, 2013). The heart is the powerhouse of the body. The heart keeps everything functioning; therefore, when the heart cannot pump enough blood to the body, other body systems begin to decline.


Signs and Symptoms


Symptoms for heart failure may vary with each individual.  Listed below are some possible signs and symptoms of heart failure:


  • Fluid Retention (water weight)
  • Fatigue
  • Shortness of breath
  • Inability to do daily exercise
  • Breathlessness
  • Pain
  • Anxiety
  • Ankle Swelling
  • Nausea
  • Loss of appetite
  • Angina (chest pain)
  • Constipation
  • Tiredness
  • Difficulty sleeping


(Gilmore et al., 2013).


Risk Factors


A risk factor is anything in a patient’s life that puts them at a risk for developing a disease.  There are modifiable and non-modifiable risk factors.  The risk factors for developing heart failure are:

  • Age ( the higher the age, the greater the risk)
  • Poor diet
  • African American
  • Smoking
  • Sedentary lifestyle
  • Type 2 Diabetes
  • Obesity
  • High levels of stress
  • High blood pressure
  • Previous heart attack

(Jugdutt, 2012 & Nicken, 2011).





Prevention is the key to avoiding heart failure. There are key preventative measures that lower the risk and occurrence of heart failure. The first of which is a heart healthy diet consisting of fruits, vegetables, and whole grains. A salt restriction may be necessary; the recommendation for men is 3.1 grams per day, and for women 2.3 grams per day (Abete et al., 2013).

High blood pressure is also of concern for heart failure (Abete et. al, 2013). Although normal blood pressure levels are highly individualized, for those over 60 years old, 140/90 or lower is acceptable. However, it is always important to consult a physician or the health care provider on what is an acceptable blood pressure for each individual. A decrease in the systolic blood pressure (the top number) by 5 mm Hg reduces an individual’s risk of heart failure by 24% (Nickens, 2011).

It is important for individuals to stop smoking if they currently do and to refrain from alcohol consumption. Prolonged alcohol intake can cause the ejection fraction or the amount of blood pushed out of the heart with each beat to be decreased. Evidence has shown that heart failure patients who moderately consume alcohol have a higher death rate. Nicotine, a key component in cigarettes, causes vessels to constrict reducing blood flow even more (Abete et. al., 2013).

Individuals with heart failure may need to be cautious of their fluid intake. Those who have symptoms of heart failure are recommended to restrict fluids to less than two liters a day. It is also important to weigh daily at the same time, preferably in the morning. It is recommended that the individual use the same scale and wear the same amount of clothing. A weight gain of three pounds in one day or five pounds in one week is significant and should be reported to the physician or health care provider as soon as possible (Abete et. al., 2013).

Participating in physical activity and maintaining a healthy weight are also important preventative measures to take for heart failure (Abete et. al, 2013). Simple exercise like walking may be sufficient, but patients may also perform weight training or resistance exercises. Weight training and resistance exercises build strong bones and a strong heart. Management of other diseases, such as diabetes is also important. Evidence has shown that diabetes affects the vascular system which works directly with the heart (Judgutt, 2012). Heart attacks are a risk factor of heart failure, some physicians recommend taking 81 milligrams of aspirin a day to reduce the risk.




In conclusion, heart failure affects many older adults in today’s society.  Knowing the signs and symptoms of heart failure can help individuals seek medical attention as well as help with management of heart failure. It is recommended if the individual with heart failure is suffering from any of the following signs and symptoms to seek medical help immediately:  breathlessness, chest pain, or a weight gain of 3 lbs. per day or 5 lbs. per week.  Individuals can use preventive measures to reduce their risk for heart failure such as proper diet; exercise; smoking cessation; and managing their diabetes, blood pressure and weight.  Using preventive measures can also slow the progression of heart failure. Knowing the signs and symptoms of heart failure can help individuals seek medical attention as well as help with management of heart failure.


Katherine Knapp, BSN Student

Shay Seibert, BSN Student

Kelcy Cullison, BSN Student

Pam Thomas, MSN, RN, CCRN

Charlotte Connerton, EdD, RN, CNE-BC

College of Nursing and Health Professions University of Southern Indiana




Abete, P., Testa, G., Della-morte., Gargiulo, G., Galizia, G., de Santis, D.,…Cacciatore, F. (2013). Treatment for chronic heart failure in the elderly: Current practice and problems. Heart Failure Reviews, 18(4), 529-51.

Gilmour, J., Strong, A., Hawkins, M., Broadbent, R., & Huntington, A. (2013). Nurses and heart failure education in medical wards. Nursing Praxis in New Zealand, 29(3). Retrieved from:

Judgutt, B.I. (2012). Prevention of heart failure in the elderly: When, where and how to begin. Heart Failure Reviews, 17(4-5), 531-44.

Nickens, D.P. (2011). Heart failure prevention is the best option to stem high costs and disease burden. Circulation: Cardiovascular Quality and Outcomes, 4. Retrieved from:

Roger, V. (2013). Epidemiology of heart failure. Heart Failure Compendium, 113, 646-659. http://dx/ 10.1161/circresaha.113.300268

Vaduganathan, M., & Gheorghiade, M. (2014). A roadmap to inpatient heart failure management. Journal of Cardiology, 65, 26-31.