Causes of systolic heart failure

The heart may lose squeezing strength after injury to heart muscle, long-standing high blood pressure, a problem with the heart valves, or a disease that directly affects the muscle. Coronary artery disease can reduce blood supply to the heart. A fast or irregular rhythm, including atrial fibrillation, may also make pumping less effective, especially when it is not controlled.

Sometimes several factors contribute, and occasionally testing does not reveal one clear cause. Finding contributing conditions matters because treating them can reduce extra strain on the heart. Cough, fatigue and swollen ankles may reflect the effects of reduced pumping, but they can also have other explanations.

A clinician may ask about past heart problems, blood pressure, infections, medicines, alcohol or drug exposure, family history and the timing of symptoms. Tests can include an ECG, blood tests, chest imaging and an echocardiogram; further assessment is chosen according to the findings.

Bring a complete medicine list and mention supplements or recreational substances. Control of blood pressure and treatment of an abnormal rhythm may form part of the plan. Keep follow-up appointments so symptoms, kidney function and treatment response can be reviewed in a chronic disease review.

Get emergency help for severe breathing difficulty, chest pressure, fainting, sudden confusion or a new collapse. Contact your healthcare team promptly if breathlessness, swelling, palpitations or fatigue is worsening, because a change can signal fluid build-up, a rhythm problem or another illness.

Ask which contributing factors were found, what tests remain, whether blood pressure or rhythm treatment is needed, and what you can safely change. Ask which medicines or non-prescription products should be avoided.