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Medical Author:

Terrence X O'Brien, MD, FACC

Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Systolic heart failure: This condition occurs when the pumping action of the heart is reduced or weakened. A common clinical measurement is ejection fraction (EF). The ejection fraction is a calculation of how much blood is ejected out of the left ventricle (stroke volume) divided by the maximum volume remaining in the left ventricle at the end of diastole, or when the heart is relaxed after filling with blood. A normal ejection fraction is greater than 55%. Systolic heart failure is diagnosed when the ejection fraction has significantly decreased below the threshold of 55%.

Diastolic heart failure: This condition occurs when the heart can contract normally but is stiff, or less compliant, when it is relaxing and filling with blood. The heart is unable to fill with blood properly, which produces backup into the lungs and heart failure symptoms. Diastolic heart failure is more common in patients older than 75 years of age, especially in patients with high blood pressure, and it is also more common in women. In diastolic heart failure, the ejection fraction is normal or increased.

Heart failure affects 2% of the adult population. In the United States, nearly four million people have heart failure. Each year about 550,000 new cases are diagnosed. The condition is more common among African Americans than Caucasians.

• Heart failure affects 1% of people age 50 years or older, about 5% of those age 75 years or older, and 25% of those age 85 years or older.
• Heart failure is the most common reason for Medicare patients to be admitted to the hospital.
• As the number of elderly people continues to rise, often from the successful treatment of other types of heart disease, the number of people diagnosed with this condition will likely increase. The rate of death from heart failure is about 10% after one year. About half of those with congestive heart failure die within five years after their diagnosis. These statistics vary widely; a patient's exact diagnosis and response to therapy play a large role in patient survival. Any questions about diagnoses and therapy should be discussed with the treating physician. Advances in research are providing more options and improving outcomes for people with congestive heart failure.

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