What is Systolic Heart Failure?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 14 August 2019
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Systolic heart failure is a condition where the heart cannot pump with enough force, leaving blood behind in the ventricles after each heartbeat. This contrasts with diastolic heart failure, when the heart fails to relax after contraction, preventing the ventricles from filling with blood. Older adults are most likely to develop systolic heart failure and it is possible to medically manage the condition. A cardiologist can evaluate a patient to learn more about what is causing the problem and develop a treatment plan for the patient.

In a patient with systolic heart failure, the ventricles tend to enlarge over time as they are constantly filled with blood and cannot empty out. Pressure rises, and leads to fluid leaks into body tissues. The patient may have peripheral edema, where fluid builds up in the extremities and causes discomfort. Pulmonary edema, fluid in and around the lungs, is also a risk. The patient may have difficulty breathing and can experience fatigue quickly, even after relatively light activities.

A doctor can diagnose systolic heart failure by listening to the heart and ordering imaging studies, as well as evaluating symptoms. One useful test is a measurement of the ejection fraction, to see how much blood the ventricles expel with each heartbeat. In people with systolic heart failure, this number usually falls below 50%. The heart will have to work harder to push the blood, and the walls of the muscle may thicken over time.


Some possible causes of this condition include myocarditis, disorders of the heart valves, and coronary artery disease. A doctor can use diagnostic testing to explore possible causes. The patient's personal and family medical history may also be a consideration in the medical evaluation. Treatments may include medications, diet and exercise modifications, surgery to treat diseased heart valves, and so forth. The patient can discuss the risks and benefits of different options to decide on the best course of action.

If systolic heart failure is not treated, the patient's heart function will continue to decline and secondary complications will develop. Patients may start to go into organ failure, and will develop extreme shortness of breath and fatigue. Eventually, the heart will no longer be able to meet the needs of the patient. The extremities can start to turn bluish due to inadequate circulation and the patient will eventually die. The earlier people receive treatment, the better the prognosis, with a much higher chance of successful and effective treatment when the condition is in the early stages.



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