Heart failure describes the heart getting progressively weaker over time. Doctors divide heart failure into stages that represent the condition's progression and how it affects your daily life and activities. The most severe stage is known as end-stage heart failure or advanced heart failure. Fortunately, several treatments are available that can help stabilize or even reverse the condition at this stage, offering hope and potential for a better quality of life.
Despite the name, heart failure doesn't mean the heart has completely stopped functioning, which would be cardiac arrest. Instead, heart failure refers to the heart getting weaker, either because of a chronic illness that strains the heart or because of damage to the heart from an acute problem like a heart attack. The severity of heart failure gets worse over time.
Doctors use stages to describe the progression of heart failure and its effects. Advanced heart failure, also called Stage D or end-stage heart failure, is the fourth and final stage and is the most severe stage of heart failure. However, there are several treatments available that can help stabilize or even reverse the condition at this stage.
Heart failure falls into one of four stages, depending on how advanced it is:
In addition to the stage system, doctors use a system called "classes" to further describe the last two stages (symptomatic and advanced heart failure). The classes describe the severity of your symptoms:
Heart failure occurs when the heart becomes weaker, and end-stage heart failure means the heart is too weak to pump blood through the body effectively. When that happens, you experience symptoms related to the poor circulation of blood:
In addition to the physical symptoms that end-stage heart failure provokes, it's common for patients with advanced heart failure to suffer psychological symptoms such as depression or anxiety about the future. Sleep problems are also common in patients with advanced heart failure.
End-stage heart failure is the result of progressive heart failure and has many causes. It typically results from other conditions or injuries that damage the heart, such as:
The risk factors for heart failure are generally the same as the causes. If you have a condition that damages the heart—especially coronary artery disease, diabetes, and high blood pressure—you're at a higher risk of heart failure and, eventually, end-stage heart failure. Other risk factors include poor diet, drug use, insufficient exercise, tobacco use, and obesity.
Prevention is the best approach to heart failure. Adopting heart-healthy lifestyle habits can help you prevent or reduce the likelihood of conditions that lead to heart failure. Good habits include:
You may not receive a heart failure diagnosis until the later stages since the early stages of heart failure don't present symptoms. In other cases, if you have risk factors for heart failure, your doctor may monitor your heart for risk factors to try and identify heart failure early.
If you have heart failure, you'll get regular checks with your doctor, and they'll be able to tell you when your heart failure has progressed.
Heart failure at all stages is diagnosed using the same tests and techniques:
Fortunately, there are many ways to help manage end-stage heart failure. Treatment for the last stages of heart failure focuses on relieving symptoms, improving quality of life, and in rare cases, achieving recovery.
A diagnosis of end-stage heart failure can be overwhelming. It's normal to feel angry, depressed, anxious, and fearful. When you receive a diagnosis of end-stage heart failure, it is important to remember that several treatments are available, even in the later stages of the illness.
Life expectancy can vary depending on factors like age, medical history, and treatment options. On average, life expectancy is about two years after diagnosis of heart failure. In Stage D heart failure, life expectancy is typically less than a year. However, for patients who receive LVADs or a heart transplant, life expectancy can be extended well beyond 5-10 years, offering hope and the potential for a longer, fulfilling life.
While congestive heart failure is a serious condition, there are ways to manage end-stage heart failure, including two life-saving treatments:
End-stage heart failure continues throughout the patient's life, but with the right treatments, there is hope for improving their condition and enhancing their quality of life.
Treatment can slow the progression of end-stage heart failure. Reversing the condition is only possible in some cases.
Typical signs of advanced heart failure include difficulty breathing, fatigue, swelling in the legs and abdomen, irregular heartbeat, and fatigue.
Hospice care focuses on giving the patient a comfortable and dignified end of life. In hospice, you won't get treatments to extend your life, but the care staff will help you manage symptoms and deal with the psychological distress and depression that accompany a diagnosis.
