Systolic Heart Failure: Causes, Symptoms, and Treatment for Impaired Heart Contraction

Introduction

Did you know? In the United States, approximately 6.7 million adults over the age of 20 are living with heart failure, and this number is expected to rise steadily to 8.7 million by 2030.

Heart failure is a long-term condition in which the heart cannot pump blood efficiently to meet the body’s needs. This does not mean that the heart has stopped working entirely. Instead, the heart muscle becomes weakened or stiff, reducing its ability to deliver oxygen-rich blood throughout the body.

This blog will mainly focus on systolic heart failure, a type of heart failure that is caused by impaired heart contraction. Additionally, we’ll also explore its causes, common symptoms, how it is diagnosed, and the treatments available. By the end, you’ll have a clear understanding of the condition, how to recognize early warning signs, and the steps you can take to protect your heart health.

What is Systolic Heart Failure?

Systolic heart failure, also known as heart failure with reduced ejection fraction (HFrEF), occurs when the heart cannot pump blood with enough force to meet the body’s needs. This condition mainly affects the left ventricle.

The left ventricle is responsible for sending oxygen-rich blood to the brain, muscles, and other vital organs. When it works well, the body receives the oxygen and nutrients it needs to function normally.

However, in systolic heart failure, the left ventricle becomes weak and enlarged (dilated). This heart muscle weakness reduces its ability to squeeze properly, leading to impaired heart contraction.

Consequently, each heartbeat pushes out less blood than normal, which lowers overall circulation. This ongoing strain causes fatigue, shortness of breath, and other symptoms linked to reduced blood flow.

Heart Failure with Reduced Ejection Fraction (HFrEF)

Ejection fraction (EF) is the percentage of blood the left ventricle pumps out with each heartbeat. In a healthy heart, this number is typically around 50–70%, indicating that the heart is squeezing efficiently and sending sufficient blood to the body.

In systolic heart failure, the heart muscle weakens, and the EF drops below 40%, meaning that the heart is not pumping enough blood. This heart-squeezing problem reduces circulation to the body, and over time, the ongoing weakness can lead to systolic heart function decline, which is why people may feel tired, short of breath, or find daily activities more challenging.

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Diastolic Heart Failure: How It Differs from Systolic Heart Failure?

Diastolic heart failure, also called heart failure with preserved ejection fraction (HFpEF), happens when the heart becomes stiff and cannot relax properly, so it doesn’t fill with enough blood. Unlike systolic heart failure, the heart’s pumping function is often normal. However, poor filling still causes symptoms like shortness of breath, fatigue, and fluid buildup.

Acute vs Chronic Systolic Heart Failure

Systolic heart failure can develop suddenly or gradually, which is why it is classified as acute or chronic. In both types, the heart struggles to pump effectively due to heart muscle weakness and poor heart contraction. The key difference lies in how quickly symptoms appear and how long the condition lasts.

• Acute systolic heart failure develops rapidly, often triggered by a heart attack, severe infection, or sudden stress on the heart. The drop in heart strength is immediate, and urgent medical attention is usually required.
• Chronic systolic heart failure develops slowly over time. The heart gradually loses its ability to contract, causing long-term low heart strength and progressive systolic heart function decline. Management focuses on controlling symptoms and slowing disease progression.

What are the Causes of Systolic Heart Failure?

Understanding the causes of systolic heart failure can help you recognize risk factors and take steps to protect your heart.

Coronary Artery Disease:

The most common cause of systolic heart failure is coronary artery disease. Narrowed or blocked arteries reduce blood flow, weakening the heart muscle and impairing contraction.

Previous Heart Attacks (myocardial infarction):

Heart attacks can cause scar tissue, reducing the heart’s ability to contract, leading to low heart strength.

Cardiomyopathy:

Diseases that enlarge, thicken, or weaken the heart muscle lead to poor contraction and reduced heart function.

High blood pressure (hypertension):

Constant high blood pressure forces the heart to pump harder than normal. This extra strain can lead to weakness of the heart muscle and contribute to poor heart contraction.

Valve disorders:

Dysfunctional heart valves make the heart work harder, gradually weakening it and potentially causing systolic heart failure.

Arrhythmias:

Abnormal heart rhythms, such as too fast, too slow, or irregular beats, can put extra stress on the heart, reduce its pumping efficiency, and may contribute to systolic heart failure.

Systolic Heart Failure Signs and Symptoms

Systolic heart failure (HFrEF) affects how well the heart pumps blood, so the symptoms often relate to fluid accumulation and poor circulation. The symptoms may include:

• Fatigue and low energy
• Shortness of breath during activity
• Reduced ability to exercise or perform daily tasks
• Swelling in the ankles or feet
• Difficulty breathing when lying flat (orthopnea)
• Rapid or irregular heartbeat
• Persistent cough or wheezing
• Lack of appetite
• Mental fog or difficulty concentrating
• Sudden weight gain due to fluid retention

Diagnosing Systolic Heart Failure

Diagnosing systolic heart failure is not based on one test alone. Your doctor will look at your medical history, symptoms, and do a thorough physical check. Risk factors such as high blood pressure, previous heart attacks, or coronary artery disease are also considered.

Key Diagnostic Tests

Echocardiogram (Echo):

This ultrasound test measures the ejection fraction, which indicates how well your heart squeezes and confirms whether your heart has reduced pumping ability.

Electrocardiogram (ECG/EKG):

It records the electrical activity of your heart to detect arrhythmias or past heart damage.

Blood Tests:

Blood tests help identify markers of heart strain, kidney function, and electrolyte imbalances.

Chest X-ray:

A chest X-ray can show fluid buildup in the lungs or an enlarged heart.

Stress Tests / Cardiac Imaging:

This imaging test is used to see how your heart performs during activity or for a more detailed look at the heart’s structure.

Hence, early and accurate diagnosis is crucial. It allows your doctor to start treatment quickly, improving symptoms and helping you maintain a better quality of life.

How is Systolic Heart Failure Treated?

Treatment for systolic heart failure focuses on helping your heart pump more effectively. Since the heart muscle is weak and doesn’t squeeze properly, the goal is to support heart function and protect other organs.

1. Lifestyle Changes

Simple lifestyle changes can make a big difference:

• Reduce salt intake to prevent fluid buildup.
• Maintain a healthy weight and eat a balanced diet.
• Quit smoking and limit alcohol.
• Stay active with moderate exercise approved by your doctor.

2. Medications

Medicines can help the heart work better and relieve symptoms:

• ACE inhibitors or ARBs: Relax blood vessels, reduce strain, and protect the heart.
• Beta-blockers: Slow the heart rate and improve pumping efficiency.
• Diuretics: Remove excess fluid, easing swelling, and shortness of breath.
• Aldosterone antagonists: Prevent further heart damage and help improve function.

3. Devices and Procedures

For some people with chronic systolic heart failure, doctors may recommend:

• Implantable cardioverter-defibrillators (ICDs) to prevent dangerous heart rhythms.
• Cardiac resynchronization therapy (CRT) to help the heart pump more efficiently.
• Surgery such as valve repair, bypass surgery, or in severe cases, a heart transplant.

The Role of Clinical Research

Clinical research plays a vital role in advancing treatments and improving patient outcomes. For people with systolic heart failure, participating in heart failure clinical research helps uncover potential new therapies and interventions that can improve quality of life.

At Northshore Research Associates (NRA), we specialize in conducting heart health trials and lead active study volunteer recruitment efforts to bring advanced clinical research opportunities to our community. Reach out to us today to learn about how you can join a study, support medical breakthroughs, and help improve heart care.

Conclusion

Systolic heart failure affects the heart’s ability to pump blood effectively, which can impact daily life if not managed early. However, with timely diagnosis, proper treatment, and healthy lifestyle changes, symptoms can be controlled, and disease progression can slowed.

Contact Northshore Research Associates (NRA) today to learn more about current research studies, patient recruitment for trials, and see how you can take part in meaningful research.