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Types of Heart Failure

The main types of heart failure are named for where they occur in the heart:

Left-sided heart failure
Right-sided heart failure
Biventricular heart failure (both sides)
Clinicians also may classify heart failure as:

Acute: You have active symptoms of heart failure, with either a new diagnosis or with long-term (chronic) heart failure.
Chronic: You have a history of heart failure, but your condition is relatively stable with no symptoms or with manageable symptoms.
Left-sided heart failure

Left-sided heart failure involves the left ventricle (bottom left chamber of the heart). When the left ventricle doesn’t pump enough blood, it backs up in the blood vessels that carry blood away from the lungs. It’s the most common type of heart failure, and tends to cause breathing symptoms.

Left-sided heart failure can be classified further as heart failure with reduced or preserved ejection fraction:

In heart failure with preserved ejection fraction (sometimes called diastolic heart failure), the left ventricle can’t relax normally. As a result, the heart can’t fill with blood between beats and things back up.
In heart failure with reduced ejection fraction (or systolic heart failure), the left ventricle can’t contract (squeeze) normally, so less blood gets into circulation.
Ejection fraction is the percentage of blood the left ventricle of the heart pumps out with every beat. A normal, healthy ejection fraction is 55% to 65%.

Right-sided heart failure

Right-sided heart failure involves the right ventricle (bottom right chamber of the heart). When the right ventricle doesn’t pump well, blood backs up in the blood vessels that carry blood from the rest of the body back to the heart. This can push fluid out of the veins and into other tissue, often leading to swelling.

Biventricular heart failure

Biventricular heart failure is a combination of left-sided and right-sided heart failure. It involves both sides of the heart, and can cause a mix of both types of symptoms.

Acute versus chronic heart failure

Acute heart failure is any heart failure that develops suddenly, such as after a heart attack or with arrhythmia. Chronic heart failure develops over time from medical conditions such as long-term hypertension (high blood pressure) or coronary artery disease.

Congestive heart failure

Many people use the terms heart failure and congestive heart failure interchangeably.

Congestive heart failure involves fluid backing up into the body’s tissues to the point that the tissues get congested and patients have symptoms. The symptoms and complications can become life-threatening, requiring timely medical attention.