What goes wrong in heart failure?

If you have heart failure, your heart has difficulty pumping blood around your body. This can happen for many reasons – commonly because you have (or had) a medical condition, which has damaged (e.g. coronary heart disease with a heart attack) or placed extra workload (e.g. high blood pressure) on your heart.

This damage or extra workload can either affect the squeezing (contraction) or filling (relaxation) of your heart, or frequently both.

If your heart doesn’t contract as it should, it will not be able to pump sufficient blood in your ventricles out of your heart. If your heart is not able to empty and relax fully, less blood will be able to enter your heart, and therefore less blood is available to pump out of your heart.

Heart failure has two main effects. Firstly, not enough blood is getting to your body, which may cause fatigue. Secondly, blood backs up waiting to enter your heart. This build-up of blood causes fluid to leak out of your blood vessels and into the surrounding tissues. This leads to fluid accumulation (usually in your legs and abdomen) and fluid (congestion) in your lungs.

At first your body will adapt to compensate for your weakened heart’s poor pumping. However, these adaptations can only compensate for a limited time, and in fact, these adaptations can actually make your heart even weaker in the long term.

Click here to find out how your heart and body adapt to try to keep up with your body’s needs.

ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers.

heartfailurematters.org is a European Society of Cardiology website

The heartfailurematters.org website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

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