How do people die from heart failure?

Answer 1

It is important to note that the course of the disease and the progression is different for everyone.

The heart is a muscular pump. In Heart Failure, this pump (over a number of years typically) has become damaged. The heart becomes ineffectual and flabby. But this "flabbiness" cannot be corrected through exercise, because of the heart damage to the muscle itself.

The "failure" can begin on the left or right side. As the heart must work harder, both sides and both upper and lower chambers can be affected. The lower chambers need to push out blood-- but cannot do it efficiently. Blood begins to back up, causing excess fluids to build up in the lungs. Heart-lung involvement is inevitable. A person with Heart disease can begin to retain fluids because the heart cannot effectively pump the blood to the kidneys. Doctors can help with using diuretics, but care must be taken to not overwhelm the kidneys too.

It becomes a balance between relieving pressure on the heart muscle, decreasing fluid build up in the lungs, increasing safe transport of excess fluids to the kidneys, but without stressing any body systems. Typically, people can live a number of years on a combination of medications, O2, and inpatient hospitalizations as needed to deal with acute symptoms.

Death occurs typically as a combination of respiratory-cardiac failure, when the lungs become overwhelmed with fluids and the body is not well perfused with O2 because the heart muscle fails. The heart can go into several ineffectual heart beating-types or simply fail to contract at all. CPR might work but only postpones the inevitable outcome: death. CPR often fails because the heart is unable to beat in a coordinated effort as in a healthy heart; it contracts more like Jello, where the electrical impulses make the heart "jiggle" or "wiggle" all over, rather than contract forcefully and in a sustained effort of the upper/lower chambers.

*Daughter of a heart failure patient