What is systolic heart failure?

systolic blood pressure Heart failure, also known as heart failure with reduced ejection fraction (HFrEF), is a type of heart failure in which the main chambers of the heart cannot pump blood efficiently. This can lead to symptoms such as fatigue, swollen legs, and shortness of breath.

This article discusses systolic heart failure and its symptoms, causes, and treatment.

Understanding Systolic Heart Failure

The heart acts as a pump, supplying oxygen and nutrients throughout the body.left ventricle It is the main chamber of the heart that pumps blood to the body. Normally, the left ventricle pumps more than half of its blood in each heartbeat.

ejection fraction

Ejection fraction (EF) is a measure of the pumping efficiency of the left ventricle, the proportion of blood pumped from the heart. An ejection fraction of 55%–60% or higher is normal, meaning that 55%–60% of the left ventricle is pumped out with each heartbeat.

Although an ejection fraction below 55% is abnormal, an ejection fraction below 40% is considered heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure.

Low EF results in reduced cardiac output. Cardiac output is the amount of blood the heart can pump per minute.

Our organs require a certain amount of cardiac output to function, and low cardiac output can negatively affect organs such as the kidneys and brain.

systolic heart failure symptoms

Symptoms of systolic heart failure are the result of low cardiac output and insufficient blood supply to the lungs and body. They include:

  • shortness of breath
  • exercise intolerance
  • fatigue
  • Unable to lie flat due to difficulty breathing
  • Difficulty breathing when waking up at night
  • Rapid heartbeat (palpitations)
  • decreased appetite and nausea
  • swelling of the legs and ankles
  • Bloating (bloating)

What causes systolic heart failure?

Systolic heart failure has many causes, including:

  • coronary artery disease
  • hypertension
  • alcohol or cocaine use
  • chemotherapy or radiation therapy
  • genetic inheritance
  • Infect
  • Heart valve disease, such as mitral regurgitation
  • Arrhythmia (heart rate or rhythm problems)
  • metabolic problems, such as thyroid disease
  • nutritional deficiencies, such as Thiamine (Vitamin B1) Deficiency
  • pressure cardiac diseasealso known as Takotsubo (sudden weakening of the heart muscle)
  • Perinatal cardiomyopathy (weakness of the heart muscle from the last month of pregnancy to several months after delivery)

Sometimes, the cause of heart failure is not known.This is considered idiopathic.

Diagnosing systolic heart failure

systolic heart failure through a Transthoracic echocardiography. This test involves an ultrasound that generates images of the heart and assesses the heart’s pumping function (EF) as well as valves and blood flow.

Other tests that can help determine the cause and complications of heart failure include:

  • blood tests, including blood cell counts, electrolyteand kidney, liver, and thyroid function
  • Electrocardiogram (recording electrical signals in the heart)
  • stress tests, such as nuclear stress tests
  • Cardiac MRI (magnetic resonance imaging of the heart)
  • coronary artery Angiography (X-ray imaging of the blood vessels of the heart)


Managing systolic heart failure requires lifestyle changes and medication. Sometimes implantable devices can help.

lifestyle changes

In addition to medications, patients with systolic heart failure should follow a low-salt diet and monitor their fluid intake. Daily weighing can help you keep track of your fluid overload.

People with systolic heart failure should avoid excessive alcohol intake and stay away from other substances.


Systolic heart failure is a well-studied disease, and several drugs have been shown to improve outcomes for people with the disease. Sometimes, weakened heart muscle can even be improved with medication.

The following are medications commonly used to treat systolic heart failure:

  • diuretics like Lasix (furosemide) or torasemide
  • beta blockersespecially Toprol XL (metoprolol succinate), Coreg (carvedilol) and bisoprolol
  • ACE inhibitors or Angiotensin Receptor blockers (ARBs)
  • enkephalinase inhibitorLike in combination pills Entresto (sacubitril and valsartan)
  • aldosterone antagonist like Aldactone (spironolactone)
  • vasodilator like Bidil (isosorbide nitrate and hydralazine)
  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors such as Farxiga (dapagliflozin) and Jardiance (empagliflozin)
  • Procoralan (ivabradine)

Note that treatment is individualized and some people may not be able to tolerate certain medications.

Implantable Device Therapy

One Implantable Cardioverter Defibrillator (ICD) Recommended for some people with low EF. An ICD is a small device placed under the skin of the chest with a lead inside the chamber of the heart. An ICD monitors the heart rhythm and delivers “shocks” to stop life-threatening arrhythmias.

Some people with abnormal ECG and systolic heart failure can benefit from Cardiac Resynchronization Therapy (Cathode Ray Tube). A CRT is a special type of ICD with extra leads that help optimize the timing of the heart’s contractions. CRT can help improve symptoms, and some people even see an improvement in their EF with this therapy.

systolic heart failure prognosis

Generally, the diagnosis of heart failure is serious because it can lead to life-threatening arrhythmias and organ failure.

Taking medications as prescribed, monitoring fluid status, and following up closely with a healthcare provider can help people with heart failure stay out of the hospital and improve their quality of life.

Advanced treatments and heart transplants are also options for people with severe heart failure.

coping with heart failure

Dealing with heart failure symptoms can be difficult, especially when it affects daily life. Exercise capacity can be greatly limited, and some people have shortness of breath with little activity or even at rest. Also, swollen legs can become painful, and it can be difficult to find the right shoes.

Staying organized is very important. Consider investing in a pill sorter to keep track of all the medications you prescribe. Every morning, write your weight, blood pressure, and any symptoms on a calendar and bring it to your healthcare provider visit.

For some people, reducing salt intake may be of great help. Using other spices can help preserve the flavor of the meal without adding salt.

As with any chronic illness, the support of a loved one can help you cope. Many hospitals also offer support groups for people with heart failure.


Systolic heart failure is a serious condition in which the main chambers of the heart cannot pump efficiently. This can lead to symptoms of shortness of breath, fatigue, and swollen legs, and increases the risk of cardiac arrhythmias and organ failure. Several drugs and devices can improve survival in people with systolic heart failure.

VigorTip words

A diagnosis of systolic heart failure is life-changing. It requires monitoring your diet and remembering to take small doses of medication. Managing the symptoms of heart failure and the side effects of medications can be overwhelming. The support of loved ones and healthcare providers can help you cope and adapt to the situation.