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Heart failure usually develops slowly and gets progressively worse, although it can occur suddenly. It typically begins with the left ventricle, which is the heart’s main pumping chamber – the chamber may not fill between beats or have become stiff and unable to squeeze effectively. In recent years, a new, “stiff” type of heart failure called Heart Failure preserved Ejection Fraction (HFpEF), where the heart cannot relax properly, has become the most common type of heart failure.

Heart failure often develops after other conditions have weakened or damaged the heart, such as:

  • Heart attack
  • Hypertension (high blood pressure)
  • Inflammation of the heart muscle
  • Congenital heart defects
  • Abnormal heart rhythms
  • Infections.

The signs and symptoms of heart failure can include:

  • Shortness of breath
  • Fatigue and weakness
  • A rapid or irregular heartbeat
  • Swelling in the legs, ankles, feet or stomach bloating
  • Coughing or wheezing
  • Sudden weight gain due to fluid retention
  • Lack of appetite and nausea
  • Difficulty concentrating
  • Chest pain.

It’s important to seek emergency treatment if any of the following are experienced. These signs may be due to heart failure, but can also indicate other serious heart and lung conditions:

  • Chest pain
  • Fainting or severe weakness
  • Sudden shortness of breath with coughed-up mucus
  • A rapid or irregular heartbeat accompanied by chest pain, shortness of breath or fainting.

The impact

Heart failure affects over 26 million people worldwide and is increasing in prevalence.1 It places a significant burden on patients and the healthcare system.

Every year, over 100,000 Australian adults suffer heart failure,2 with over 3,000 people dying from it.3 Around 37,000 Australian women have heart failure.4

Between 50 to 75 per cent of people diagnosed with heart failure die within five years of diagnosis.5

The risk

Heart failure mainly affects the older population. In Australia, two-thirds of people with heart failure are over 65 years of age.2 Rates of heart failure are also higher among Indigenous Australians, women, and people living in rural and remote areas.

If an individual has had a heart attack or coronary artery disease, they are at risk of heart failure, as these conditions could have damaged or weakened the heart.

Some risk factors can be changed or managed. These include:

  • high blood pressure
  • obesity
  • diabetes
  • smoking
  • alcohol use.

Visit the risk factors page for more information.

What is HRI doing?

HRI is conducting innovative research to develop new therapies for detecting and managing heart failure and other cardiovascular diseases.

Our Cardiometabolic Disease Research Group is investigating “stiff” heart failure (HFpEF). By understanding which factors contribute to the development of HFpEF, identifying the exact mechanisms leading to it and highlighting who is most at risk, we can build the foundations for novel drug development for effective treatment. Successfully developing a drug to improve or reverse HFpEF could save hundreds of thousands of lives in Australia, and millions worldwide.


  1. Savarese G et al; Global Public Health Burden of Heart Failure; Card Fail Rev. 2017 Apr; 3(1): 7–11.
  2. Australian Institute of Health and Welfare 2018. Cardiovascular disease. How many Australians have cardiovascular disease?
  3. Australian Bureau of Statistics 2018, Causes of Death 2017, ABS cat. no. 3303.0, September.
  4. Australian Institute of Health and Welfare. Cardiovascular disease in Australian women—a snapshot of national statistics. Published June 2019.
  5. Sahle BW, Owen AJ, Mutowo MP, Krum H, & Reid CM. (2016). Prevalence of heart failure in Australia: a systematic review. BMC Cardiovascular Disorders, 16, 32. doi:10.1186/s12872-016-0208-4.

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