Most people lack a basic understanding of heart failure, a public health threat affecting nearly six million Americans, according to a recent national survey commissioned by the American Heart Association.

Two-thirds of respondents confused heart failure with heart attack; 58 percent mistook heart failure for a natural cause of death occurring when the heart stops beating; and 46 percent said heart failure was a silent killer with no symptoms.

In reality, heart failure occurs when the heart can’t pump blood efficiently enough to meet the body’s needs. Symptoms include difficulty breathing, fatigue, weight gain of three or more pounds in a day and swelling of the feet, ankles and legs. There is no cure, although heart failure can be managed.

More than 1,600 people, a portion of whom were heart failure patients and their caregivers, responded to the first annual heart failure survey from the AHA, with support from Novartis Pharmaceuticals Corp., which has funded a multi-year awareness campaign about heart failure.

“Being aware of the risks and symptoms of heart failure and receiving prompt and proper treatment are key to battling this disease, and that’s why these survey results are concerning,” said Gregg C. Fonarow, M.D., director of the Ahmanson-University of California Los Angeles Cardiomyopathy Center and co-chief of the UCLA division of cardiology.

Caregivers were more likely than heart failure patients to report the correct signs and symptoms, although they also bore the brunt of the impact, with 75 percent versus 63 percent of patients reporting anxiety and 69 percent versus 56 percent reporting depression.

“Many people with heart failure can lead full, enjoyable lives managing their condition with proper treatment and healthy lifestyle changes,” said Fonarow, who is also a professor of medicine at the UCLA Division of Cardiology.

“These insights and further findings from the survey can guide us as we bring together individuals and organizations to provide solutions that will truly make an impact on patients and their loved ones,” he said.

An estimated one in five Americans will develop heart failure in their lifetime, according to the AHA. One in nine deaths include heart failure as a contributing cause. In the U.S., the condition costs more than $30 billion a year in hospitalizations and other costs.