What is Congestive Heart Failure (CHF)?
Congestive heart failure (or CHF) is a chronic progressive long-term condition. It is the condition where the heart becomes unable to pump the blood in order to meet the requirement of the body.
Basically, heart failure doesn’t mean that the heart stops working, but it is when your heart enters the condition of working less efficiently than normal. The meaning of congestive is the buildup of fluid in the lungs, arms, feet, ankles, and other organs of the body.
More often it is simply called heart failure, but CHF exactly refers to the stage in which fluid builds up within the heart and causes it to pump inefficiently.
It is a serious health condition that seeks medical attention. If it does not get treated on time, it can be life-threatening too. But, if it is diagnosed on time and at an early stage, it can be both prevented and treated.
In this article, we will discuss important information about congestive heart failure, such as its causes, symptoms, diagnosis, preventions, complications, treatment, stages, types, and risk factors. But before that, let’s first understand how CHF occurs.
How Does Congestive Heart Failure (CHF) Occur?
The ineffectiveness of the heart to pump blood, due to the buildup of fluid is known as congestive heart failure. Heart has four chambers, where the upper half contains 2 atria and the lower half contains 2 ventricles.
The ventricles are responsible for pumping blood to the tissues and organs of the body, while atria are responsible for receiving blood back in the process of circulation.
Congestive heart failure develops when your heart ventricles are unable to pump enough blood volume to the body. Ultimately, blood often backs up and fluid can build up in your lungs, arms, feet, ankles, and other organs of the body.
How Is Congestive Heart Failure (CHF) Caused?
CHF may result from various conditions that damage the heart muscle, including:
Coronary Artery Disease
Coronary artery disease or CAD is a disease that causes blockage or severe narrowness in the coronary arteries. The function of these arteries is to supply blood and oxygen to the heart. Due to CAD, the blood flow to the heart muscle decreases. In the condition of blocking or critically narrowing the arteries, the heart does not get enough nutrients and oxygen for its functioning.
Heart Attack
A sudden blockage of the coronary artery prevents the blood flow to the heart muscles which eventually leads to a heart attack. The heart attack results in damage to heart muscles and an area that is not able to work properly.
Cardiomyopathy
It is the condition when heart muscles get damaged from causes other than blood flow or artery problems, like drug abuse, alcohol consumption, or infections.
Conditions That Overwork the Heart
In such situations, heart failure is caused by conditions such as diabetes, kidney disease, thyroid disease, valve disease, high BP, or heart defects present right from birth.
What Are The Symptoms of Congestive Heart Failure (CHF)?
You most likely don’t notice any changes in your health during the early stages of congestive heart failure (CHF). But you’ll experience gradual changes in your body, If your condition progresses.
| Initial symptoms of CHF | Symptoms indicating the worse condition of CHF | Symptoms indicating critical heart condition |
| Increased urination, especially at night | Shortness of breath (which might be a sign of pulmonary edema) | Fainting |
| Weight gain | Wheezing | The blueness of the skin which may be due to a lack of oxygen in the lungs |
| Swelling in ankles, legs, and feet | Cough developing from congested lungs | Rapid breathing |
| Fatigue | Irregular heartbeat | Chest pain radiating through the upper body |
Similar symptoms can also be caused by many other conditions, so it is important to consult a doctor. Individuals who have been diagnosed of heart failure should monitor their symptoms carefully and immediately report any sudden changes to their doctor.
Diagnosis of Congestive Heart Failure (CHF)
In the process of diagnosis of CHF, the doctor will consider physical exam, medical history, and family history along with different test results. They will also ask and review your symptoms.
In the physical examination, the health care provider will be
- Checking the fluid buildup in the legs and abdomen.
- Examining veins in the neck.
- Checking the heart for the whooshing sounds (murmurs) which might be the sign of heart failure.
- Listening to the lungs to check fluid buildup which might be a sign of lung congestion.
After physical examination, the doctor may suggest certain tests which include:
| Tests | How it is done | What it detects |
| Blood tests | – | Shows signs of any disease that may have an impact on the heart |
| Chest X-ray | X-ray images are taken. | Show the condition of the heart and lungs |
| Electrocardiogram (ECG) | Records electrical signals in the heart. | Shows the length and timing of the heartbeats |
| Echocardiogram | Sound waves are used to produce images of a moving heart. | Shows the structure and size of the heart. Shows heart valves and the flow of blood through the heart. Shows how well the heart is pumping. Measures ejection fraction Helps to classify heart failure. Guides treatment. |
| Stress test | The doctor will ask you to walk on a treadmill along with the attached ECG machine. The doctor may give you an IV drug to stimulate the impact of exercise on the heart. | Determines how well the heart and lungs get oxygen. And how well they breathe out carbon Dioxide. |
| Cardiac computerized tomography (CT) scan | You need to lie on a table inside a doughnut-shaped machine. The machine contains an X-ray tube that rotates around the body to collect the pictures of the chest and heart. | Measures the ejection fraction Examine the heart’s arteries and valves. Can help the doctor to determine if the individual has had a heart attack |
| Magnetic resonance imaging (MRI) | You need to lie on a table inside a long, tube-like machine. Radio waves are used to create pictures of the heart. | Measures the ejection fraction Examine the heart’s arteries and valves. Can help your doctor to see if there’s damage to your heart. |
| Coronary angiogram | A thin and flexible catheter is inserted into a blood vessel, usually in the groin, and guided to the coronary arteries, and then a dye is injected through this catheter to make the heart arteries show up more clearly on an X-ray. | Helps to detect coronary artery disease or narrowed arteries. |
| Myocardial biopsy | A very small piece of the heart muscle is removed by the insertion of a small cord in the vein of the neck or groin. | Helps to diagnose certain types of heart muscle diseases that can cause heart failure. |
What Are The Types of Congestive Heart Failure (CHF)?
There are various types of congestive heart failure. This condition may affect just one side of the heart, the deoxygenated or oxygenated side, or both sides.
2 Main Types of congestive heart failure are:
1) Left-sided CHF and
2) Right-sided CHF
Let’s understand both in detail.
1) Left-Sided Congestive Heart Failure (CHF)
Left-sided CHF is the most common type of congestive heart failure. This condition is caused when the left ventricle is not able to perform its functions properly. As this condition worsens, it may lead to breathing difficulties due to the fluid build-up in the lungs.
There are 2 types of left-sided CHF:
a) Systolic Heart Failure
It is the condition when the left ventricle fails to contract normally. As a result, the level of force available to push blood into circulation reduces; and being deprived of this force, the heart can’t pump properly.
b) Diastolic Heart Failure or Diastolic Dysfunction
It is the condition when the left ventricle’s muscles become stiff. As it can no longer relax, the heart is unable to fill completely with blood between heartbeats.
2) Right-Sided Congestive Heart Failure (CHF)
Right-sided CHF is the condition caused when the right ventricle is not able to perform its functions properly. It may lead to fluid retention in the abdomen, lower extremities, and other crucial organs.
It is possible that right-sided CHF and left-sided CHF can occur at the same time. Normally, it begins with the left side and after that, it moves to the right side, if left untreated.
What Are The Stages of Congestive Heart Failure (CHF)?
The stage-based classification system uses letters 1 to 4. Doctors use this classification system to ascertain risk factors, and begin early, more aggressive treatment to aid prevent or delay heart failure.
| Stages | Major symptoms | Outlook |
| Stage 1 | Rare or no possible signs or symptoms. | At this stage, CHF can be managed by: Regular monitoring. Heart medications. Lifestyle changes. |
| Stage 2 | You may feel comfortable during rest. But a little or normal physical activity may result in shortness of breath, palpitations, fatigue, etc. | At this stage, CHF can be managed by: Careful monitoring. Heart medications. Lifestyle changes. |
| Stage 3 | You might be comfortable while at rest, but not be able to do much physical activity. Even a mild exercise may result in shortness of breath, palpitations, fatigue, etc. | Critical treatment might be needed at this stage. |
| Stage 4 | You might not be able to feel comfortable even at rest. You might not be able to do any physical activity even without having any symptoms. | There are hardly any available treatments at this stage of CHF, but the quality of life and palliative care options are available. |
What Are The Risk Factors For Congestive Heart Failure (CHF)?
Risk factors for congestive heart failure are:
Age
As the age increases, the risk of heart failure also increases. People above 65 years of age are most likely to get hospitalized due to heart failure.
Gender
Usually, males are at higher risk of heart failure than females. Whereas, females may easily develop diastolic heart failure as compared to males.
Ethnicity
Research says that African-Americans may easily develop this condition before the age of 50 and may also die due to this.
Family History And Genetics
People who are having family history related to cardiomyopathies are at higher risk of developing any issues related to heart failure. Cardiomyopathy is a condition that may damage the heart muscles. There are not enough findings related to any genetic condition which may develop this risk.
Coronary Artery Disease
Narrowed arteries may reduce the supply of oxygen-rich blood to your heart, and result in weakened heart muscle.
Heart Attack
A heart attack can damage your heart muscle and cause your heart to no longer pump as efficiently as it should be.
Irregular Heartbeats
The abnormal heartbeat rhythms, mainly if they are very recurrent and fast, can lead to heart failure.
Diabetes
Diabetic people are at higher risk of developing any condition related to heart failure. Some drugs for diabetes or any chronic kidney disease because of diabetes may worsen the condition even more.
Obesity
Obesity leads to many other health problems such as Type 2 diabetes, high BP, etc. These conditions increase the risk of heart failure in people.
High Blood Pressure
The heart works harder than it has to if you are suffering from hypertension.
Sleep Apnea
The inability to breathe properly during sleep may result in low levels of oxygen in the blood and an increased risk of irregular heartbeats. Both problems can weaken your heart.
Lifestyle Factors
Drug abuse, drinking too much alcohol, a sedentary lifestyle, and smoking, are certain lifestyle factors that become the reason for heart failure in people.
Viruses
Some viral infections may cause damage to the heart muscle.
Medications
The use of some medications may cause heart problems or heart failure.
These medications include non-steroidal anti-inflammatory drugs (NSAIDs), certain medications used to treat high blood pressure, blood conditions, nervous system diseases, cancer, irregular or abnormal heartbeats, mental health conditions, lung and urinary problems, infections, and inflammatory diseases.
What is The Treatment for Congestive Heart Failure (CHF)?
The treatment for congestive heart failure depends on certain factors. The type of heart failure stage and cause are some of the factors which will decide what treatment will be effective and how it should be done.
The treatment includes lifestyle changes, medications, and surgery as well. Here, we will understand the treatment of CHF based on its stages:
Treatment Plan For Stage A Congestive Heart Failure
The general treatment plan for individuals with Stage A congestive heart failure includes:
- Exercise on a regular basis such as walking etc.
- Quit using products made up of tobacco.
- Treating high BP (with an active lifestyle, a low-sodium diet, medications, etc.)
- Quitting alcohol consumption as well as recreational drugs.
- Use of angiotensin II receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACE inhibitor), if the individual is suffering from high BP, diabetes, coronary artery disease, or other cardiac or vascular conditions.
- Treatment of high BP with Beta-blocker.
Treatment Plan For Stage B Congestive Heart Failure
The general treatment plan for individuals with Stage B congestive heart failure includes:
- All treatments of Stage A.
- In case, you have diabetes and 35% or less EF or had a heart attack, the treatment includes an Aldosterone antagonist.
- Angiotensin II receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACE Inhibitor), in case you aren’t already taking one.
- Intervention or surgery according to the requirement, such as treatment of congenital heart disease, valve disease, heart attack, or coronary artery blockage.
Treatment Plan For Stage C Congestive Heart Failure With Reduced EF
The general treatment plan for individuals with Stage C congestive heart failure (CHF) with reduced EF includes:
- All treatments of Stages A and B.
- If the already done treatments are not proven to be effective to stop the symptoms, the doctor may suggest medications with a combination of nitrate/ hydralazine.
- If the heart rate is more than 70 beats per minute with other symptoms, the doctors may suggest some medications to slow down the heart rate.
- If the symptoms still exist, the doctor will advise a diuretic (or water pill).
- Lower the consumption of salt or sodium in the diet.
- Keeping track of the weight regularly. Consult with the doctor, in case of losing or gaining more than 4 pounds in a short period of time.
- The doctor will suggest restricting the consumption of fluid.
- If required, a biventricular pacemaker or cardiac resynchronization therapy.
- If needed, ICD or implantable cardiac defibrillator therapy.
Treatment Plan For Stage D Congestive Heart Failure
The general treatment plan for individuals who have Stage D congestive heart failure includes
- All treatments of stages A, B, and C.
- Research therapies.
- Hospice or palliative care.
- Continuous infusion of intravenous inotropic drugs.
- Heart surgery.
- Ventricular assist devices.
- Heart transplant.
Treatment Plan For Stages C and D Congestive Heart Failure with Preserved EF
Treatment of individuals with Stage C and Stage D congestive heart failure and preserved EF (CHF-pEF) includes:
- Treatments of stages A and B, after checking if appropriate or not.
- Drugs or medications to treat the health conditions which may cause heart failure or worsen the condition. Such medical conditions include kidney disease, high cholesterol, chronic lung disease, coronary artery disease, obesity, diabetes, high BP, and atrial fibrillation.
- Diuretic (or water pill) to relieve symptoms.
Lifestyle Changes To Prevent Congestive Heart Failure (CHF) From Getting Worse
Making some positive changes in your lifestyle can help in relieving signs and symptoms of congestive heart failure and prevent the condition from worsening to some extent.
These lifestyle changes are:
1) Sleep Well And Easily
If you feel difficulties while sleeping such as shortness of breath etc., then use a pillow and keep your head up. If the problem is getting critical, be sure to consult with your health care provider.
2) Avoid Taking The Stress
The stressed person often has a higher heartbeat and BP as compared to the normal. This can increase the chances of making heart failure worse. Spend time on the things which make you feel relaxed and try to avoid taking stress as much as you can.
3) Keep Your Body Active
Keep yourself active in order to keep your body healthy. Some moderate aerobic and exercise programs will help you to maintain your body.
4) Consume Alcohol And Fluids Within The Limit
If you are not an alcoholic, then it is the best achievement for your heart. If you are, it is sincerely recommended to reduce or avoid its consumption as much as you can.
Because alcohol can interact with your medication, weaken your heart muscle, and increase your risk of abnormal heart rhythms.
In case you have severe heart failure, then your doctor can also suggest that you limit the amount of fluid you drink.
5) Keep Yourself Vaccinated
Take all the important vaccinations to prevent any other health condition. Ask your health care provider to check out your vaccination status and ask them for recommendations as well.
6) Limit Saturated Or Trans Fat In Your Diet
Always try to include the foods with the lowest saturated and trans fat in your diet. These foods contain harmful substances which increase the risk of heart failure.
7) Consume Salt Within The Limit
Consuming food with high amounts of salt or sodium can result in water retention. It causes difficulties in the functioning of the heart, swollen feet, ankles, and legs, and shortness of breath. One thing you should note is that the packaged food already contains salt, and also be vigilant while using any salt substitutes.
8) Consume A Healthy Diet
Consume a healthy diet that includes lean proteins, low-fat or fat-free dairy products, whole grains, vegetables, and fruits.
9) Maintain A Healthy Weight
You should maintain an ideal and healthy weight. Moreover, you need to be focused on reducing weight, if you are overweight. Even a loss of a small amount of weight can help in the improvement of your heart health.
10) Keep An Eye On Ankles, Legs, And Feet For Swelling
Check your ankles, legs, and feet carefully for swelling on a daily basis. If it becomes critical, contact your healthcare provider.
11) Limit Or Quit Smoking
If you want to keep your heart healthy, quit or limit smoking to the lowest level if you are a smoker.
Smoking leads to faster heart rate, decreases the amount of oxygen in the blood, increases BP, and damages your blood vessels. Your doctor may suggest some programs to quit smoking.
What Are The Complications Of Congestive Heart Failure (CHF)?
Complications of congestive heart failure (CHF) depend on your overall health, the severity of heart disease, and other factors like your age, etc.
Below are some complications of congestive heart failure:
Angina And Heart Attacks
There is a high risk of angina and heart attacks in persons having conditions of heart failure. In such conditions, special care is required with strenuous and sudden exertion.
Arrhythmias (Irregular Beatings Of The Heart)
The condition of irregular heart rhythms or heartbeats refers to Arrhythmias. There are different varieties of Arrhythmias, namely:
1). Ventricular tachycardia and ventricular fibrillation
2). Left bundle branch block
3). Atrial fibrillation
Congestion (Fluid Buildup)
Firstly, with left-sided heart failure, fluid builds up in the lungs. The condition is known as pulmonary edema.
With right-sided heart failure, the fluid builds up in the abdomen, feet, and legs. Such health conditions are treated by adopting certain lifestyle changes such as reducing the amount of salt in foods etc.
Heart Valve Problems
Your heart valves may not work properly if the pressure in your heart is very high or if the heart is enlarged due to congestive heart failure.
Kidney Damage Or Failure
Congestive heart failure can reduce the blood flow to your kidneys, which may lead to kidney failure if left untreated. Kidney failure or damage due to heart failure can require dialysis for treatment.
Cardiac Cachexia
Cardiac cachexia is a condition that leads to rapid unintentional weight loss (weight loss of a minimum of 7.5% in a period of 6 months). This condition means heart failure is getting worse.
Liver Damage
Congestive heart failure can lead to fluid buildup which may put too much pressure on the liver. This fluid backup and pressure can lead to scarring and makes it more difficult for your liver to work accurately.
How to Prevent Congestive Heart Failure (CHF)?
Sometimes with some risk factors, you might not be able to control some health issues. But you can prevent congestive heart failure to some extent by adopting some positive changes in your lifestyle.
There are numerous things that you can do to reduce your risk of congestive heart failure, or at least delay onset. So, here let’s understand what changes you can make in your lifestyle for congestive heart failure (CHF) prevention.
Avoid Or Quit Smoking
If you do smoke, then quit smoking, and if you are not able to quit then consult with your doctor for a suitable program to help you quit. Also, avoid secondhand smoke. If you live with a smoker then ask them to smoke outdoors.
Eat A Well-Balanced Diet
Consume a heart-healthy diet that is rich in fruits, vegetables, and whole grains. You should avoid added sugars, solid fats, and refined grains. You should also limit your salt (sodium) intake.
Maintain A Healthy Weight
Being obese or overweight can be hard on your heart. So, you should maintain a healthy weight. You can ask your doctor for weight loss If you aren’t at a healthy weight for your body.
Exercise
Moderate aerobic exercise can improve your heart health. Walking, swimming, and bicycling are good forms of exercise.
Control Other Conditions
If you are suffering from other conditions, like high blood pressure, heart disease, and diabetes, then you take their medications as directed by your doctor.
Regularly visit your doctor to monitor your condition and also report any new symptoms right away.
Consume Alcohol Within The Limit
If you are an alcoholic, then it is recommended to reduce or avoid its consumption as much as you can. Reducing or avoiding its consumption is always good in order to reduce the risk of heart failure.
Reduce And Manage Stress
Stress is also linked with a higher heartbeat and hypertension. Thus, stress can increase the chances of heart failure. So, you should find ways to reduce stress in your life and spend time on the things which make you feel relaxed.
What Is The Outlook For People With Congestive Heart Failure (CHF)?
With lifestyle changes, medication, or surgery your condition may improve and congestive heart failure may not stop you from doing the things you enjoy. Your outlook for the future depends on
- Your symptoms
- How well your heart muscle is functioning
- How well do you respond to and follow your treatment plan
- Whether you have other health conditions to treat, like diabetes or high blood pressure.
When congestive heart failure results from CAD (coronary artery disease) or cardiomyopathy, then the individual has a less positive outlook than someone with congestive heart failure in its earliest stage.
Doctors can’t reverse the damage involved, but treatments can provide symptomatic relief and improve the quality of life.
If anyone experiences symptoms of congestive heart failure should consult a doctor for a diagnosis. The earlier your illness is diagnosed, the better your outlook.
So, this is all about the health condition named congestive heart failure or CHF. It is important to treat the condition on time before it gets worse. Moreover, it is always beneficial to consult with your healthcare provider before coming to any conclusion related to any health condition.
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Disclaimer: This article is intended for informational purposes only. Any information associated with this article should not be considered as a substitute for prescriptions suggested by local health care professionals.
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