Congestive Heart Failure occurs when the heart is unable to pump adequately enough to meet the needs of the body. There are several conditions that may result in Congestive Heart Failure including:
- Coronary Artery Disease,
- High Blood Pressure,
- long term alcohol abuse,
- heart valve disorders,
- heart attack and
- cardiomyopathy (Kulik, 2018)(Mayo Clinic, 2023).
There are approximately six million people in the United States affected by Congestive Heart Failure and approximately 670,000 people are diagnosed each year. Among individuals 65 and older, Congestive Heart Failure is the leading cause of hospitalization (WebMD, 2018).
Because a heart is weakened by Congestive Heart Failure, its pumping ability is also weakened and moves blood throughout the body slower (decreased cardiac output) and increases the pressure within the heart. As a result, decreased amounts of Oxygen and nutrients reach the body. With the increase in pressure within the heart, its chambers are stretched and may become stiff and thickened. The stiff, thickened heart muscle is less able to pump blood. Ejection fraction is the measurement of how effective the heart is pumping. Normal ejection fractions are above or equal to 50% (Mayo Clinic, 2023). Congestive Heart failure can occur in the left, right or both sides of the heart, but usually starts in the left side of the heart (Mayo Clinic, 2023). Types of Congestive Heart Failure include:
- Systolic dysfunction - heart does not create enough force to pump Oxygen rich blood through the body
- Diastolic dysfunction - heart is able to contract, however, because the ventricles do not properly relax, less blood is able to enter the heart (WebMD, 2018).
As the heart muscle becomes weakened, stiff and thickened, its pumping effectiveness decreases. As efficiency decreases, kidneys begin to retain fluid and salt. The fluid building up in extremities (arms, legs, feet), lungs and organs causes the body to become congested. Symptoms of Congestive Heart Failure include:
- fluid retention
- dizziness
- fatigue
- weakness
- rapid or irregular heartbeats
- shortness of breath
- diminished exercise capacity (Kulick, 2018)(WebMD, 2018).
Shortness of breath is the hallmark symptom and can occur at rest, with activity, lying flat or can wake an individual up during sleep. Risk factors include: high blood pressure, coronary artery disease, heart attacks, Diabetes, some Diabetic medications, other medications, sleep apnea, congenital heart defects, valvular heart disorders, viruses, age, alcohol use, tobacco use, obesity, and irregular heartbeats (Mayo Clinic, 2023).
Tests, in addition to physical exam, can be performed to help diagnose Congestive Heart Failure. Tests such as cardiac blood tests, chest x-ray, electrocardiogram, echocardiogram, stress test, cardiac CT scan, MRI, coronary angiogram, and myocardial biopsy may all assist in diagnosis. Once Congestive Heart Failure has been diagnosed, the stage can be determined. According to the American Heart Association and the American College of Cardiology, stages range from A to D and are based on symptoms present and treatments needed. According to the New York Heart Association, stages range from I to IV and are based on symptoms and level of shortness of breath (Mayo Clinic, 2023).
Once diagnosed with Congestive Heart Failure, there are times when you should contact your primary clinician including:
- if your symptoms worsen suddenly
- you have a new symptom
- you gain 5 or more pounds within a few days
Complications of Congestive Heart Failure may include:
- Kidney damage or failure: due to reduced blood flow to kidneys
- Other heart problems: due to changes in heart size and/or function
- Liver damage: due to fluid build up in the liver
- Sudden cardiac death: due to irregular heart rhythm (Mayo Clinic, 2023)
Treatments for Congestive Heart Failure include medications, surgery, and devices. Medications used are:
- ACE Inhibitors
- Angiotensin II Receptor blockers
- Beta Blockers
- Diuretics
- Aldosterone Antagonists
- Inotropes
- Digoxin
Surgeries and medical devices that can be utilized are:
- Coronary Bypass Surgery
- Heart Valve Repair or Replacement
- Implantable Cardioverter-Defibrillators
- Cardiac Resynchronization Therapy
- Biventricular Pacing
- Ventricular Assist Devices
- Heart Transplant (WebMD, 2018)
Things that can be done to improve Congestive Heart Failure are:
- improve blood pressure
- monitor weight and swelling
- monitor fluid intake and output
- limit salt
- lose weight
- monitor symptoms (Kulick, 2018)(Mayo Clinic, 2023).
Eating a healthy diet, exercising, and obtaining vaccines to prevent respiratory infections can also improve living with Congestive Heart Failure (WebMD, 2018).
To learn more about Congestive Heart Failure, watch our Youtube video.
Updated 3/11/2023
Kulick, D. (2018) Congestive Heart Failure (CHF) Symptoms, Stages, Prognosis. MedicineNet.com Retrieved from https://www.medicinenet.com/congestive_heart_failure_chf_overview/article.htm
Mayo Clinic, (2023) Heart Failure. Mayo Clinic. Retrieved from
https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142
WebMD. (2018) Congestive Heart Failure and Heart Disease. Retrieved from
https://www.webmd.com/heart-disease/guide-heart-failure#6-11
