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Everything You Need to Know About Congestive Heart Failure

Did you know that congestive heart failure is the leading cause of hospitalization in people over the age of 65? If you or a loved one has been diagnosed with congestive heart failure, it’s important to learn everything you can about the condition.

In this blog post, we’ll discuss the causes, symptoms, and treatment options for congestive heart failure. We’ll also provide advice for living with this condition.

What is congestive heart failure?

Congestive heart failure, or CHF, is when the heart cannot pump enough blood to meet the body’s needs. This happens when the heart muscle becomes so weak that it cannot push blood through the body.

A normal healthy heart pumps out about 5 liters of blood per minute. In congestive heart failure, the heart can only pump out 3 liters per minute or less. As a result, fluid builds up in the lungs, ankles, and abdomen — causing shortness of breath, fatigue, and swelling.

What causes congestive heart failure?

Congestive heart failure occurs when the heart muscle cannot relax and fill with enough blood to pump out into circulation. This can result from many different underlying conditions, including:

Coronary artery disease

Coronary artery disease (also called coronary heart disease) narrows the arteries that supply your heart with blood. When this happens, your heart has to work harder to get blood to your body’s other organs, including the brain and kidneys. If this continues over time, your heart may become enlarged and weakened, leading to CHF.

Heart attack

A heart attack occurs when blood flow to part of the heart muscle is blocked, usually by a clot or scar tissue. This prevents oxygen from reaching the muscle cells in the affected area, leading to cell death over time. The damaged area of the heart will not pump effectively, so it has to work harder than usual. Eventually, this strain can cause congestive heart failure.


Cardiomyopathy is a condition that causes your heart muscle to become enlarged or stiff. This can restrict blood flow through your heart and lead to congestive heart failure. In some cases, cardiomyopathy may develop after you have a viral infection or bacterial infection in the lung that spreads to the heart.


Diabetes can cause heart failure by damaging the small blood vessels that supply your heart with oxygen and nutrients. This damage can lead to a condition called diabetic cardiomyopathy, which causes heart muscle cells to die and triggers an abnormal heart rhythm (arrhythmia).

High blood pressure

High blood pressure (hypertension) is the most common cause of congestive heart failure in the United States. But it’s not always present with the disease. In fact, many people with congestive heart failure have normal blood pressure or only mildly elevated levels.

High blood pressure forces your heart to work harder and strain to pump blood through your arteries. This increases your risk of developing CHF later on.


Arrhythmia (an irregular heartbeat). Some types of arrhythmia cause the heart to beat too slowly (bradycardia), while others cause it to beat too quickly (tachycardia). A rapid or irregular heartbeat can put extra strain on the heart muscle and cause CHF.

Who is at risk for congestive heart failure?

Most people with CHF have heart disease that has progressed slowly over many years. But sometimes, CHF develops suddenly after a major illness or injury. Moreover, you may be at risk for congestive heart failure if you:

  • Have high blood pressure (hypertension) or high cholesterol levels
  • Smoke cigarettes or use other tobacco products regularly
  • Have diabetes mellitus (sugar diabetes)
  • Have had a previous heart attack or chest pain caused by coronary artery disease (heart disease)
  • Had thyroid surgery that removed all or part of your thyroid gland
  • Have kidney disease
  • Have a heart valve problem or leaky heart valves
  • Are you overweight, especially if you have diabetes mellitus

What are the symptoms of congestive heart failure?

The symptoms of congestive heart failure vary from person to person but may include:

Shortness of breath. This may come on suddenly or gradually over time. It’s often worse with activity or when lying down. You may notice that you have to catch your breath after climbing a flight of stairs, for example.

Swelling in the ankles and feet, especially at night or when lying down flat. The swelling may be mild at first and get worse over time.

A racing heartbeat (tachycardia). You might notice an irregular heartbeat or feel like your heart is pounding in your chest (palpitations).

Legs and feet feel heavy and tired all the time (decreased leg strength). This can make it hard to walk more than a few blocks without resting.

Fatigue that comes on suddenly, especially after physical activity. You may feel like you have no energy to do anything.

Chest pain that doesn’t go away after a few minutes of rest (angina). You might experience it as mild discomfort in the center of your chest or around the left side of your heart area.

How will my doctor make a diagnosis?

Your doctor will ask you questions about your symptoms and medical history and perform a physical examination. They may also do blood tests and an electrocardiogram (ECG).

The ECG helps determine if you have abnormal patterns in your heartbeat and whether there’s too much strain on your heart muscle from pumping blood through narrowed arteries (coronary artery disease).

Additional tests might include:

Chest X-ray

An X-ray image of the inside of your chest can help show whether fluid is building up in your lungs due to congestive heart failure or another condition.


This test uses sound waves (echoes) to create moving pictures of structures within your body, such as your heart and blood vessels.

The test can show if there are any problems with the structure of your heart or its valves, as well as detect any leaks in your heart valves.

Exercise stress test

This test can help your doctor determine if you have coronary artery disease. It involves walking on a treadmill or riding a stationary bike while wearing a heart monitor.

Holter monitor

This test can help your doctor determine if you have an irregular heartbeat. You wear a small device that records your heart’s activity over a 24-hour period.

How is congestive heart failure treated?

Congestive heart failure is a complex condition that requires careful treatment to reduce symptoms and improve quality of life. Treatment for congestive heart failure focuses on three main goals:

  • Control of symptoms and their underlying cause, if possible
  • Prevention of further damage to the heart and blood vessels
  • Maintenance of physical conditioning

Congestive heart failure is usually treated with medications and lifestyle changes. But some people may also need surgery or other procedures.

Medications for congestive heart failure

Your doctor may prescribe one or more medicines to treat your symptoms, including:

Diuretics (water pills)

These help rid your body of excess fluid. Two types are commonly used: loop diuretics and thiazide diuretics.


These lower your blood pressure by blocking the effect of adrenaline on your heart and blood vessels. This makes it easier for your heart to pump blood.

Beta-blockers don’t affect how much oxygen gets into your lungs. But they do help prevent chest pains that could happen when you breathe deeply or cough heavily during an attack of CHF.

Angiotensin-converting enzyme (ACE) inhibitors

This help relax the muscles that surround your heart. This makes it easier for your heart to pump blood. These also help prevent fluid from leaking into your lungs. This is important because it could cause an attack on CHF.

Blood thinners

This help prevents clots from forming in your body. Clots can block blood flow through the heart, causing chest pains or a heart attack.

Surgery For Congestive Heart Failure

If your doctor recommends surgery to treat your symptoms of congestive heart failure, it’s important to understand what type of surgery you may need and why. Some people need only one procedure. However, others need multiple surgeries over time.

The type of surgery depends on which part(s) of your heart isn’t functioning well and how well your left ventricle is working overall. Moreover, there are three major types of surgery for congestive heart failure.

Coronary artery bypass grafting (CABG)

CABG is used to improve blood flow to the heart muscle when arteries clog up with plaque. A surgeon uses a bypass procedure to redirect circulation around a clogged artery or artery segment.

Mitral valve repair or replacement

The mitral valve opens and closes each time your heart beats, allowing blood to flow from the left upper chamber of your heart (left atrium) into your left lower chamber (left ventricle). Congestive heart failure can cause this valve to leak or close too slowly.

Ventricular assist device implantation

VAD therapy may be an option for some people who have severe symptoms, and other treatments haven’t worked well enough. A VAD is implanted in your chest before you leave the hospital and connected directly to your heart’s right ventricle by a lead that runs through your femoral vein into your right atrium. The device takes over some of the work of pumping blood throughout your body while leaving your native heart intact.

How can I manage or prevent congestive heart failure?

If you have CHF, taking steps to manage your condition can help you feel better, live longer and improve your quality of life.

Here are some tips for managing congestive heart failure:

Eat a healthy diet

You may be advised to eat low-sodium foods or avoid salty foods altogether if you have heart failure. Reducing salt can help decrease fluid retention, which can reduce your body’s workload.

Drink plenty of water

Drinking enough water helps improve urine output and prevent dehydration, which can cause fatigue and make it harder for your heart to pump blood effectively.

Exercise regularly

Regular exercise strengthens your heart muscle and improves blood flow throughout the body. This also helps reduce symptoms of CHF, such as shortness of breath and fatigue. If you have chronic heart failure, talk with your doctor about what exercise is safe for you.

Maintain a healthy weight

Being overweight can increase your risk of developing heart failure. Losing just 5 to 10 percent of your body weight can help reduce symptoms and improve your prognosis.

Keep your blood pressure under control

High blood pressure (hypertension) increases stress on the heart and can lead to heart failure. If you have high blood pressure, work with your healthcare provider to find ways to lower it.

Reduce stress

Stress is a major contributor to heart failure. If you are under a lot of stress, try relaxation techniques such as meditation or yoga.

Stop smoking

Smoking is a major risk factor for heart failure. If you smoke, talk to your doctor about ways to quit.

Bottom Line

Always remember that congestive heart failure is a serious, life-threatening condition. If you think you might be suffering from it, it’s very important to seek treatment immediately. Your doctor will be able to diagnose the situation and offer the help you need to live as comfortably as possible.

The earlier you can treat yourself, the better your chance of preventing major problems and prolonging your life in good health. If you’re concerned about your heart health, schedule an appointment with us.