Congestive Heart Failure

What Is Congestive Heart Failure? Symptoms & Causes of CHF

Congestive heart failure, also known as CHF, is a medical condition that affects the heart’s ability to pump blood properly. When the heart is not functioning as it should, it can lead to a range of symptoms, including shortness of breath, fatigue, and fluid buildup in the body. If your organs don’t get enough blood, they might not work correctly, which can cause major problems, including kidney and liver failure.1


How Common Is Congestive Heart Failure?

Congestive heart failure is a serious condition that affects a large number of people in the United States. According to the Centers for Disease Control and Prevention (CDC), about 6.2 million adults have congestive heart failure in the US.2


Congestive heart failure affects both men and women, but it is more common in older adults. The average age of onset is around 75 years. The incidence of congestive heart failure increases with age, with about 8 percent of adults over 65 having congestive heart failure.3


What Are the Causes of Congestive Heart Failure?

There are several causes of congestive heart failure,7 including:


  • Coronary artery disease: Coronary artery disease is a condition in which the arteries that supply blood to the heart become narrow and clogged, reducing the amount of blood that reaches the heart muscle. Over time, this can lead to congestive heart failure.
  • High blood pressure: High blood pressure puts additional stress on the heart and blood vessels, leading to congestive heart failure.
  • Heart attacks: Heart attacks, which are caused by coronary artery disease, result in damage to the heart muscle. Heart attacks are the typical cause of heart failure in patients with coronary artery disease.
  • Cardiomyopathy: Cardiomyopathy is a disease that affects the heart muscle, causing it to enlarge, thicken, or become rigid. This can make it harder for the heart to pump blood, leading to congestive heart failure.
  • Valvular heart disease: Valvular heart disease occurs when the heart valves become damaged, leading to inefficient blood flow. This can cause congestive heart failure.
  • Arrhythmias (irregular heartbeat): Arrhythmias are abnormal heart rhythms (contraction and relaxation of the heart) that can make it harder for the heart to pump blood, leading to congestive heart failure.
  • Diabetes: People with diabetes are at a higher risk of developing congestive heart failure. The relationship between congestive heart failure and diabetes is complex.
  • Obesity: Being overweight or obese can increase the risk of congestive heart failure, as it puts additional strain on the heart and blood vessels.
  • Substance abuse: Substance abuse, particularly the abuse of alcohol and drugs, can damage the heart and lead to congestive heart failure.
  • Viral infections: Viral infections, such as myocarditis, can cause inflammation and damage to the heart muscle, leading to congestive heart failure.


What Are the Risk Factors Associated With Congestive Heart Failure?

The following are the risk factors associated with congestive heart failure10:


  • High blood pressure
  • Coronary artery disease
  • Diabetes
  • Previous heart attack or heart disease
  • Age (over 65 years old)
  • Family history of heart disease
  • Smoking
  • Obesity
  • Sleep apnea (a sleep condition where breathing stops and restarts frequently)
  • Alcohol or drug abuse
  • Viral infections, such as myocarditis or cardiomyopathy (a disease of the heart muscle in which the heart loses its ability to pump blood effectively)


Types of Heart Failure

Congestive heart failure is classified in different ways by researchers. Based on the symptoms, the New York Heart Association (NYHA) Functional Classification sorts congestive heart failure into four different groups or classes depending on how much patients are limited during physical activity.5


Congestive Heart Failure Classes and Patient Symptoms

Class I: There is no limitation on physical activity. Ordinary physical activity does not cause undue fatigue, palpitations (feelings of having a fast-beating, fluttering, or pounding heart), or dyspnea (shortness of breath).


Class II: Slight limitation of physical activity. At ease when resting. Ordinary physical activity results in fatigue, palpitation, and dyspnea.


Class III: Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.


Class IV: Unable to carry out any physical activity without discomfort. Symptoms of heart failure at rest. Discomfort increases with any physical activity.


Systolic vs. Diastolic Heart Failure

Additionally, congestive heart failure can be classified into two main types: systolic heart failure (often referred to as heart failure with reduced ejection fraction, or HFrEF) and diastolic heart failure (heart failure with preserved ejection fraction, or HFpEF).6


Systolic heart failure: In this type of congestive heart failure, the heart muscle weakens and is unable to contract effectively to pump blood throughout the body. This results in a reduced ability to pump blood, leading to a buildup of fluid in the lungs and other parts of the body.


Diastolic heart failure: In this type of congestive heart failure, the heart muscle is stiff and cannot relax properly, leading to an inability to fill with blood efficiently. This results in a reduced amount of blood being pumped to the rest of the body, leading to a buildup of fluid in the lungs and other parts of the body.


What Are the Symptoms of Congestive Heart Failure?

The following are the symptoms of congestive heart failure 8:


Shortness of breath: This is a common symptom of heart failure and can occur during physical activity or while lying down. Breathing may become labored, and you may feel as if you can’t catch your breath.


Fatigue: Heart failure can cause a decreased ability to perform normal activities due to reduced blood flow and oxygenation to the body. This can lead to feelings of exhaustion and fatigue, even after a short period of activity.


Swelling: As fluid accumulates in the body, it can cause swelling in the legs, ankles, and feet. You may also notice swelling in your abdomen, which can indicate fluid buildup in the liver and intestines.


Rapid weight gain: A sudden increase in weight over a short period of time can be a sign of fluid buildup and may indicate heart failure.


Chest pain or pressure: Some people with heart failure may experience chest pain or pressure, which can be similar to angina (a condition in which the heart muscle doesn’t receive enough oxygen-rich blood).


Arrhythmia: Heart failure can cause arrhythmias, or irregular heartbeats, which can cause a fluttering or racing feeling in the chest


Coughing: A persistent cough, especially at night, can be a symptom of heart failure. This can occur as fluid accumulates in the lungs, making it difficult to breathe.


Decreased ability to exercise: As heart failure progresses, you may find it difficult to perform physical activities that you previously found easy. You may become short of breath and feel fatigued more quickly.


How Does Heart Failure Affect the Body?

Congestive heart failure can affect the body in the following ways4:


Body fluid buildup: One of the primary effects of heart failure is a buildup of fluid in the body, particularly in the lungs, legs, and ankles. This fluid buildup, also known as edema, can make it difficult to breathe and can cause swelling.


Reduced oxygen supply to the body: Congestive heart failure  can cause fatigue, weakness, and a lack of energy. This is because the body is not getting enough oxygen-rich blood, which can make it difficult to perform even simple tasks.


Low blood pressure: Congestive heart failure decreases the ability of the heart to pump blood, which can lead to low blood pressure. This can cause dizziness, fainting, and an increased risk of falls.


Kidney damage: Congestive heart failure can affect the kidneys, as they rely on a healthy flow of blood to function properly. When the heart is not able to pump blood effectively, the kidneys may not receive enough blood, leading to kidney damage.


Heart compensation and failure: The heart may grow and enlarge in size as it tries to make up for its decreased pumping ability, leading to further strain on the heart and potentially causing an irregular heartbeat.


How Is Congestive Heart Failure Diagnosed?

The diagnosis of congestive heart failure involves a combination of medical history, physical examination, and tests.11


Blood tests: Blood tests help diagnose congestive heart failure and determine its severity. They can also help rule out other potential causes of symptoms, such as anemia, kidney failure, and liver disease.


Electrocardiogram (ECG): ECG is a test that measures the electrical activity of the heart. It helps detect heart problems, including congestive heart failure, by showing abnormalities in the heart’s rhythm or electrical signals.


Chest x-ray: A chest x-ray can help identify fluid accumulation in the lungs, which is a common sign of congestive heart failure. It can also help determine the size and shape of the heart and lungs.


Echocardiogram: An echocardiogram is an ultrasound of the heart that shows the heart’s structure, size, and pumping ability. It also helps identify any underlying heart problems that may contribute to congestive heart failure.


Cardiac CT (computed tomography): Cardiac CT is a non-invasive test that uses x-rays and computer processing to create detailed images of the heart and surrounding blood vessels. It can help identify blockages in the coronary arteries and other structural problems that may be contributing to congestive heart failure.


Cardiac catheterization: Cardiac catheterization is an invasive procedure that involves inserting a small tube (known as a catheter) into a blood vessel and threading it to the heart. This test helps evaluate the heart’s function to determine the presence and severity of heart disease.


Cardiopulmonary exercise test: A cardiopulmonary exercise test measures how the heart and lungs respond to exercise. It helps determine the severity of congestive heart failure and evaluates how effective treatments are.


A prompt and accurate diagnosis of congestive heart failure is crucial for the effective treatment and management of the condition. The various diagnostic tests mentioned above can help healthcare providers diagnose congestive heart failure and determine its underlying causes and severity. If you begin experiencing symptoms such as shortness of breath, fatigue, or swelling, you should seek medical attention immediately.


What Are the Complications of Congestive Heart Failure?

Congestive heart failure can lead to complications9, including:


Arrhythmias: Congestive heart failure can cause arrhythmias, which can be dangerous and lead to sudden cardiac arrest.


Kidney and liver damage: The heart’s inability to pump blood effectively can cause a buildup of waste products in the body, leading to kidney and liver damage and decreased function.


Pulmonary edema: Congestive heart failure can cause fluid to build up in the lungs, making it difficult to breathe and leading to a condition called pulmonary edema. This can be life-threatening and requires immediate medical attention.


Cognitive impairment: Congestive heart failure has been linked to a decline in cognitive function, including memory loss and confusion.


Depression: Congestive heart failure can have a significant impact on a person’s mental health, including increasing the risk of depression and anxiety.


How Long Can You Live with Congestive Heart Failure?

Congestive heart failure is a progressive condition, meaning that it can get worse over time. However, with proper medical treatment and lifestyle changes, many people with congestive heart failure are able to manage their symptoms and maintain a good quality of life. On average, people with congestive heart failure can expect to live 5 to 7 years after their diagnosis, although some people may live much longer.12


The length of time a person can live with congestive heart failure depends on several factors, including the severity of the condition, the underlying cause, and overall health. In most cases, congestive heart failure can be managed with lifestyle changes and medications alone. However, in more severe cases, surgical procedures such as a heart transplant or an implanted heart pump may be necessary to improve heart function and prolong life.


Preventing Congestive Heart Failure

The following are the steps you can take to prevent congestive heart failure and maintain a healthy heart.13


Manage high blood pressure: High blood pressure is a leading cause of congestive heart failure. Make sure to monitor your blood pressure regularly and work with your doctor to control it through lifestyle changes and, if needed, medication.


Exercise regularly: Regular physical activity can help improve heart function and strengthen your heart muscles. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.


Eat a healthy diet: A diet rich in fruits, vegetables, whole grains, and lean protein can help control weight and lower the risk of congestive heart failure. Limit salt, sugar, and unhealthy fats.


Quit smoking: Smoking damages the heart and blood vessels, making congestive heart failure more likely. If you smoke, quitting is one of the best things you can do for your heart.


Manage stress: Stress can trigger the release of hormones that can damage the heart and lead to congestive heart failure. Practice stress-reduction techniques such as deep breathing, meditation, and exercise.


Control conditions such as diabetes and obesity: These conditions can increase the risk of congestive heart failure. Work with your doctor to manage them through lifestyle changes and, if needed, medication.


Get regular check-ups: Regular check-ups with your doctor can help catch congestive heart failure early and manage it effectively.


In conclusion, congestive heart failure is a serious condition that affects the ability of the heart to pump blood effectively, leading to a range of symptoms and associated problems. While there is no cure for congestive heart failure, it can be managed through a combination of lifestyle changes, medications, and medical procedures, helping to reduce symptoms and improve quality of life. If you are experiencing symptoms of congestive heart failure, it is important to seek medical attention to get a proper diagnosis and develop an effective treatment plan.


Medical Disclaimer: The information provided in this article is not a substitute for the advice of qualified healthcare professionals. While we strive to publish accurate information, it is not possible to cover all potential scenarios, including drug or treatment effects, interactions, or usage. You should not rely solely on this article to determine whether a particular treatment, drug, or clinical trial is suitable for you or any other individual. Always consult a healthcare professional before starting or changing any treatments.

Sources

  1. American Heart Association. What Is Heart Failure? May 31, 2017. Accessed from: https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure
  2. Centers for Disease Control and Prevention. Facts About Heart Failure in the United States. Accessed from: https://www.cdc.gov/heartdisease/heart_failure.htm#print
  3. Azad N, Lemay G. Management of chronic heart failure in the older population. J Geriatr Cardiol. 2014 Dec;11(4):329-337. Accessed from: https://pubmed.ncbi.nlm.nih.gov/25593582/
  4. Schwinger RHG. Pathophysiology of heart failure. Cardiovasc Diagn Ther. 2021 Feb;11(1):263-276. Accessed from: https://pubmed.ncbi.nlm.nih.gov/33708498/
  5. American Heart Association. Classes of Heart Failure. May 31, 2017. Accessed from: https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/classes-of-heart-failure
  6. Little WC, Applegate RJ. Congestive heart failure: Systolic and diastolic function. J Cardiothorac Vasc Anesth. 1993 Aug;7(4 Suppl 2):2-5. Accessed from: https://pubmed.ncbi.nlm.nih.gov/8369466/
  7. American Heart Association. What Causes Heart Failure? May 31, 2017. Accessed from: https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure
  8. American Heart Association. Heart Failure Signs and Symptoms. May 31, 2017. Accessed from: https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure
  9. Malik A, Brito D, Vaqar S, Chhabra L. Congestive Heart Failure. In: StatPearls. Treasure Island (FL): StatPearls Publishing; November 7, 2022. Accessed from: https://pubmed.ncbi.nlm.nih.gov/28613623/
  10. Centers for Disease Control and Prevention. What Are the Risk Factors for Heart Failure? Accessed from: https://www.cdc.gov/heartdisease/heart_failure.htm
  11. Inamdar AA, Inamdar AC. Heart failure: Diagnosis, management and utilization. J Clin Med. 2016 Jun 29;5(7):62. Accessed from: https://pubmed.ncbi.nlm.nih.gov/27367736/
  12. Medical News Today. How Long Can you Live with Congestive Heart Failure? Accessed from: https://www.medicalnewstoday.com/articles/321538.
  13. Butler J. Primary prevention of heart failure. ISRN Cardiol. 2012;2012:982417. Accessed from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3431085/