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Congestive heart failure or CHF is a type of heart failure that involves a backup of fluid and swelling throughout the body. Heart failure does not mean that the heart has stopped pumping. Instead, this condition is characterized by a heart that cannot effectively pump blood throughout the body. Sometimes, the terms “congestive heart failure” and “heart failure” are used interchangeably but congestive heart failure can have its own unique symptoms and treatment.
What is Congestive Heart Failure?
Because heart failure causes fluid to back up in the body, it can lead to congestion in the body’s tissues, leading to severe swelling. Congestive heart failure causes severe swelling in the legs and ankles and it can also cause fluid collection in the lungs, resulting in shortness of breath and difficulty breathing.
Congestive heart failure usually requires prompt medical attention to ensure that further complications do not arise. Many people live with congestive heart failure, which affects about 6.2 million adults in the United States.
Other Types of Heart Failure
CHF is only one of three types of heart failure. The heart is divided into four chambers and the left and right sides of the heart have different functions. For this reason, heart failure that affects the right side will have different symptoms from heart failure affecting the left side.
Left-Sided Heart Failure
The left side of the heart is responsible for pumping oxygen-rich blood to the body. When left-sided heart failure occurs, the body does not get enough oxygenated blood and the blood backs up into the lungs. This causes pulmonary symptoms such as shortness of breath and fluid in the lungs. There are two types of left-sided heart failure, systolic and diastolic.
- Systolic failure occurs when the left ventricle is unable to contract normally. The heart becomes unable to pump forcefully enough, causing a reduced ejection fraction.
- Diastolic failure occurs when the left ventricle is unable to relax normally. This causes the heart to be unable to fill back up with blood in between heartbeats.
Right-Sided Heart Failure
The right side of the heart pumps blood to the lungs to collect oxygen. Right-sided heart failure usually occurs as a result of left-sided heart failure, since the accumulation of blood in the lungs causes the right ventricle to work harder. It can also result from other conditions such as lung disease or valve disease too. Right-sided heart failure causes fluid to back up in the legs, feet and abdomen causing swelling in these areas.
Stages of Heart Failure
There are four stages of heart failure that help to classify the severity and extent of the disease. They range from mild to severe.
Stage A
This stage is considered pre-heart failure and involves no heart failure symptoms. Someone who has Stage A heart failure is at high risk of developing heart failure because of family history or one or more of the following conditions:
- Hypertension
- Coronary artery disease
- Diabetes
- Metabolic syndrome
- History of rheumatic fever
- History of alcohol abuse
- History of taking drugs that can damage the heart muscles
Stage B
Stage B is also sometimes referred to as asymptomatic or silent heart failure. If you have Stage B heart failure, it means that the left side of the heart is not functioning properly but you haven’t yet had any symptoms of heart failure. To reach a diagnosis of Stage B heart failure, doctors usually perform an echocardiogram. If the echocardiogram shows an ejection fraction of 40% or less, then you will be diagnosed with Stage B heart failure.
Stage C
Stage C heart failure involves a diagnosis of heart failure with current or previous signs and symptoms such as shortness of breath, tiredness or fatigue, low activity tolerance or swelling throughout the body.
Stage D
Individuals with Stage D heart failure have advanced symptoms that occur even with little to no physical activity.
Symptoms
Heart failure can develop slowly over time or it can happen suddenly. Heart failure that has a slower onset is considered chronic, while heart failure that happens suddenly is considered acute.
Common signs of heart failure include:
- Chest pain
- Shortness of breath
- Irregular heartbeat
- Rapid weight gain
Symptoms of heart failure can vary depending on whether it is left-sided or right-sided heart failure. The symptoms of left-sided heart failure include congestion in the lungs and difficulty breathing. Right-sided heart failure causes symptoms like swelling in the feet and legs.
Causes
Heart failure usually develops secondary to other heart-related conditions that have caused damage to the heart muscle. The ventricles are the chambers of the heart that are responsible for pumping blood. In heart failure, these ventricles become stiffened or weakened and they do not fill properly between beats. Over time, the heart loses its ability to keep up with the demands of the body.
Risk Factors
If you already have heart disease, you’re at an increased risk of developing heart failure. Cardiovascular conditions that increase the risk of developing heart failure include coronary artery disease, heart attack, heart valve disease, high blood pressure, irregular heartbeat and congenital heart disease.
Other risk factors that make you more likely to develop heart failure include:
- Diabetes
- Certain medications
- Alcohol use
- Sleep apnea
- Smoking
- Obesity
- Viruses
Diagnosis
If your doctor thinks you may have heart failure, they may use several different diagnostic tests to confirm it. Usually, they will start with a physical exam and they will ask detailed questions about your health history and your family history to determine what types of risk factors exist. They will look at vital signs such as your blood pressure and heart rate and they’ll want to listen to your heart sounds and lung sounds to check for an abnormal heart sound (such as a murmur) or the sound of fluid buildup in the lungs.
Chest X-Ray
Chest X-rays show images of the heart and lungs. This imaging scan can help your doctor look for fluid in the lungs and enlargement of the heart, two potential indications of heart failure.
Blood Tests
Blood tests will give your doctor an idea of your overall health and can indicate if there are any other issues going on that could be causing the heart failure. Doctors typically order a blood test called B-type natriuretic peptide, which tends to be increased with heart failure. Your doctor may also order other blood tests to look at your heart health such as a lipid panel or cardiac markers.
Stress Test
A stress test will give your doctor an idea of how well your heart functions with physical activity. This test involves hooking a patient up to an EKG monitor while they walk on a treadmill. Your doctor will watch your heart’s activity while you’re moving and see how it responds to increases in activity.
Echocardiogram
An echocardiogram is an ultrasound that is performed on the heart. Echocardiograms provide images of your heart while in motion. This test can also be used to measure something called ejection fraction, an important measurement used for diagnosing heart failure. Ejection fraction shows how efficiently the heart is pumping to help classify heart disease and determine a treatment plan.
Electrocardiogram
Electrocardiograms are also referred to as ECGs or EKGs. This is a painless and simple test in which you have sticky electrodes placed on your chest. The test measures your heartbeat to look for any irregularities in the heart’s electrical signaling.
Heart Failure Treatment
There are a variety of different treatment options for heart failure that depend on the extent of symptoms and whether there is an underlying condition that needs to be addressed. There are some medications that can be prescribed for heart failure, such as ACE inhibitors and beta blockers. Your cardiologist may also recommend surgery to help the heart function better and relieve symptoms.
Surgery & Procedures
If your doctor has recommended surgery for heart failure, rest assured that the professionals at UCF Health are here to help you. Two common surgery options for heart failure involve heart transplant and ventricular assist devices.
Heart Transplant
A heart transplant may be a good treatment option for advanced heart failure. However, heart transplants are a major form of surgery and present their own risks and challenges. If your heart failure has reached an advanced stage, then this may be one of the final treatment options your doctor would recommend.
Ventricular Assist Devices
A ventricular assist device of VAD is an implanted device that can help the heart pump more effectively. Sometimes, VADs are placed in patients who need a heart transplant but cannot yet get one. The VAD can help keep their heart functioning well while they wait for a donor heart to be available to them.
How to Prevent It
Taking steps to live a healthy life won’t just help you live longer but it could even prevent you from developing a condition like congestive heart failure. Some steps you can take to prevent congestive heart failure include:
- Treating and managing any known heart conditions you have (such as high blood pressure)
- Quitting smoking
- Avoiding the use of drugs
- Moderating alcohol use
- Exercising regularly
- Eating a healthy diet that is low in sodium and rich in omega-3s
- Maintaining a healthy weight
Can Other Conditions Cause Heart Failure?
Heart failure often develops over time and is often related to other underlying health conditions. Some conditions that can damage the heart and cause heart failure include:
- High Blood Pressure. When the blood pressure is elevated the heart has to work harder to get the blood pumped throughout the body. The extra work that the heart has to do can cause the heart to stiffen and weaken over time.
- Past Heart Attack. Heart attacks happen when the coronary artery becomes blocked. Heart attacks lead to heart damage that results in heart failure.
- Coronary Artery Disease. Coronary artery disease occurs when there is a buildup of fatty deposits in the arteries. This reduces blood flow and can lead to heart attack and heart failure.
- Abnormal Heart Valves. The heart valves are present between the ventricles and arteries and at certain major arteries. The purpose of the valves is to keep the blood flowing in the right direction and prevent backflow when the heart pumps. When the heart valves are not working properly, the heart has to pump harder than it normally would. This leads to damage to the heart muscle.
- Heart Muscle Disease. Any type of condition that causes damage to the heart muscle can cause heart failure. Common heart muscle issues occur from drug or alcohol use and viral infections.
- Congenital Heart Defects. Congenital heart defects are heart conditions that are present at birth. When the heart does not form correctly at birth, it can cause damage to the heart muscle when it has to work harder.
Conclusion
At the end of the day, your health is in your hands. Taking the steps to live a healthy lifestyle can help you thrive and keep your heart pumping strong. One important step that should never be overlooked is visiting your cardiologist regularly to keep a close watch on your heart health. The cardiologists at UCF Health know exactly what to do to diagnose and treat heart conditions like congestive heart failure. Make your appointment today.