Congestive Heart Failure: Causes, Symptoms, & Stages
Heart failure is a medical term used to describe several types of heart-related problems. Congestive heart failure is one type of heart failure, although you’ll often see the terms used interchangeably. It’s a serious medical condition that typically isn't curable. However, many people suffering from the condition use medication and make changes in their lifestyle to lead a full life.
What Is Congestive Heart Failure?
If you’re diagnosed with heart failure, it means that your heart muscle isn’t pumping enough blood to meet your body’s requirements. The heart will often try to compensate for the lack of circulation by pumping harder.
When your heart can no longer keep up with the blood flow, blood builds up (or becomes congested) around the heart. As a result, kidneys may cause the body to start retaining water in other places like the lungs or legs. That’s the source of the term congestive heart failure.
Stages and Types of Heart Failure
The American Heart Association and American College of Cardiology have identified four stages of heart failure.
- Stage A: This stage includes anyone who is at high risk of developing heart failure. See below.
- Stage B: People whose heart has a defect, but who have never experienced the symptoms of heart failure (learn more below).
- Stage C: People in this stage experience symptoms of heart failure, and they have defects in their heart.
- Stage D: This stage represents advanced heart failure where patients would need specialized advanced treatment such as a heart transplant or the use of a medical device that helps their heart circulate blood.
Symptoms and Causes
The causes of congestive heart failure come from several areas. Sometimes the cause of heart failure is unknown. In other situations, a person has a heart defect, such as abnormal heart valves, or a heart muscle disease like myocarditis that prevents their heart from operating effectively. Finally, everyone’s heart loses some efficiency as we age; when age is combined with other risk factors, it does contribute to causing heart failure.
Some symptoms of heart failure indicate that you need to consult with a doctor. Others fit into a more urgent category and suggest that you should get an immediate evaluation.
Caution symptoms Include:
- A dry cough
- Shortness of breath when you’re active
- Swelling in your feet, ankles or legs
- Discomfort or swelling in your abdomen
- Trouble sleeping
Urgent symptoms Include:
- Frequent coughing
- Shortness of breath when you’re not active
- Severe swelling
- Sudden weight gain, meaning 2-3 lbs. within 24 hours or 5 lbs. in a week
- Dizziness, confusion, sadness or depression
- Loss of appetite
- Inability to lie flat to fall asleep
Prevention and Risks
People at higher risk include those over 65, African-Americans, and people who are overweight. Many medical conditions also increase your risk of having heart failure because they increase the stress on your heart.
- Coronary artery disease: This is a result of cholesterol and fatty deposits building up in your arteries.
- High blood pressure: High blood pressure indicates that your heart must work harder.
- Heart attack: Heart attacks cause damage to the muscle of the heart. Even after recovery, your heart will need to work harder to function properly.
- Severe lung disease: Lung diseases such as COPD cause the heart to work harder.
- Sleep apnea: If you have sleep apnea, you stop breathing during your sleep. That interruption causes the heart to work harder.
Because heart failure is a medical condition that worsens over time, it’s best to start prevention early. The first thing everyone can do is maintain a heart-healthy lifestyle as described below. After that, make sure you get annual checkups to catch any medical problems early. If your risk is high, it’s important to control the factors that increase your risk, such as high blood pressure.
Diagnosis and Tests
Diagnosing congestive heart failure starts with an exam from your doctor, who may order tests.
- Bloodwork: The results will show if there is any strain on organs such as the kidneys and liver, which can be caused by heart failure.
- Chest X-rays: An X-ray will show if you have an enlarged heart, or if you have fluid in your lungs.
- Electrocardiogram (EKG): This test will show if you’ve had a heart attack, if your heart muscle is thickened, or if your heart rhythm is abnormal.
- Echocardiography (Echo): This test will show your doctor how well your heart is pumping blood.
- Exercise Stress Test: This test will help your doctor determine how your heart responds to stress and if the blood supply is reduced in your arteries during exercise.
- Radionuclide Ventriculography or Radionuclide Angiography (MUGA Scan): The results of this test indicate how well your heart is working and if there has been any damage to your heart from a heart attack.
- Cardiac Catheterization: This test will reveal heart blockages and identify the parts of your heart that are being damaged from lack of blood.
Treatment, Procedures, and Medications
To get diagnosed with heart failure, start by seeing your primary care physician, who can perform annual physicals to spot any signs or symptoms of heart failure. As needed, your primary care physician will typically refer you to a cardiologist. The cardiologist will perform more advanced diagnostic tests, and work with you to manage congestive heart failure.
After lifestyle changes, medications are the most common treatment. These medications include ACE inhibitors that expand blood vessels to lower blood pressure and beta blockers to slow your heart rate.
If your doctors can identify a correctable problem, they may recommend procedures such as an angioplasty to open restricted blood vessels. During angioplasty, a catheter is threaded through an artery in the leg or arm to the heart, and a tiny balloon is inflated in the blocked artery to open it.
Some patients are candidates for devices such as a pacemaker, which is a small device placed in the chest to regulate the heartbeat using low-energy electrical impulses. In very rare cases, a patient would be eligible for a heart transplant. Transplant candidates typically must be healthy with the exception of their heart problems, and they cannot be in any high-risk categories for age, smoking, substance abuse, etc.
Healthy Lifestyle Tips
A heart-healthy lifestyle can help reduce congestive heart failure symptoms, slow the progression of the disease and make everyday living much easier. This lifestyle includes:
- No smoking
- Maintaining a healthy weight
- Avoiding alcohol
- Getting exercise
- Managing stress
- Getting sufficient rest
- Monitoring blood pressure and symptoms to take action as indicated
A heart-healthy diet can also have a significant impact on the progression of heart failure. A heart-healthy diet is one that follows healthy eating plans that focus on fruits, vegetables, whole grains, and fat-free or low-fat dairy products. You should include portions of lean meat, poultry, and fish, but don’t forget beans, eggs, and nuts to round out your nutritional intake.
It’s also critical to make sure your meals are low in fat – both saturated and trans fats. In addition, avoid salt, cholesterol and added sugars. Track your meals to ensure that you keep your daily caloric intake within the range of your requirements to maintain a healthy weight.
Learn more about congestive heart failure by reading our additional articles. If you believe you may have early signs or symptoms, contact your doctor right away. If you don’t have symptoms, just keep the risk factors in mind and take control of your health by following a heart-healthy lifestyle now.
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- American Heart Association: Types of Heart Failure
- Emory Healthcare: Heart Failure Statistics
- Heart Failure: Heart Failure Classifications and Stages Are Key to Treatment
- Heart Failure: Stages of Heart Failure
- American Heart Association: Self-Check Plan for HF Management
- National Heart, Lung, and Blood Institute: What Is Heart Failure?