What is Congestive Heart Failure?

Congestive heart failure (or, heart failure) is a condition in which the heart can’t pump enough blood to the body’s other organs.

Heart failure often results from:

  • The narrowing of arteries that supply blood to the heart muscle (coronary artery disease)
  • Previous heart attack (or, myocardial infarction) resulting in scar tissue that interferes with the heart muscle’s ability to do its job
  • High blood pressure
  • Heart valve disease resulting from rheumatic fever or other causes
  • Primary disease of the heart muscle itself (called, cardiomyopathy)
  • Congenital heart defects (heart defects present at birth)
  • Infection of the heart valves and/or heart muscle itself (endocarditis and/or myocarditis)

In the case of heart failure, the ‘failing’ heart continues working, but not as efficiently as it should. People with heart failure can’t exert themselves physically, because they quickly become too tired and short of breath.

As blood flow from the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Swelling (edema) often results. Typically, there’s swelling in the legs and ankles, but it can happen in other parts of the body, too. Fluid can collect in the lungs and interfere with breathing (causing shortness of breath), especially when a person is lying down. Heart failure also affects the kidneys’ ability to dispose of sodium and water. The water retention increases swelling.

How do you diagnose and treat congestive heart failure?

Your doctor is the best person to make the diagnosis. The most common signs of congestive heart failure are swollen legs or ankles, and/or difficulty breathing. Another symptom is weight gain (when fluid builds up).

Typically, the treatment program for heart failure includes:

  • Sufficient rest
  • Improved, healthy diet
  • Modification of daily activities
  • Medications (including angiotension-converting enzyme (ACE) inhibitors, beta blockers, digitalis, diuretics, and/or vasodilators)

A variety of medications are used to treat congestive heart failure. Each performs a different function. ACE inhibitors and vasodilators expand blood vessels and decrease resistance, allowing blood to flow more easily and effectively causing the work of the heart to become easier and/or more efficient. Beta blockers aim to improve how well the heart’s left lower chamber (left ventricle) pumps blood. Digitalis increases the pumping action of the heart, and diuretics help the body to eliminate excess salt and water.

When a specific cause of congestive heart failure is discovered, it should be treated, and when possible, corrected. For example, in some cases, certain elements of congestive heart failure can be treated by effectively addressing a person’s high blood pressure. In the case that heart failure is caused by an abnormal heart valve, the valve can be surgically replaced. If the heart has become so damaged that it cannot be repaired, a more drastic approach may be considered (including a heart transplant as an option). Most people with mild and moderate congestive heart failure can be treated.