Congestive Heart Failure
Understanding Congestive Heart Failure (CHF)
Congestive Heart Failure (CHF) is a condition where the heart cannot pump blood effectively, causing fluid to build up in the lungs and other parts of the body. Symptoms include shortness of breath and swelling.
What is Heart Failure?
What Happens
- Heart muscle becomes weak or stiff
- Heart muscle cannot pump enough blood to meet the body's needs for blood and oxygen
- Less blood is pumped with each heartbeat
- Blood backs up in blood vessels
- Fluid leaks into tissues
- Body doesn't get enough oxygen
Common Causes
- Coronary artery disease
- High blood pressure
- Damage due to heart attack
- Diseases of the heart muscle (cardiomyopathies)
- Inflammation of the heart muscle (myocarditis)
- Heart valve problems
- Congenital heart defects
Types of Heart Failure
Systolic Heart Failure
Heart muscle is weak and cannot pump well
- Left sided heart failure
- Reduced ejection fraction (HFrEF)
- Heart cannot pump enough blood into circulation
Diastolic Heart Failure
Heart muscle is stiff and can't fill well
- Left sided heart failure
- Preserved ejection fraction (HFpEF)
- Heart doesn't relax normally due to stiffness
- Heart cannot fill with blood like it should during the time between each beat
Right Sided Heart Failure
- Typically caused by left sided heart failure Left side of heart fails and cannot pump enough blood out
- Increased fluid pressure pushed back through lungs and damages the right side of heart
- Blood backs up in veins
Signs and Symptoms
What to watch for
Call Your Doctor Immediately If You Have:
- Sudden severe shortness of breath
- Chest pain
- Rapid weight gain (2-3 lbs in 1 day)
- Fainting or near-fainting
- Severe swelling in legs or abdomen
- Persistent cough with pink/white foam
- Rapid or irregular heartbeat
- Confusion or difficulty thinking
Breathing Problems
- Shortness of breath during activity
- Trouble breathing when lying flat
- Waking up short of breath
- Persistent cough
Fluid Retention
- Swelling in feet, ankles, legs
- Rapid weight gain
- Abdominal swelling
- Decreased urination
Other Symptoms
- Fatigue and weakness
- Dizziness
- Loss of appetite
- Difficulty concentrating
Treatment
How heart failure is managed
Lifestyle Changes
Small but consistent changes to daily habits to protect your heart and stay healthier long-term.
- Low-sodium diet (less than 2000mg/day)
- Fluid restriction if recommended
- Regular, gentle exercise
- Quit smoking
- Limit alcohol
- Weight monitoring
Medications
- ACE inhibitors and Angiotensin Receptor Blockers (ARBs): Lower blood pressure and reduce heart's workload
- Angiotensin Receptor Neprilysin Inhibitor (ARNI): replaces ACE/ARB, improves artery opening and blood flow, reduces sodium retention, decreases strain on the heart
- Beta-blockers: Slow heart rate, reduce workload
- Aldosterone antagonists: Diuretic that reduces blood pressure and improves heart function
- Sodium glucose cotransporter-2 inhibitors (SGLT2): help control blood sugar, first used in diabetics but also help with improving cardiac function and helping with HF symptoms
- Digoxin: Helps to reduce fast heart rate, helps with heart's ability to contract
- Diuretics: Remove excess fluid ("water pills")
Advanced Treatments
- Pacemakers or defibrillators
- Cardiac resynchronization therapy
- Heart valve repair/replacement
- Ventricular assist devices
- Heart transplant (severe cases)
Self-Management
Taking care of yourself at home
Daily Weight Monitoring
- Document your weight daily
- Weigh yourself every morning
- Use the same scale, same time of day, and same amount of clothing
- Weigh after using bathroom, before eating
- Call doctor if you gain 2-3 lbs in 1 day or 5 lbs in 1 week
Medication Management
- Take medications exactly as prescribed
- Don't skip doses
- Use a pill organizer
- Know why you are taking each medication and what it does
- Talk to your doctor and get approval before stopping any medication
Activity Guidelines
- Stay as active as possible
- Start slowly and build up
- Stop if you feel short of breath
- Balance activity with rest
- Ask about cardiac rehabilitation
Living with Heart Failure
Long-term outlook and quality of life
Good News
- Many people live well with heart failure
- Treatments have improved greatly
- Symptoms can be well-controlled
- You can still enjoy activities you love
- Early treatment prevents worsening
Keys to Success
- Follow your treatment plan
- Keep all doctor appointments
- Monitor your symptoms
- Stay connected with family and friends
- Join a heart failure support group
- Learn about your condition
- Don't wait until next medical appointment to ask any questions or mention a concern or symptom
When to Call Your Doctor
- Worsening shortness of breath
- Rapid weight gain
- Increased swelling
- New or worsening symptoms
- Side effects from medications
- Questions about your care