What Is Congestive Heart Failure?
Congestive heart failure (CHF) is a chronic and progressive disease that affects more than 26 million people worldwide. The condition is increasing in prevalence, with current statistics showing that 20 percent of all people will develop CHF at some point during their lifetime.
CHF is a complex diagnosis because the wording of the condition is misleading for many people.
Some individuals believe that heart failure means that their heart is stopping. Instead, the heart muscle has weakened so that it has difficulty pumping the full amount of blood to the lungs and the rest of the body.
The heart tries to overcome its weakened condition by increasing in size and stretching to pump with greater force and beats faster to transport more blood to organs and tissues. Over time, these changes continue to weaken contractile ability.
Congestive heart failure can happen at any time of life but tends to occur as we age.
The Different Types of Congestive Heart Failure
CHF falls into two separate categories: left-sided heart failure, and right-sided heart failure.
Left-sided heart failure affects the left ventricle’s ability to push enough blood out to the body to provide oxygen necessary for normal functioning of organs and tissues.
Left-sided heart failure can have a reduced or a preserved ejection fraction, which is the percentage of blood that the left ventricle empties out to the rest of the body with each beat.
Right-sided heart failure compromises the right ventricle’s capacity to feed blood to the lungs after it has returned from having the oxygen extracted for energy in other areas of the body.
Right-sided heart failure often happens because of left-sided heart failure. Individuals with heart failure in both the left and right ventricle have biventricular heart failure.
The New York Heart Association (NYHA) has established four distinct levels of heart failure based on severity, which are:
- Class I: Individuals with no physical activity impairment.
- Class II: Individuals with mild physical activity impairment who experience dyspnea, fatigue, angina pain, or palpitations with increased exertion. No symptoms are present at rest.
- Class III: Individuals with significant physical activity impairment who experience dyspnea, fatigue, annual pain, or palpitations with basic low-level exertion.
- Class IV: Individuals that are experiencing symptoms of heart failure at rest that increase during any physical activity.
What Causes Heart Failure?
Many various conditions lead to developing CHF. The primary contributing factors are ailments such as:
- Alcohol abuse
- Cardiomyopathy
- Congenital heart defects
- Coronary artery disease
- Heart arrhythmias like atrial fibrillation
- Heart valve problems
- History of myocarditis
- Hypertension
- Kidney disease
- Long-term use of medications such as nonsteroidal anti-inflammatory’s, steroids, certain medicines used for treating type II diabetes, and some calcium channel blockers
- Previous heart attack
- Other types of heart disease
- Idiopathic (unknown) causes
Although they don’t cause congestive heart failure, problems like obesity, thyroid disease, diabetes, allergic reactions, and severe infections can contribute to the onset of CHF.
The Signs and Symptoms of Congestive Heart Failure
The symptoms of congestive heart failure vary from person-to-person and often depend on the stage of the disease. Some individuals have few if any warning signs when diagnosed and tend to experience more as the disease progresses.
Hallmark symptoms of the beginnings or worsening of CHF are:
- Chest pain
- Chronic coughing
- Confusion or impaired thinking
- Exercise limitations
- Fainting
- Fatigue
- Fast or regular heart rate
- Increased urination
- Nausea or lack of appetite
- Rapid, unexplained weight gain
- Swelling in the feet, ankles, legs, or abdomen
- Unusual shortness of breath
- Unusual weakness
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If any of these symptoms occur, you need to seek medical attention at your earliest opportunity. Some of the symptoms are more critical than others, but you and your healthcare team should always track each occurrence.
Diagnosis and Treatment of Congestive Heart Failure
If your warning signs lead your physician to suspect CHF, he or she will use several methods to confirm the presence of your condition.
The process often starts with a review of your past medical history paired with a physical examination. Once these are complete, your doctor will schedule the tests most appropriate for confirming the disease.
Typical tests for evaluating the presence of congestive heart failure include:
- Blood tests
- Cardiac catheterization
- Chest x-ray
- EKG
- Echocardiogram
- Exercise stress test
- MRI
- Multiple Gated Acquisition Studies (MUGA)
Once your tests are complete, your physician will develop a treatment plan tailored to your type of CHF, considering your other existing medical problems. Your individualized blueprint will cover the following areas:
- Lifestyle modifications including exercise and nutrition guidelines and smoking cessation information. Obtaining a physician’s order to enroll in outpatient cardiac rehab program will help you receive the instruction and support from specialized clinicians to make these changes in a safe and supervised environment.
- Medications including ace inhibitors, beta-blockers, calcium channel blockers, digitalis, diuretics, and vasodilators, which are all prescriptions often used to treat heart failure that will help manage your symptoms. Your physician will prescribe those that are right for you.
- Implanted devices such as an AICD (Automated Implantable Cardiac Defibrillator) or biventricular pacemaker can help improve your heart’s pumping ability and are available options if your classification of CHF warrants it.
- If heart transplant is a consideration, your physician will schedule a consult at a transplant center.
If you have CHF, you need to understand the causes, types, symptoms, and treatment options so you can work with your healthcare providers to best manage the disease.
Standard treatment guidelines for CHF are always updated, with innovations and breakthroughs in care happening on a frequent basis.
Many people with CHF have long and enjoyable lives. Learning about CHF and implementing proven care strategies will help you achieve the best possible quality of life.
