Congestive Heart Failure: Symptoms, Causes, Treatment

in Heart Health

In the United States, a person dies from heart disease every 37 seconds. This sobering fact, provided by the Centers for Disease Control and Prevention (CDC), is just one of many statistics that point to heart disease as the leading cause of death among Americans, regardless of demographics. In fact, nearly 650,000 people die each year from cardiovascular diseases that are largely preventable. Moreover, the cost of heart disease, in terms of healthcare costs and lost productivity, is estimated at a staggering $219 billion each year. 

February is American Heart Month, a federally designated event that aims to bring Americans together in an effort to raise awareness of heart-related diseases and urge others to make heart-healthy life choices. By understanding the risk factors and causes of conditions like congestive heart failure, one of the most prevalent heart problems in the country, the hope is that more and more people take preventative measures like heart screenings

What is Congestive Heart Failure? 

Congestive heart failure (CHF), also known as congestive cardiac failure, is a condition characterized by the heart being unable to maintain sufficient blood flow to maintain the body’s needs. Heart failure is typically caused by an underlying condition that damages or weakens one or more parts of the cardiovascular system. Not to be confused with singular cardiac “events” like a heart attack, heart failure is a chronic condition that a person can potentially live with for several years. 

The terms “heart failure” and “congestive heart failure” are sometimes used interchangeably, but there is a notable difference. Heart failure refers to the general inability of the heart to pump sufficient blood; when this starts to happen, the body may attempt to compensate by having the heart beat faster, thereby raising the blood pressure. The increased blood pressure can cause the body to retain water and salt; when this excess fluid builds up around the heart muscle, it is called congestive heart failure. 

It is estimated that over six million adults suffer from heart failure in the United States, and it leads to approximately 1 out of every 8 deaths each year. While heart failure can happen to anyone of any gender in any age or ethnic group, it is slightly more prevalent among patients over the age of 65. Overall, heart failure is the cause of over 11 million visits to a doctor or hospital each year, and more than 50% of patients who are hospitalized are readmitted within six months. Sadly, more than half of those who have heart failure die within five years of being diagnosed.      

Types of Congestive Heart Failure

The classification of congestive heart failure is usually understood in terms of the area of the heart that is affected. The heart is divided into four chambers, and those four chambers are further divided between the right side and left side of the heart. The right atrium receives deoxygenated blood from around the body and passes it to the right ventricle; the right ventricle then pumps the blood to the lungs, which is called pulmonary circulation. The left atrium then receives oxygen-rich blood from the lungs and passes it to the left ventricle; the left ventricle then pumps the blood to the rest of the body through arteries, which is called systemic circulation. 

In a person diagnosed with heart failure, it is in the two ventricles (right and left) where the problem can happen. There are three main types of heart failure: 

  • Left-sided heart failure: This is the most common type, and it is defined by the left ventricle being unable to pump enough blood through the arteries to various body systems. This typically means that blood builds up in the veins that lead from the lungs back to the left atrium. 
  • Right-sided heart failure: In these cases it is the right ventricle that is too weak to pump enough blood. When this happens, the blood that should flow easily into the lungs builds up in the veins leading to the heart; this buildup leads to increased pressure that can cause blood leach out of the veins into the surrounding tissue. 
  • Biventricular heart failure: As the name implies, this is when both ventricles are unable to pump normally, and the result is usually a combination of both types of fluid buildup. 

Along with left-sided heart failure being the most common, it is also further categorized based on the nature of how the heart muscle relaxes and contracts while pumping. This is measured by ejection fraction, which is the amount of blood, as a percentage, that is pumped out after each contraction. There are two subtypes of left-sided heart failure related to compromised ejection fraction: 

  • Reduced ejection fraction (HFrEF): Also known as systolic failure, this type happens when the left ventricle isn’t able to contract sufficiently and thus it doesn’t have enough power to pump blood out. 
  • Preserved ejection fraction (HFpEF): Also known as diastolic failure, this happens when the left ventricle can’t relax normally. In this case, the left ventricle can’t fill properly between pumps, and thus less blood is pumped into circulation. 

What are the Causes of Congestive Heart Failure?

There are a wide variety of diseases and conditions that can weaken or damage the heart enough to cause heart failure. A few are congenital (you are born with them), but the vast majority are conditions that are very preventable:  

  • Coronary artery disease: buildup of plaque in the arteries
  • Cardiomyopathy: damage to the heart muscle
  • High blood pressure
  • Myocarditis: inflammation of the heart muscle 
  • Congenital heart defects
  • Arrhythmia: abnormal heart rhythm 
  • A faulty heart valve
  • Hyperthyroidism 

Coronary artery disease is the most common underlying cause of heart failure, due to the buildup of plaque (mostly fatty deposits and other cellular debris) that happens in the arteries. The buildup leads to narrowed arteries and an increase in blood pressure as the heart works harder to pump blood. Over time, the increased work the heart has to do can cause it to be weakened or damaged and ultimately create the conditions for heart failure. 

Heart Failure Symptoms

The symptoms of heart failure can vary depending on severity or the area of the heart where the failure is occuring. The following are the most common symptoms: 

  • Shortness of breath (particularly in left-sided heart failure)
  • Swelling in the legs or feet (particularly in right-sided heart failure)
  • Fatigue or weakness
  • Irregular heart rate
  • Persistent cough 
  • Wheezing
  • Lack of appetite
  • Nausea
  • Chest pain
  • Fluid retention and subsequent rapid weight gain 

Risk Factors

Besides coronary artery disease, the most common conditions that can lead to heart failure are a previous heart attack or high blood pressure. But the risk factors for heart failure are also correlated to many of the risk factors for heart disease in general:

  • Obesity 
  • Diabetes
  • Tobacco use 
  • Alcohol use 
  • Lack of physical activity
  • Unhealthy diet

The good news is that (with the exception of genetics being a factor in some cases of diabetes) all of these risk factors can be mitigated with proper nutrition and exercise. The American Heart Association has provided a series of helpful diet and exercise guidelines that can help anyone live a healthy life that will ensure heart disease is virtually a non-threat. 

Treatment Options

With any form of heart disease, prevention is the best treatment. But for patients who already have congestive heart failure, doctors have a variety of treatment options available, depending on the severity of the case. In general, treatment is focused on preventing the progression of the condition as well as improving the symptoms. With appropriate treatment and lifestyle changes, the heart can actually regain some of its strength and life expectancy can increase. 

There are also some medications, such as ACE inhibitors or beta blockers, that can regulate blood pressure or even widen blood vessels. In more advanced cases, doctors may turn to surgery. In cases of extreme plaque buildup, bypass surgery might be needed to circumvent major blockages. There are also implants, like an implantable cardioverter-defibrillator (ICD) or ventricular assist device (VAD), that can help regulate heartbeat or the actual pumping action. 

Schedule a Heart Screening

Congestive heart failure is too common in the United States, but it can be prevented through a healthy diet, sufficient exercise, and overall healthy living. But even if you already have a weakened or damaged heart for any reason, the sooner it is discovered, the better. 

One of the easiest ways to get insight (and peace of mind) into your heart health is to get a heart screening from a qualified healthcare provider. The TrustCare Heart Clinic has heart screenings starting at $25; learn more about your options and make an appointment today.

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