What is congestive heart failure?

Congestive heart failure (CHF) or heart failure is when your heart does not pump as strongly as it should so your body does not get the right amount of blood and oxygen it needs to work properly. This weakened pumping action can cause a backup of fluid in your lungs and other parts of your body. Excessive fluid in your lungs can cause a life-threatening condition called acute pulmonary edema, which requires emergency treatment.

Congestive heart failure has many causes:

  • Poor blood flow to the heart over a long period of time, which may cause chest pain (angina)
  • Heart muscle damage from a previous heart attack
  • Long-standing high blood pressure
  • A faulty heart valve
  • An infection causing inflammation of the heart muscle
  • Excessive use of alcohol or drugs
  • Diabetes
  • An unknown disease of the heart muscle

Diagnosis
Treatment

Symptoms

When the heart doesnt pump well and congestion happens, you may experience:
  • Shortness of breath
  • Swollen ankles and legs
  • Sudden weight gain
  • Tiredness or loss of energy
  • Loss or change in appetite
  • Fluid buildup in the lungs, causing a nighttime cough

Certain factors may cause these symptoms to worsen, such as eating high-salt foods, drinking excessive fluids, taking medications that cause salt and water to be retained or having fast heart rhythms, a cold or the flu.

When should I call my doctor?
Contact your doctor if you experience any of the following:
  • Increased shortness of breath
  • Weight gain of more than 2 pounds (1 Kg) over 2 days, or 5 pounds (3 Kg) in a single week
  • Nausea or vomiting
  • Bloating or feeling full all the time
  • Cough or cold symptoms that last for two weeks or more
  • Extreme tiredness
  • Increased swelling of the feet or legs
  • Increased urination at night.

How is congestive heart failure diagnosed?

There is no specific test to determine if you have heart failure. Your doctor will likely do a thorough medical history and physical examination and may also want to do a few other tests including:

Blood tests
Echocardiogram
Electrocardiogram (ECG/EKG)
Exercise electrocardiogram
Chest X-ray
Thallium or cardiolite scan (nuclear medicine)

Treatment

You can manage your congestive heart failure by working with your healthcare team and taking your medications. Your doctor may also recommend surgery.

Medications
Some medications commonly used to treat CHF include:

ACE inhibitors
Beta blockers
Digoxin
Diuretics
Aldosterone antagonists reduce the stress on your heart and also have a weak diuretic effect.

Surgery
Sometimes, lifestyle changes and medications may not be enough to control your symptoms. If you have severe heart failure, you may need surgery.

Cardiomyoplasty
Coronary artery bypass surgery
Heart pump is a special device placed inside the body to take over the hearts pumping action usually until a donor heart becomes available for transplant.
Heart transplant
Implantable pacemaker

Lifestyle
You can lower your risk of heart disease by knowing and controlling your blood pressure, diabetes and blood cholesterol. It is also important to lead a healthy lifestyle by being smoke-free and physically active, eating a healthy diet that is lower in fat, especially saturated and trans fat, achieving and maintaining a healthy weight, limiting alcohol use and reducing your stress.

For more information, please see Managing Congestive Heart Failure under Other Resources

Last reviewed April 2007.