Congestive Heart Failure

What is Congestive Heart Failure?

Congestive heart failure is a condition in which the heart’s function as a pump is inadequate to deliver oxygen rich blood to the body. Congestive heart failure can be caused by:

  1. Diseases that weaken the heart muscle,
  2. Disease that cause stiffening of the heart muscle, or
  3. Diseases that increase oxygen demand by the body tissue beyond the capability of the heart to deliver adequate oxygen-rich blood. 

What are some of the Symptoms of Congestive Heart Failure?

The symptoms of congestive heart failure vary among individuals according to the particular organ systems involved and depending on the degree to which the rest of the body has compensated for the heart muscle weakness. In general, symptoms of congestive heart failure include:

The symptoms of congestive heart failure vary among individuals according to the particular organ systems involved and depending on the degree to which the rest of the body has compensated for the heart muscle weakness. In general, symptoms of congestive heart failure include:

  • Shortness of breath, especially when you exert yourself or when you lie down
  • Fatigue and weakness
  • Swelling in your legs, ankle, and feet
  • Rapid or irregular heartbeat
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood-tinged phlegm
  • Sudden weight gain from fluid retention
  • Swelling of your abdomen (ascites)
  • Lack of appetite and nausea
  • Difficulty concentrating or decreased alertness
  • Chest Pain

What are some of the Causes of Heart Failure?

Many disease processes can impair the pumping efficiency of the heart to cause congestive heart failure. The most common causes of congestive heart failure are:

  • Coronary Artery Disease
  • High Blood Pressure
  • Faulty heart valves
  • Damage to the heart muscle
  • Myocarditis
  • Congenital Heart Defect
  • Abnormal heart rhythms (heart arrhythmias)
  • Diabetes
  • Severe anemia
  • Hyperthyroidism/Hypothyroidism
  • Emphysema
  • Lupus
  • Hemachromatosis and amyloidosis
  • Alcohol

What are Tests Commonly Used to Diagnose Congestive Heart Failure?

  • Blood tests
  • Chest X-ray 
  • Electrocardiogram (ECG). 
  • Echocardiogram
  • Stress test
  • Cardiac computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Coronary catheterization (angiogram)

What are Treatment Options for Congestive Heart Failure?

Heart failure is a chronic disease needing lifelong management. However, with treatment, signs and symptoms of heart failure can improve and the heart sometimes becomes stronger. Doctors sometimes can correct heart failure by treating the underlying cause. For example, repairing a heart valve or controlling a fast heart rhythm may reverse heart failure. But for most people, the treatment of heart failure involves a balance of the right medications, and in some cases, devices that help the heart beat and contract properly.


Doctors usually treat heart failure with a combination of medications. Depending on your symptoms, you might take one or more of these drugs. They include:

  • Angiotensin-converting enzyme inhibitors
  • Angiotensin II receptor blockers
  • Digoxin
  • Beta blockers
  • Diuretics
  • Aldosterone antagonists

You’ll probably need to take two or more medications to treat heart failure. Your doctor may prescribe other heart medications as well — such as nitrates for chest pain, a statin to lower cholesterol or blood-thinning medications to help prevent blood clots — along with heart failure medications.

You may be hospitalized for a few days if you have a flare-up of heart failure symptoms. While in the hospital, you may receive additional medications to help your heart pump better and relieve your symptoms. You may also receive supplemental oxygen through a mask or small tubes placed in your nose. If you have severe heart failure, you may need to use supplemental oxygen long term.

Surgery and Medical Devices

In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Some treatments being studied and used in certain people include:

  • Coronary bypass surgery. If severely blocked arteries are contributing to your heart failure, your doctor may recommend coronary artery bypass surgery. In this procedure, a vein from your leg, arm or chest replaces a blocked vein in your heart to allow blood to flow through your heart more freely.
  • Heart valve repair or replacement. If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing the valve. The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons also can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes
  • Implantable cardioverter-defibrillators (ICDs). An ICD is a device implanted under the skin and attached through the veins in your chest to your heart with small wires. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to shock it back into normal rhythm.
  • Cardiac resynchronization therapy (CRT) or biventricular pacing. A biventricular pacemaker sends timed electrical impulses to both of the heart’s lower chambers (the left and right ventricles), so that they pump in a more efficient, coordinated manner. As many as half the people with heart failure have problems with their heart’s electrical system that cause their already-weak heart muscle to beat in an uncoordinated fashion. This inefficient muscle contraction may cause heart failure to worsen. Often a biventricular pacemaker is combined with an ICD for people with heart failure.
  • Heart pumps (left ventricular assist devices, or LVADs). These mechanical devices are implanted into the abdomen or chest and attached to a weakened heart to help it pump. Doctors first used heart pumps to help keep heart transplant candidates alive while they waited for a donor heart. 
LVADs are now sometimes used as an alternative to transplantation. Implanted heart pumps can significantly extend and improve the lives of some people with severe heart failure who aren’t eligible for or able to undergo heart transplantation or are waiting for a new heart
  • Heart transplant.  Some people have such severe heart failure that surgery or medications don’t help. They may need to have their diseased heart replaced with a healthy donor heart. Heart transplants can dramatically improve the survival and quality of life of some people with severe heart failure. However, candidates for transplantation often have to wait months or years before a suitable donor heart is found. Some transplant candidates improve during this waiting period through drug treatment or device therapy and can be removed from the transplant waiting list.