What is congestive heart failure?

Nearly 5 million Americans are living with congestive heart failure, according to the American College of Cardiology, and the American Heart Association estimates 670,000 people are diagnosed with a type of heart failure -- left-sided heart failure, right-sided heart failure or coronary heart failure -- every year. Congestive heart failure (CHF) is a debilitating and progressive condition where the heart is failing -- unable to get enough blood to the body's organs.

As we probably remember from basic anatomy class, the heart muscle is a pump. The right side pumps blood from the veins into the lungs; the left side pumps blood from the lungs through the arteries to the body. Simply, when blood is pumped out the heart contracts and hen the heart relaxes blood flows in. When the heart pumps too slowly it causes blood to back up in the body's veins -- think of it like a traffic jam. The backup causes congestion, in the body's tissues instead of in the HOV lane.


Several conditions can lead to CHF, but at its root it's a weakened heart muscle. One of the most common symptoms of CHF is edema (swelling) in the ankles and legs, although sometimes fluid can build up in the lungs leading to shortness of breath and breathing problems even while in a resting state. Left untreated, CHF can adversely affect multiple vital organs, from kidneys to lungs to the liver and even the brain. In a study published in the February 2009 issue of Journal of Cardiac Failure, it was found that nearly half (47 percent) of patients living with heart failure have problems with memory (most commonly short-term memory) and cognitive functioning.

Researchers from the University of Michigan Health System and the Veteran's Affairs Ann Arbor Healthcare System found that people living with CHF were also likely to have difficulty carrying out daily activities. In a study published in the January 2008 issue of Journal of General Internal Medicine about 42 percent of CHF patients reported trouble walking across the room, and more than 35 percent had difficulty grocery shopping.

"The prevalence of congestive heart failure imposes a substantial burden on patients, families and the long-term care system," stated Tanya Gure, M.D., the study's lead author and a lecturer in the Division of Geriatric Medicine at the University of Michigan Health System, in a press release. "The degree of disability in this group is quite high, and their caregiving needs are extensive."

Because there is no cure, preventing heart failure is key, doctors say. It's important to get timely medical care when symptoms of heart failure arise, but it's equally important to work with a physician to avoid the condition altogether.


Heart Failure & LifeStyle Changes

If you have CHF, changes in lifestyle are important. Quit smoking, limit alcoholic beverage consumption (men should drink no more than 2 alcoholic drinks per day, women no more than 1), and aim for a BMI (body mass index) of less than 30. Increasing your activity level is key, too. The American Heart Association recommends every adult exercise for at 30 minutes every day.

Diagnosing heart failure in patients requires a thorough evaluation including:


  • The patient's medical and family history
  • A physical examination
  • Assessment of the patient's cardiac structure and function
  • Evaluation of any arrhythmias (irregular heartbeat), coronary disease and myocardial ischemia (a condition that happens when the blood flow to the heart muscle is partially or completely blocked)

A visit to the physician will also help identify any physical conditions or genetic factors that may increase a patient's risk, such as a prior heart attack or stroke, uncontrolled hypertension, diabetes, congenital defects, valvular heart disease from rheumatic fever, heart valve diseases (such as an infection or calcium buildup in the lining of the heart valves) or cardiomyopathy (a deterioration of the heart muscle).

Some patients, however, are asymptomatic.

There is no cure for CHF. The goal of treatment is to minimize symptoms and slow the disease's progression. Doctors often prescribe lifestyle changes along with medications (diuretics and vasodilator therapies) to prevent cardiac failure as long as possible. As CHF also impairs kidney function, causing the body to retain sodium and water, dietary sodium restrictions are important. An analysis published in the January 21, 2010, New England Journal of Medicine suggests that if we all reduce our daily salt intake by 3-grams (a half a teaspoon) we would reduce annual diagnoses of heart disease and stroke by roughly one-third. Vasodilator medications such as ACE (angiotensin-converting enzyme) inhibitors and beta blockers are most often used in patients who are at high risk.

What puts you at high risk? Coronary heart disease, peripheral vascular disease, stroke or diabetes.