Learn About Congestive Heart Failure

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Heart Health

Congestive heart failure is the term used when an area of the heart stops contracting, or pumping blood efficiently.

The heart is made up of fours chambers: two atria (right and left) and two ventricles (right and left). Most commonly, congestive heart failure is the result of left sided heart failure.

When any chamber of the heart is damaged, or not operating at full capacity, a decreased volume of blood is forced from the heart during each contraction. Blood returns to the heart after it circulates in the body and, simply stated, it all backs up. The result is an accumulation of fluid, or congestion in the lungs and body tissues, causing edema or swelling. Congestive heart failure decreases physical endurance, makes breathing more difficult and interferes with quality of life.
Symptoms of Congestive Heart Failure.

What are the symptoms?

Symptoms include unexplained weight gain from accumulation of fluid anywhere in the body. Swelling in the legs and ankles is very characteristic. Abdominal swelling and lung congestion, accompanied by shortness of breath, are also warning signs of congestive heart failure. Kidney failure is closely associated with congestive heart failure. When fluid accumulates to excess in the body, the kidneys can no longer keep up with eliminating sodium and water from the body.


A physician's diagnosis of congestive heart failure is necessary. Your doctor will perform an exam, blood tests, chest X-ray and special heart tests such as echocardiogram, nuclear stress tests and EKG. Cardiac catheterization can measure pressures in the heart chambers, sometimes performed to determine the exact cause of congestive heart failure.

Causes of Congestive Heart Failure

Long standing high blood pressure can cause the ventricle of the heart to become enlarged, just as any muscle does when it works hard. The result causes stiffness of the heart chamber, and inefficiency in the pumping activity which leads to congestive heart failure.

Heart failure can ensue from heart damage, following a heart attack, seen more commonly in women than men. It is possible to develop congestive heart failure if you have a serious heart murmur--an indication that the heart valves are not closing, or otherwise operating properly. Incomplete closure of the heart valves allows a backflow of blood into the heart chambers. An echocardiogram can establish the nature and severity of any heart murmur that might contribute to congestive heart failure.

Problems with the electrical signals in the heart are also a known cause of congestive heart failure. When the electrical impulses that make the heart contract and relax follow or originate other than in the upper heart chamber, the heart can beat irregularly, causing ineffective pumping and congestive heart failure.


Newer evidence shows heart failure can also develop from too much sugar and carbohydrate that damages the heart muscle.

Heart failure prevention

After a heart attack, it's important to follow your doctor's advice regarding medications that are prescribed, diet and exercise.

Medications prescribed after heart attack are designed to reduce the workload of the heart, preventing "overstretching" of the heart muscle as it tries to repair itself. If you think of the heart like a rubber band, you can imagine the benefits of following your medical regimen to prevent the heart from become "overstretched"--damaged heat muscle doesn't move. As the heart contracts, it stretches to compensate for the area that is no longer functioning. Over time, it wears out and loses its resiliency, leading to congestive heart failure. The medicines your doctor gives you can be seen as very important once you really understand how they work.

Diet, exercise, blood pressure control and cholesterol management are all preventive strategies for decreasing your risk of congestive heart failure.


Medications such as ACE inhibitors, calcium channel blockers, beta blockers, digitalis, diuretics, fish oil and co-enzyme Q10 are effective treatments for congestive heart failure. It is also important to follow a low-salt diet. Exercise is shown to increase life-span for anyone suffering from congestive heart failure.

Treatment of heart valve disorders may require surgery. If coronary artery disease is present, coronary artery bypass surgery may be needed. Other surgical intervention includes a procedure known as a myectomy (removal of overgrown heart muscles) to treat congestive heart failure.

Implanted devices, known as ventricular assist devices (VAD), can help the heart pump more efficiently. Your doctor will tell you if you are a candidate. Cardiac pacemakers can stabilize abnormal heart rhythms that cause congestive heart failure. Implanted cardiac defibrillators do not treat congestive heart failure, but can be used to prevent sudden death from heart rhythm disturbance.

Written by Kathleen Blanchard RN
Updated 6/16/2013

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