Congestive heart failure (CHF) is a serious, chronic condition in which there is a deficiency in the heart’s ability to pump oxygen-rich blood. Left-ventricle (left side) heart failure occurs when the heart’s left ventricle cannot pump blood efficiently from the heart to the rest of the body. As the flow of blood is slowed, blood becomes backed-up in the veins returning to the heart, often leading to congestion in the lungs. Right-ventricle (right side) heart failure occurs when the heart’s right ventricle is not pumping blood efficiently. This usually results after left-ventricle heart failure. Right-ventricle heart failure causes swelling in the veins and in the legs and ankles.
CHF usually occurs from a weakening of the heart over a long period of time. This may be due to a number of conditions, including:
- Coronary artery disease
- History of myocardial infarction (heart attack)
- Hypertension (high blood pressure)
- Diabetes
- Cardiomyopathy (disease of the heart muscle)
- Valvular heart disease
- Congenital heart disease
- Endocarditis or myocarditis (inflammation of the heart muscle)
- Arrhythmia or dysrhythmia (abnormal heart rhythms)
- Lung disease
- Hyperthyroidism (overactive thyroid gland)
- Severe anemia
The first symptoms of CHF typically include fatigue, dyspnea (shortness of breath), or wheezing. Other noticeable symptoms include heart palpitations, swollen ankles and legs, and weight gain due to fluid build-up.
CHF is often diagnosed by physical exam with careful attention to the heartbeat, blood pressure measurements, weight and medical history. Other diagnostic modalities that may be used include blood tests, echocardiogram, electrocardiogram, stress test, chest x-ray, nuclear medicine imaging and coronary angiography.
The prognosis of CHF depends on several factors, including age at diagnosis, the severity of CHF and the patient’s overall health. Lifestyle changes (including changes to diet, lowering cholesterol and blood pressure levels, etc.) and medications can sometimes be effective for patients with mild CHF. However, the heart often tries to compensate for its pumping inefficiency by enlarging to pump more blood, developing more muscle mass, pumping blood at a faster rate, etc. In the long term, these corrective attempts can cause considerable damage to the heart.
In some cases, surgery may be necessary to correct problems that are causing CHF, such as coronary artery disease (CAD) or a defective heart valve. Specific treatments for thyroid disease, anemia or other conditions that are contributing to CHF may also benefit patients. However, most patients with CHF must learn to live with the condition by making diet and lifestyle changes and taking medication.
Updated: February 2011
