- Symptoms & Signs
In general, about half of all people diagnosed with congestive heart failure will survive 5 years. About 30% will survive for 10 years.
In patients who receive a heart transplant, about 21% of patients are alive 20 years later.
What Is Congestive Heart Failure?
Heart failure is a condition in which the heart does not pump enough blood and oxygen to the organs and tissues of the body. As a result, the organs in the body do not get the blood they need and fluids back up in the body.
Heart failure does not mean the heart has stopped beating; it simply means the heart has failed to work as it should.
What Are Symptoms of Congestive Heart Failure?
Early on, patients with heart failure may have no symptoms. As the condition progresses and worsens, symptoms may include the following:
- Trouble breathing/shortness of breath
- This may lead to decreased activity
- Difficulty breathing when lying down, which may cause people to need pillows to prop them up at night to sleep
- Fast heartbeat, even at rest
- Swelling in the feet, ankles, and legs
- Swelling in the abdomen
- Weight gain
What Causes Congestive Heart Failure?
Heart failure may be caused by other conditions that weaken the heart, such as...
- Coronary artery disease, the most common type of heart disease
- Congenital heart disease
- Faulty heart valves
- High blood pressure (hypertension)
- Inflammation or damage to the heart muscle (myocarditis)
Some medical conditions can increase the risk of developing heart failure, such as...
An unhealthy lifestyle and behaviors can also increase the risk of developing heart failure, especially in people with the medical conditions listed above. Behaviors that can contribute to developing heart failure include the following:
How Do Doctors Diagnose Congestive Heart Failure?
Heart failure is diagnosed with a physical exam and tests that may include:
- Electrocardiogram (ECG) to measure the electrical activity in the heart
- Brain natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) blood tests
- BNP or NT-proBNP level is high in people with heart failure
- Chest X-ray to check for fluid in the lungs and to see the general shape of the heart and large blood vessels in the chest
- Echocardiogram (“echo”) uses sound waves to create a picture of the heart as it beats and can show how well the heart is pumping, and how well the heart valves are working
- Stress test to see if the heart gets enough blood when under stress
- Patients may run or walk on a treadmill with ECG or other heart tests
- Medicine to stress the heart may be administered for patients unable to walk or run
- Cardiac catheterization (“cardiac cath”) involves a thin tube inserted into a blood vessel in the leg or arm that is threaded up to the heart to take measurements. This can show if any arteries in the heart are narrowed or blocked (coronary angiography).
What Is the Treatment for Congestive Heart Failure?
Treatment for heart failure usually includes lifestyle modifications and medications to control the condition. In severe cases, surgery may be indicated.
Medications used to treat heart failure include the following:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (also called ARBs or angiotensin-2 receptor antagonists)
- Angiotensin-receptor neprilysin inhibitors (ARNIs)
- If channel blockers
- Beta-blockers (also called beta-adrenergic blocking agents)
- Aldosterone antagonists
- Hydralazine and isosorbide dinitrate (specifically of benefit for African-Americans with heart failure)
- Diuretics (water pills)
- Other medications might be prescribed depending on a patient’s other health problems, such as:
The following lifestyle modifications treat and manage heart failure:
- Not smoking
- Losing weight if you are overweight
- Limiting fluid intake if recommended
- Limiting or avoiding alcohol
- Limiting or avoiding caffeine
- Consuming a heart-healthy diet
- Exercising regularly
- Practicing stress reduction techniques such as deep breathing, yoga, and meditation
- Tracking symptoms and reporting them to your doctor
- Keeping blood pressure in check
- Getting adequate sleep
- Joining a support group
- Getting vaccinated for flu and pneumonia
Implantable devices used to treat heart failure include...
- Implantable cardioverter defibrillator (ICD)
- Cardiac resynchronization therapy (CRT)
- Left ventricular assist device (LVAD)
Surgery used to treat heart failure includes...
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Healthy Heart Resources
"Heart Failure Risk Calculator." <http://www.heartfailurerisk.org/>.
"Treatment Options for Heart Failure." American Heart Association. Apr. 30, 2017. <https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure>.
United States. Centers for Disease Control and Prevention. "Heart Failure." Sept. 8, 2020. <https://www.cdc.gov/heartdisease/heart_failure.htm>.