In the amount of time that it takes you to read this article, a healthy adult heart will circulate a person’s entire supply of blood through their body 30 times. The right side of your heart continuously receives blood from your body and sends it to your lungs in order to expel carbon dioxide and pick up oxygen. The oxygen-rich blood then flows from your lungs to the left side of your heart. From there, your heart pumps oxygenated blood throughout your body. Your body’s muscles, organs, and tissues use oxygen from the blood and replace it with carbon dioxide. The blood then returns back to the right side of your heart, and the cycle repeats.
What is Congestive Heart Failure?
When your heart fails to pump blood as it should, we call the condition “heart failure.” Heart failure is different from cardiac arrest or a heart attack. Cardiac arrest is an electrical problem with your heart muscle that causes your heart to stop beating altogether. A heart attack occurs when the flow of blood to your heart muscle is blocked, causing permanent damage to your heart muscle. With heart failure, your heart continues to beat and pump blood; however, it is not able to pump the amount of blood that your body needs.
There are two types of heart failure: left-side heart failure and right-side heart failure. Left-side heart failure occurs when the lower left chamber of your heart is not able to contract with enough force to pump enough blood out to your body. Left-side heart failure also occurs when that lower left ventricle is not able to relax enough to receive enough blood from your lungs to pump out to your body.
Right-side heart failure usually occurs as a result of left-sided heart failure. As the left side of your heart fails, back pressure builds up in your veins and small blood vessels called capillaries. This pressure damages the right side’s ability to receive blood from your body and pump it to your lungs. Many people with heart failure have both left-side and right-side heart failure.
When heart failure progresses, blood moves more slowly through your veins and backs up. This back up of blood can allow fluids to leak out through your capillaries and collect in your lungs or in other parts of your body. Because this collection of fluid congests your breathing, heart function and other body processes, we call the condition “congestive heart failure.”
Congestive heart failure is common. According to the American Heart Association, approximately 6.5 million people in the United States have the condition, and the Center for Disease Control reports that it is the leading cause of hospitalization in people 65 years of age and older.
What Causes Congestive Heart Failure?
Many diseases and lifestyle factors can weaken your heart or cause its walls to become too stiff. Both situations can decrease your heart’s ability to pump blood efficiently. This decrease in heart function usually occurs gradually over time.
Common causes of congestive heart failure include:
Coronary artery disease (CAD)
When the supply of blood to your heart muscle is blocked, a heart attack can occur and your heart muscle can be permanently damaged. CAD is the most common cause of congestive heart failure.
Congenital heart defect
When parts of your heart are not formed correctly at birth, the rest of your heart must work harder to compensate for the defect. This weakens the heart over time.
Likewise, when your heart muscle or valves are damaged by disease or infection, the healthy parts of your heart must work harder to compensate.
Abnormal heart rhythm (cardiac arrhythmia)
When your heart beats to quickly or too slowly, it must work harder.
High blood pressure (hypertension)
When your blood pressure is too high, your heart must work harder to circulate blood throughout your body. This extra work can lead to your heart becoming weak or stiff.
There are several other diseases and medical conditions that contribute to congestive heart failure.
- Thyroid disorder
- Kidney disease
- Sleep apnea
- Build-up of iron, protein or vitamin E
There are also several lifestyle factors that contribute to congestive heart failure.
- Alcohol abuse
- Drug abuse
- Tobacco use
In addition to knowing the potential causes listed above, you should also be aware of certain uncontrollable factors that can increase your risk of congestive heart failure. These risk factors include:
Aging weakens the heart, and the older you are, the more likely it is that you have experienced the potential causes listed above. Therefore, if you are 65 years of age or older, your risk for heart failure increases significantly.
Males are at higher risk of heart failure than females.
African-Americans are more likely to have heart failure and show symptoms of heart failure at an earlier age than any other race.
A family history of heart disease and other contributing factors increases your risk of congestive heart failure.
What are the 4 stages of Congestive Heart Failure?
Years ago, the American Heart Association and the American College of Cardiology identified the stages of congestive heart failure. Those stages were updated and revised in 2005. Understanding these stages can help you recognize that congestive heart failure is a progressive disease that can worsen over time.
Here is a description of the 4 Stages of Congestive Heart Failure:
At this stage, you do not have congestive heart failure, nor do you show any signs or symptoms. However, you are at a high risk of developing heart failure because you have a family history of heart failure, or you have one or more of the diseases, medical conditions or lifestyle behaviors that are contributing factors. For example, at Stage A, your heart has no structural problem, it is pumping the amount of blood your body needs, but one or more of the following might be true:
- You have coronary artery disease (CAD).
- You have high blood pressure.
- You have diabetes.
- You smoke tobacco.
At this stage, your heart has a structural problem that is probably picked up by an echocardiogram or some other test. You may have had a heart attack. You may have an enlarged heart. The left side of your heart may not be functioning properly. However, you still show no signs or symptoms of congestive heart failure. For example, at Stage B, your heart is pumping the amount of blood your body needs; but one or more of the following might be true:
- You had a heart attack.
- You have a damaged heart valve.
- You have a damaged heart muscle.
At this stage, you have been diagnosed with heart failure. You are currently showing symptoms or you have previously shown symptoms of failure of the left side of your heart working properly. For example, at Stage C, your heart is failing to pump the amount of blood your body needs, and one or more of the following might be true:
- You are experiencing shortness of breath.
- You are experiencing weakness or fatigue.
- You are not able to exercise like before.
- You are waking up more often to urinate at night.
- You have swollen feet, ankles, legs or lower abdomen.
- You previously had one of the above symptoms, but the symptom went away after treatment started.
At this stage, you have advanced heart failure with significant symptoms that do not improve with treatment. This is the final and most serious stage of heart failure.
What are the Signs of Congestive Heart Failure?
Signs of disease are evidence that can be observed by others. Following is a list of signs that may indicate that you have congestive heart failure:
1. Shortness of breath
Shortness of breath is the most common sign of congestive heart failure. As fluid congests your lungs, breathing can become difficult even when you resting.
2. Lung congestion
Lung congestion can cause rattling in your lungs and wheezing when you breathe.
3. Persistent dry, hacking cough
Persistent dry, hacking cough can be another result of lung congestion.
4. Coughing up a pink-tinted mucous or foam
Coughing up a pink-tinted mucous or foam is caused by fluid leaking from capillaries and collecting in your lungs.
5. Swelling of feet, ankles, and legs
Swelling of feet, ankles, and legs (edema) occurs as fluids collect in body tissues. The effect of gravity causes the fluids to flow downwards into the extremities of your legs and feet. The swelling often gets worse as the day goes on.
6. Swelling in the lower abdomen
Swelling in the lower abdomen (ascites) occurs as fluids collect in your abdominal cavity. This can cause an increase in abdominal size and discomfort.
7. Rapid weight gain
Rapid weight gain can be caused by water retention and collection of fluids.
8. Rapid or irregular heartbeat
Rapid or irregular heartbeat will occur as your heart beats faster in order to keep up with your body’s need for oxygen-rich blood.
Fainting can result from low blood supply to your brain.
What are the Symptoms of Congestive Heart Failure?
Symptoms of the disease are evidence that can only be detected by the affected individual. Following is a list of symptoms that may indicate you have congestive heart failure:
1. Chest pain
Chest pain (angina) is especially common when your congestive heart failure is caused by coronary artery disease.
2. Fatigue and weakness
Fatigue and weakness occur as your muscles, organs and body tissues experience a lack of oxygen from reduced blood flow and an electrolyte imbalance.
3. Dizziness and difficulty concentrating
Dizziness and difficulty concentrating can result from your brain experiencing a lack of oxygen from reduced blood flow.
4. Reduced ability to exercise
Reduced ability to exercise can become so severe that you are unable to walk across a room without breathing heavily and feeling exhausted.
5. Increased need to urinate at night
Increased need to urinate a night occurs as your kidneys work overtime to excrete the excess water from your body.
6. Nausea or lack of appetite
Nausea or lack of appetite can result from the accumulation of fluids in your abdomen.
Several of the signs and symptoms of congestive heart failure can also be associated with other diseases and medical conditions. Therefore, it is important that you see your doctor when any of them present themselves and persist.
If you are being treated for congestive heart failure and any of these signs and symptoms get worse, or if you begin to experience additional signs and symptoms, you should inform your doctor immediately. This can indicate that your heart failure is progressing and that your treatment is not working.
Congestive Heart Failure Treatments
Currently, there is no cure for congestive heart failure. Treatments are designed to reduce symptoms and slow progression of the disease. However, early diagnosis and treatment can help you lead a long and active life. The good news is that more congestive heart failure treatment options exist today than ever before. The specific treatment plan prescribed for you will depend largely upon the type of heart failure you have and on its underlying causes. All treatment options will have the same four basic goals:
1. Treat the underlying diseases and conditions causing your heart failure.
2. Reduce the symptoms of your heart failure.
3. Stop your heart failure from getting worse.
4. Maximize the quality and length of your life after diagnosis.
Treatment options for congestive heart failure will fall under one of four categories:
1. Lifestyle / behavior changes
Lifestyle changes are important to any treatment plan you and your doctor decide upon. Here are some changes that your doctor may discuss with you:
- Quit smoking. If you smoke, quitting is one of the most effective ways to improve your heart’s health.
- Limit alcohol use. Drinking too much alcohol can raise levels of certain fats in your blood, increase blood pressure, cause weight gain and damage your heart.
- Exercise regularly. When tailored to your body’s tolerance, regular exercise can produce many heart health benefits and improve your quality of life.
- Limit sodium and fluids in your diet. As congestive heart failure causes your body to retain fluids, eating a low sodium diet and regulating your fluid intake can help reduce swelling and congestion.
Your doctor will prescribe medication based on the type of heart failure you have, how severe it is, and your response to certain medicines. The following medications are commonly used to treat congestive heart failure:
- Diuretics (water pills) help reduce fluid retention, congestion, and swelling.
- Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure and reduce strain on your heart. They also may reduce the risk of a future heart attack.
- Aldosterone antagonists trigger the body to remove excess sodium through urine. This lowers the volume of blood that the heart must pump.
- Angiotensin receptor blockers relax your blood vessels and lower blood pressure to decrease your heart’s workload.
- Beta blockers slow your heart rate and lower your blood pressure to decrease your heart’s workload.
- Digoxin makes the heart beat stronger and pump more blood.
- Isosorbide dinitrate / hydralazine hydrochloride helps relax your blood vessels so your heart doesn’t work as hard to pump blood.
3. On-going care
Continued management of underlying diseases and health conditions must be part of your congestive heart failure treatment plan. So, you will need to see your doctor regularly. If you have coronary artery disease, diabetes, high blood pressure, high cholesterol or any other condition that contributes to congestive heart failure, it must be treated and watched carefully. Avoiding flu and upper respiratory infections are also important. Ask your doctor about flu and pneumonia vaccines.
4. Medical procedures / surgery
If your congestive heart failure has progressed to the point that lifestyle changes, medication, and on-going care are not working, there are several procedural and surgical options available:
- Implanting a device like a defibrillator, pacemaker or left ventricular assist device (LVAD) can help your heart to maintain a strong and regular beat.
- Angioplasty can open a blocked artery. Your doctor may place a stent in the artery to help keep it open.
- Coronary artery bypass surgery will reroute blood vessels to avoid blocked or diseased blood vessels.
- Valve replacement surgery will transplant a healthy heart valve or install a mechanical valve to replace a diseased or damaged valve.
- Heart transplant surgery is a high-risk option that is used only when your congestive heart failure is severe, it is not responding to other treatments and you meet several strict criteria to qualify as a transplant candidate.
Congestive Heart Failure Life Expectancy
Your life expectancy after receiving a diagnosis of congestive heart failure will depend upon several factors. Among them:
- The current stage of progression of your heart failure
- The underlying causes of your heart failure
- The degree to which other organs are involved with your heart failure
- The way your body responds to treatment
Although a diagnosis of congestive heart failure will probably mean major life changes and treatment for the rest of your life, it is important to keep in mind that there are things you can do to stay healthier longer and maximize the quality of your life.
Follow your treatment plan.
It is critical to take your medications as prescribed by your doctor and to keep all of your medical appointments. Tell your doctor immediately if you have any complications with your medications.
Make the changes necessary to prevent the progression of your heart failure.
Make the recommended changes to your diet and lifestyle. Follow your doctor’s advice regarding exercise and physical activity. If you are having trouble making any needed changes, talk to someone about your struggles. Resources are available to help you.
Learn about congestive heart failure and pay attention to your body.
Know what signs and symptoms might require you to seek immediate medical help.
Seek emotional support.
Living with heart failure may cause fear, anxiety, depression, and stress. Tell your doctor how you feel. Talking to a professional counselor can also help. Your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with congestive heart failure by hearing how others cope with the same disease. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help.
How Diversity Home Health Group Can Help
If you have received a congestive heart failure diagnosis, Diversity Home Health Group offers services that can help. Here are just a couple of the services we offer:
If you are an older adult with congestive heart failure, Diversity Home Health Group offers services that will help you to follow your treatment plan, manage your medications and make all dietary and lifestyle changes while you continue to live at home. We can provide the extra medical attention you need in the comfort and privacy of your own space. We’re also able to provide assistance with tasks that you may no longer be able to do on your own. We can help you keep up with things around the house, allowing you to focus on getting healthy and feeling better.
A congestive heart failure diagnosis comes with a high emotional cost. It’s life-changing, and it’s never easy. Living with congestive heart failure takes a toll on your physical health and your mental health. Diversity Home Health Group offers compassionate professional services to help as you learn to cope with your “new normal.” It’s important to remember as you live with your disease that you don’t need to do it alone. We can help.
To schedule a free consultation and learn more about these and other services offered by Diversity Home Health Group, call us at (952) 224-5535 in the Twin Cities, or call us at (507) 205-7322 in Rochester.