Congestive heart failure means the heart can't pump enough blood to meet the body's needs. Don't confuse it with a heart attack where the heart stops beating completely.
Basically, congestive heart failure means the heart muscle isn't working well enough. It can happen fast (acute) or slowly over time (chronic).
This article covers symptoms of congestive heart failure, why it happens, how it's diagnosed, and treatment options.
Symptoms of congestive heart failure
Symptoms can vary based on which part of the heart is damaged, which is divided into three areas:
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Left-sided heart failure.
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Right-sided heart failure.
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Heart failure.
- Left-sided heart failure
The left side of the heart takes in oxygen-rich blood from the lungs and pumps it to the body. If left-sided heart failure happens, blood backs up into the lungs, which means the body doesn’t get the oxygen it needs.
Symptoms of left-sided heart failure include:-
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Fatigue.
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Dizziness.
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Shortness of breath (especially when lying down or exerting yourself).
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Wheezing.
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Crackling sounds in the lungs.
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Irregular heartbeat.
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Shortness of breath during sleep.
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Low body temperature.
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Bluish body color due to lack of oxygen.
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Confusion.
- Right-sided heart failure
The right side of the heart takes in oxygen-poor blood from the body and pumps it to the lungs to get oxygen. When right-sided heart failure happens (right ventricle failure), the heart can't fill with enough blood, causing blood to back up into the veins.
Symptoms of right-sided heart failure include:
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Fatigue.
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Weakness.
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Shortness of breath, especially during exercise.
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Fluid buildup, usually in the lower legs and lower back.
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Swelling of the neck jugular vein.
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Irregular heartbeat.
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Chest pain or pressure.
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Dizziness.
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Chronic cough.
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Nighttime urination.
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Fluid buildup in the belly.
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Enlarged liver.
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Nausea.
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Loss of appetite.
- Both ventricles failing
Biventricular heart failure means both the left and right ventricles of the heart are failing. It's the most common type of heart failure or congestive heart failure. You'll see symptoms from both left and right heart failure with this type.
A common feature of biventricular heart failure is pleural effusion, which is fluid buildup between the lungs and chest wall. While this can happen in right-sided heart failure and less so in left-sided, it's most common when both sides fail.
Symptoms of pleural effusion include:
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Sharp chest pain.
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Shortness of breath, especially during activity.
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Chronic dry cough.
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Fever.
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Trouble breathing when lying down.
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Persistent hiccups.
Complications of congestive heart failure
Congestive heart failure is a complication of many different diseases and disorders, but it can also cause further complications, increasing the risks of illness and death.
Complications of congestive heart failure include:-
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Venous blood clots.
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Kidney failure.
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Liver damage.
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Lung failure.
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Heart valve damage.
Causes of congestive heart failure
Causes of congestive heart failure include coronary artery disease, high blood pressure, heart valve diseases, infections, alcohol use, and past heart attacks.
Congestion means extra fluid in veins and tissues of the lungs and other parts of the body. This congestion causes many of the typical symptoms of congestive heart failure.
Also, congestive heart failure happens due to conditions that damage the heart muscle itself, called cardiomyopathy.
Common causes of congestive heart failure include:-
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Coronary artery diseases.
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Heart muscle infarction.
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Heart muscle stress.
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Infections.
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Alcohol and drug abuse.
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Chemotherapy for cancer.
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Amyloidosis.
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Obstructive sleep apnea.
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Toxic exposure to lead or cobalt.
Diagnosis of congestive heart failure.
If the healthcare provider suspects congestive heart failure, they will diagnose it by reviewing symptoms, doing physical exams, blood tests, imaging tests, and other checks to see how the heart is working.
Tests to diagnose congestive heart failure can include the following:-
1. Physical exams
After going over your symptoms and medical history, the healthcare provider will do physical exams to spot signs that point to congestive heart failure, This will include checking the following:-
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Blood pressure.
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Heart rate.
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Looking for irregular heartbeats.
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Lung sounds to check for congestion.
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Lower limbs to look for signs of swelling.
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Neck jugular vein to see if it’s bulging.
2. Lab tests
There are several blood tests used to diagnose congestive heart failure, some can help find the underlying cause of the dysfunction, and These tests include:-
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Complete blood count CBC.
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C-reactive protein.
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Liver function tests.
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Kidney function tests.
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Thyroid function.
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B-type natriuretic peptide test.
3. Imaging tests
The main imaging tool to diagnose congestive heart failure is an echocardiogram, plus angiography to check for blockages that can damage the heart muscle.
Also, X-rays can help spot an enlarged heart and signs of swollen blood vessels in the heart. Chest X-rays and ultrasounds can help diagnose pleural effusion (fluid buildup).
4. Other tests
Besides the previous tests, other tests can be used to support diagnosis or find the cause of dysfunction, These tests can include:-
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Electrocardiogram ECG.
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Cardiac stress test.
Treatment of congestive heart failure
Treatment focuses on easing symptoms and stopping the disease from getting worse. It also involves treating the root cause, like infection, heart disorder, or chronic inflammation.
Treatment is mostly driven by which stage the heart failure is at. It can include lifestyle changes, prescribed drugs, implanted devices, and heart surgeries.
- Lifestyle changes
One of the first steps to manage congestive heart failure is to make lifestyle changes to improve diet, fitness, and fix bad habits that contribute to the disease.
Depending on the stage of congestive heart failure as determined by the healthcare provider, lifestyle changes might be fairly easy or may need serious adjustments. Lifestyle changes may include:
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Reducing sodium (salt) intake.
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Limiting fluid intake.
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Reaching and maintaining a healthy weight.
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Quitting smoking.
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Stopping alcohol consumption.
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Doing regular exercise.
- Prescription medications
There are several prescription drugs usually used to improve heart functions, These drugs include:-
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Diuretics.
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ACE inhibitors.
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Angiotensin receptor blockers ARBs.
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Sodium-glucose co-transporter 2 inhibitors.
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Vasopressin receptor blockers.
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Lanoxin (digoxin).
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Apresoline (hydralazine).
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Beta blockers.
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Ivabradine (Corlanor).
Also, there are other drugs that heart failure patients might need to avoid. These can worsen the condition or add to heart congestion, andThese drugs can include:-
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Steroidal anti-inflammatory drugs.
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Calcium channel blockers.
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Salt substitutes that contain potassium.
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Antacids.
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Decongestants.
You should also check with the healthcare provider about any meds the patient is taking, including supplements and herbal treatments.
- Implantable devices
If a person's heart rate drops below 35%, or they have severe arrhythmia due to congestive heart failure, the healthcare provider might suggest an implantable device to lower the risk of disease and death.
These devices can include the following:-
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Automatic implantable pacemakers.
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CRT heart beat synchronization device.
- Surgery
Surgery may be needed to fix causes of heart failure. This might include fixing or replacing leaking heart valves or CABG surgery to reroute blood around one or more blocked arteries.
Also, after a heart attack, surgery is often done to fix the left ventricle bulge and flow. Some surgeries are minimally invasive, others are major like open heart surgery or heart transplant.
Having congestive heart failure doesn’t mean a person will die or their heart will suddenly stop. It just means the heart isn’t working normally. Some important steps can be taken to keep or improve heart function.
