By Stephanie Trelogan, MS
by Andy Avins, MD
Congestive heart failure, or simply heart failure, is a condition that occurs when the heart is unable to pump enough blood to meet the needs of the body's tissues. It generally occurs as a result of other forms of heart disease.
Congestive heart failure can result from two problems:
- When the heart fails to pump out all the blood that enters its chambers; or
- When the heart's chambers are too stiff and cannot relax enough to fill with blood.
When failure occurs in the large chamber on the left side of the heart (the left ventricle), blood backs up into the lungs, causing the lung tissues to fill with fluid. This congestion results in shortness of breath and fatigue. When failure occurs in the large chamber on the right side of the heart (the right ventricle), blood backs up in other tissues. This causes swelling in areas such as the liver and the legs.
Unfortunately, people with heart failure tend to get gradually worse. Initially, the heart can compensate for weakness by beating faster and enlarging. Although this may offer a short-term fix, the damage it causes to the heart can be significant in the long term.
The good news is that doctors have recently made great strides in treating heart failure. Therefore, it is important to obtain medical care for this condition as early as possible. It is also important to see your doctor regularly in order to catch heart disease in its early stages when it may be easier to treat.
More on Screening for Heart Disease (Coming Soon)
Heart failure is generally the result of other heart diseases. The major causes of congestive heart failure include:
heart failure usually occurs as a result of other
artery disease (CAD). The most common cause of
congestive heart failure is coronary artery disease
(CAD), which is when the arteries
that supply blood to the heart become clogged. CAD
cuts off the heart's blood supply and damages the
heart muscle. This damage can eventually result in
congestive heart failure.
blood pressure. Uncontrolled high blood pressure
is a major cause of heart failure. In chronic high
blood pressure, the heart muscle thickens in order
to pump harder and overcome the increased resistance
in the blood vessels. Over time, this thickening weakens
the heart's ability to contract and relax, preventing
it from filling properly with blood.
Many people with diabetes are
also at risk for obesity, high
blood pressure, and CAD all of which contribute
to congestive heart failure.
Heart Disease. When heart valves don't function
properly, the heart muscle must work much harder to
compensate for abnormal blood flow. Over time, this
excessive workload causes the heart muscle to fail.
Before antibiotics were available, most cases of valvular
heart disease were caused by rheumatic fever. Now
most valvular disease is congenital, which means that
people are born with a physical defect.
Cardiomyopathy literally means disease of the heart
muscle. There are several different types of cardiomyopathy,
some if which are inherited while others are not.
The progressive deterioration of the heart muscle
that results from cardiomyopathy often leads to congestive
infections. Certain viral illnesses can cause
an infection of the heart muscle known as acute myocarditis.
Although this condition is rare, it produces temporary,
but potentially life-threatening, heart failure. In
some cases, it can even result in chronic congestive
Many symptoms of heart failure result from the congestion that develops as fluid backs up into the lungs and leaks into the tissues. Other symptoms result from the body not getting enough oxygen. Since heart failure can progress rapidly, it is essential to consult a physician immediately if you experience any of the following symptoms:
Symptoms of left-side heart failure may include:
- Fatigue and shortness of breath (but unlike the breathlessness of angina, which feels like a heavy weight pressing on the chest)
- Difficulty breathing at night, sometimes causing awakening
- Asthma-like wheezing or a dry hacking cough that worsens with lying down, but improves with sitting up or standing.
- Unintended weight loss
Symptoms of right-side heart failure may include:
- Accumulation of fluid: first in the feet, next in the ankles and legs, and finally in the abdomen
- Enlargement of the liver
- Weight gain (although muscle mass is lost and appetite may be depressed, weight gain often occurs because salt and water are retained)
If you experience the following symptoms, proceed immediately to the nearest emergency room:
- A cough that produces a pinkish froth; wheezing and a sensation of bubbling in the lungs; or a feeling of drowning
- Pale, clammy, or blue-tinged skin
Coats, A. J. S. (1997) Syndrome of Chronic Heart Failure: Origin of Symptoms. In P. A. Poole-Wilson, et al. (Eds.), Heart Failure. (pp. 297310). New York, NY: Churchill Livingstone, Inc.
Poole-Wilson, P. A. (1997) History, Definition, and Classification of Heart Failures. In P. A. Poole-Wilson, et al. (Eds.), Heart Failure. (pp. 269278). New York, NY: Churchill Livingstone, Inc.
Vosberg, H.-P. & McKenna, W. J. (1997) Cardiomyopathies. In D. L. Rimoin, et al. (Eds.), Emery and Rimoin’s Principles and Practice of Medical Genetics, volume 1 (pp. 843877). New York, NY: Churchill Livingstone, Inc.