Baptist Health is known for advanced, superior care for patients with heart disease and the diagnosis, management and treatment of heart failure. The American Heart Association awarded us with the Get With the Guidelines® Bronze Award in 2016 for consistent application of quality measures in treating heart failure.

What is Congestive Heart Failure

Congestive heart failure is a progressive disease with four stages. If untreated, congestive heart failure can become worse and cause many symptoms that effect quality of life. In general, heart failure is when the heart does not circulate blood normally because the walls of the ventricles are too thin to pump the blood through the ventricles as it should. Therefore kidneys receive less blood and filter less fluid into urine – causing this fluid to build up in the lungs, liver, around the eyes, or in in the legs. This is known as fluid congestion.

Visit our Heart Failure page to learn more about the different types of heart failure.

Signs and Symptoms of Congestive Heart Failure

Some people have no congestive heart failure symptoms. For others, signs of congestive heart failure can range from mild to severe. The more severe symptoms are related to later stages of the condition. 

In some cases, especially in the early stages, congestive heart failure is present without any symptoms. Another heart condition, certain disorders or a known weakness of the heart may be present before any symptoms have occurred. Some of the earliest signs of congestive heart failure include:

• Shortness of breath: Waking at night, during exercise or while laying flat
• Dizziness, fatigue and weakness
• Fluid retention causing swelling in the ankles, legs, feet and/or abdomen

Additional symptoms include:

• Sudden weight gain
• Coughing or wheezing, sometimes with white or pink phlegm
• Difficulty concentrating
• Increased urge to urinate
• Lack of appetite and nausea
• Rapid or irregular heartbeat

Four Stages of Congestive Heart Failure (CHF)

Stage 1 (Pre-CHF): Typically no symptoms but another disorder that can affect the heart may be present or a weakness of the heart may have been identified.

Stage 2: May have symptoms and a heart related diagnosis but not yet defined as congestive heart failure. Lifestyle changes may be recommended to reduce stress and increase overall heart health.

Stage 3: Symptoms are noticeable and may be hindering tasks in daily life. Combined with other health conditions, those who are diagnosed at this stage may have limited ability to perform physical activities. 

Stage 4: Often referred to as late-stage CHF, symptoms are frequent throughout the day, even while at rest. Medical and surgical intervention is usually required at this stage of the condition.

Congestive Heart Failure Diagnosis

To diagnose congestive heart failure, we ask questions about your medical history and do a physical exam. We then use advanced diagnostic procedures to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures and technologies can include:

Blood tests: These tests can measure substances that are elevated in people with heart failure and can check kidney, liver and thyroid function and look for signs of other diseases that affect the heart.

CT Scan: X-rays and computers are used to create images of the aorta. This provides a more detailed picture than an ultrasound.

Chest X-ray: A common imaging test of the heart and aorta.

Coronary angiography: This procedure often is done with cardiac catheterization. During the procedure, dye that can be seen on an X-ray is injected into the heart chambers or coronary arteries. The dye lets a physician study blood flow through the heart and blood vessels to detect any blockages.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged or overworked. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Electrophysiology study: This test records the heart’s electrical activities and pathways. It can help find what’s causing heart rhythm problems and identify the best treatment. 

Magnetic Resonance Imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Myocardial biopsy: For this procedure, the physician removes a piece of heart muscle, often during cardiac catheterization. The heart muscle is studied under a microscope to see whether changes in cells have occurred. These changes may suggest cardiomyopathy.

Stress testing: This test is conducted during exercise to make the heart work hard and beat fast while heart tests are done. If a patient can’t exercise, medicine is given to increase heart rate. Used along with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure.

Congestive Heart Failure Causes

There are many causes of congestive heart failure, including:

• Cardiomyopathy
• Coronary artery disease
• Diabetes
• Heavy alcohol use
• High blood pressure
• Obesity
• Sleep apnea
• Smoking

Congestive Heart Failure Risk Factors

Risk factors that could contribute to congestive heart failure include:

Chronic diseases: Type 1 diabetes, HIV, hyperthyroidism, hypothyroidism, a buildup of iron (hemochromatosis) or a buildup of protein (amyloidosis) may contribute to heart failure.

Congenital heart defects: Structural heart defects may prevent proper blood circulation from the heart.

Irregular heartbeats: Abnormal heart rhythms, especially if they are very frequent and fast, can weaken the heart muscle.

Previous heart attack: Damage to the heart muscle may affect its ability to pump blood effectively.

Some diabetes and chemotherapy medications: Certain drugs have been found to increase the risk of heart failure.

Valvular heart disease: Damage or a defect in one of the four heart valves can prevent the heart from pumping blood effectively.

Viral infection: Certain viral infections can damage the heart muscle.

Congestion Heart Failure Prevention

While you cannot prevent all types of heart failure, you can take steps to lower your risks for diseases or conditions that can lead to or complicate the condition.

Balance your blood sugar: If you have diabetes, watch what you eat and check your blood glucose regularly. Talk to your physician about medications that control blood sugar spikes.

Be active: Moderate exercise helps circulation and decreases stress on your heart muscle.

Eat a healthy diet: Limit sugar, saturated fat, cholesterol and salt, and eat plenty of fruit, vegetables, whole grains and low-fat dairy products.

Get regular checkups: And, if you experience new or changing symptoms or side effects from medications, see your physician.

Maintain a healthy weight: Losing weight and maintaining a healthy weight puts less stress on the heart.

Reduce stress: Stress can contribute to a fast or irregular heartbeat.

Reduce your alcohol intake: In some cases, you may need to stop drinking entirely. If you can drink, keep your intake low.

Stop smoking: Smoking damages blood vessels, raises blood pressure, reduces the amount of oxygen in the blood and makes the heart beat faster.

Take your medications as prescribed: If you’ve been prescribed a medication for heart failure or a causative condition, be sure to take it as prescribed.

Prognosis for Congestive Heart Failure

Prognosis varies depending on the cause of congestive heart failure, the severity a person’s congestive heart failure symptoms and impairment, the degree to which other organ systems are involved, and his or her response to medications.

While medication and surgery are common for those with late stage congestive heart failure, there is no cure for this condition. Managing your condition by following the recommendations of your physician, including lifestyle changes is imperative for managing any heart condition. 

Congestive Heart Failure Treatment

Congestive heart failure treatment may include:

Angiotensin-converting enzyme inhibitors (ACE Inhibitors) and angiotensin receptor blockers (ARBs): These medications relax blood vessels to improve blood flow.

Beta-blockers: These drugs can reduce blood pressure and slow a rapid heart rhythm.

Diuretics: Heart failure causes the body to retain fluid. These drugs reduce your body’s fluid content by promoting urination.

Surgery and Other Procedures: If medications are not effective, your physician may recommend an angioplasty to open a blocked artery or surgery to repair a heart valve.

Vasodilators: These medications are another option for opening blood vessels if you cannot tolerate ACE inhibitors.

Congestive Heart Failure Complications

Heart failure can lead to other conditions, including:

Anemia: This condition that develops when your blood lacks enough healthy red blood cells or hemoglobin can cause weakness and fatigue.

Atrial fibrillation: This irregular heart rhythm can increase the risk of stroke and blood clots.

Cardia cachexia: This unintentional weight loss can be life-threatening without supplemental nutrition.

Impaired kidney function: Decreased kidney function is common in patients with heart failure, and it increases the risks for heart complications, hospitalization and death.

Leg venous stasis and ulcers: Poor circulation can cause skin to thicken, change color and look shiny. Hair may fall out and ulcers can develop if you sustain an injury.

Liver disease: People with heart failure are at risk for developing liver disease.

Stroke: If the blood supply to the brain is decreased or cut off, the brain can be deprived of oxygen, causing cells to die.

Congestive Heart Failure Doctors at Baptist Health

You will appreciate timely appointments and respectful attention to your concerns, all in a positive and friendly atmosphere. Here, you have access to the region’s most comprehensive, multidisciplinary team of congestive heart failure doctors and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.