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You can live a full, high-quality life with congestive heart failure

Congestive heart failure is a condition that develops when your heart no longer works as it should. Your heart grows weak or doesn’t fill with enough blood, and as a result, it can’t pump enough blood throughout your body, and your tissues and organs don’t get the oxygen they need.

Types of congestive heart failure

Left-sided heart failure, also called left ventricular heart failure, impacts the larger, more powerful side of the heart. The most common type of heart failure, it causes blood to pool in the veins that carry blood away from the lungs.

Left-sided heart failure can be classified as systolic or diastolic:

  • Systolic heart failure, also called heart failure with reduced ejection fraction, occurs when the heart pumps 40% or less of the blood in the left ventricle.
  • Diastolic heart failure occurs when the heart muscle becomes stiff and the left ventricle can’t relax, causing blood to back up in the lungs, liver and other parts of the body.

Right-sided heart failure develops over time due to damage caused by left-sided heart failure. The right ventricle loses its ability to move blood from the heart into the lungs. Heart failure may sound like a concerning diagnosis, but finding the right treatment can help you manage the condition and live a full life.

Congestive heart failure symptoms

Symptoms of heart failure include:

  • Bloody cough
  • Difficulty breathing while lying down
  • Feeling tired throughout the day and unable to perform daily activities
  • Loss of appetite
  • Memory loss and confusion
  • Nausea
  • Shortness of breath, even when resting
  • Racing or throbbing heart
  • Sleep problems
  • Swollen ankles, fingers, feet, legs or other body parts due to fluid buildup
  • Weakness in the legs while walking
  • Weight loss or gain without any known cause

These symptoms may get worse as heart failure advances. Tracking your symptoms will help you and your care team decide whether you need changes to your treatment.

What causes congestive heart failure?

For many people, heart failure occurs because of another medical condition. The conditions most often associated with heart failure include:

Congestive heart failure risk factors

While anyone can experience heart failure, your risk of developing it increases based on your health history and other factors, including:

  • African American ancestry
  • Age (being 65 or older)
  • Being overweight or obese
  • Drug or alcohol misuse
  • Eating a diet high in fat, sodium and cholesterol
  • Family history of heart failure
  • History of high blood pressure, valve disease or coronary artery disease
  • History of radiation therapy or chemotherapy treatments
  • Not getting enough physical activity
  • Smoking
  • Other conditions, such as severe anemia, hyperthyroidism and diabetes

Diagnosing congestive heart failure

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Diagnosing congestive heart failure starts with a physical exam. Your doctor will ask about your symptoms, and based on what you share, they may order diagnostic tests. Some of the tests most frequently used to diagnose heart failure include:

  • Blood tests

    Blood tests

    Different blood tests measure electrolyte levels and kidney function, often impacted by heart failure.

  • Electrocardiogram (EKG or ECG)

    Electrocardiogram (EKG or ECG)

    An electrocardiogram (EKG or ECG) tests your heart’s electrical signals to monitor for irregularities.

  • Stress tests

    Stress tests

    Stress tests can help determine how well your heart functions at rest and during various levels of exercise.

  • Ejection fraction

    Ejection fraction

    Ejection fraction is a measurement of the amount of blood that is pumped through your body with each heartbeat.

  • Imaging tests

    Imaging tests

    Imaging tests like chest X-rays and echocardiograms give doctors a closer look inside your heart to find structural issues or blockages.

Blood tests

Different blood tests measure electrolyte levels and kidney function, often impacted by heart failure.

Electrocardiogram (EKG or ECG)

An electrocardiogram (EKG or ECG) tests your heart’s electrical signals to monitor for irregularities.

Stress tests

Stress tests can help determine how well your heart functions at rest and during various levels of exercise.

Ejection fraction

Ejection fraction is a measurement of the amount of blood that is pumped through your body with each heartbeat.

Imaging tests

Imaging tests like chest X-rays and echocardiograms give doctors a closer look inside your heart to find structural issues or blockages.

Stages of congestive heart failure

​​​​​​​​​​​​​There are four stages of congestive heart failure.
  • Stage A: At risk for heart failure

    Stage A: At risk for heart failure

    Individuals at this stage are at risk for heart failure but do not yet have symptoms of heart disease. Risk factors vary but include hypertension, coronary vascular disease, diabetes, obesity, exposure to cardiotoxic agents, and genetic or family history of cardiomyopathy.

  • Stage B: Pre-heart failure

    Stage B: Pre-heart failure

    This stage is for people without current or previous symptoms of heart failure, but who are living with heart disease or other risk factors listed above.

  • Stage C: Symptomatic heart failure

    Stage C: Symptomatic heart failure

    This stage is for people with current or previous symptoms of heart failure.

  • Stage D: Advanced heart failure

    Stage D: Advanced heart failure

    Advanced heart failure is characterized as people with heart failure symptoms that interfere with their daily lives or have experienced repeated hospitalizations.

Stage A: At risk for heart failure

Individuals at this stage are at risk for heart failure but do not yet have symptoms of heart disease. Risk factors vary but include hypertension, coronary vascular disease, diabetes, obesity, exposure to cardiotoxic agents, and genetic or family history of cardiomyopathy.

Stage B: Pre-heart failure

This stage is for people without current or previous symptoms of heart failure, but who are living with heart disease or other risk factors listed above.

Stage C: Symptomatic heart failure

This stage is for people with current or previous symptoms of heart failure.

Stage D: Advanced heart failure

Advanced heart failure is characterized as people with heart failure symptoms that interfere with their daily lives or have experienced repeated hospitalizations.

Congestive heart failure treatment

When you are in the early stages of congestive heart failure, your treatment will most likely focus on managing symptoms with healthy lifestyle changes and medications.

Lifestyle changes

Your doctor may recommend several lifestyle changes:

  • Monitor your fluid intake: When your heart doesn’t function as well as it should, fluid can build up in your body. You may need to limit the fluid you consume—from coffee, tea, water, soup, food and other sources—to avoid having too much in your system.
  • Quit smoking and avoid alcohol: By doing so, you’ll improve symptoms of heart failure.
  • Stay physically active: Exercise helps reduce symptoms and boosts your energy levels.



Medications

Medications can help manage heart failure symptoms by addressing the disease’s cause. Many common medications for heart failure target hormones that increase blood pressure and heart rate.

Those medications include:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Beta-blockers

Your provider may prescribe a diuretic, a medication that helps your body eliminate extra fluid, as part of your treatment plan.

Surgery and procedures

Advanced heart failure, the final stage of the disease, develops when lifestyle changes and medications no longer work to control your symptoms.

Many advanced heart failure treatments involve medical procedures that address the underlying cause of your disease or improve your heart's function. These treatment options can include:

  • Coronary artery bypass surgery (CABG) to open blocked arteries caused by heart disease.
  • Percutaneous coronary intervention (PCI) to help expand obstructed blood vessels and allow more blood flow.
  • Heart valve repair and replacement to address heart valve diseases that affect the amount of and directional flow of blood between the heart and the body.
  • Implantable cardioverter defibrillators (ICDs) and pacemakers to address arrhythmias that impact your heart rhythm.
  • Cardiac resynchronization therapy (CRT) utilizes electrodes to manage the left and right ventricles' functions, which pump blood to and from the heart.
  • Ventricular assist devices (VADs) can help offset weakened heart functionality by assisting in pumping blood from the heart to the rest of the body.
  • Heart transplant, an option for people with very advanced heart failure and those who are no longer responding to other courses of treatment.

Download our guide to heart failure treatment