Congestive Heart Failure- Stages, Causes, And Treatment

What Is Congestive Heart Failure?

Congestive Heart Failure (CHF) is a condition that occurs when the heart cannot pump blood efficiently to meet the body's needs.

Congestive Heart Failure is a chronic condition that prevents the filling or emptying of blood from the heart. CHF is caused due to a structural and/or a dysfunctional abnormality. The common clinical manifestations include shortness of breath, edema, and weight gain.

[Also Read: Causes of swollen hands and feet]

By understanding the congestive heart failure - stages, causes, and treatment, one can manage the condition if it is in the early stages and the knowledge on the preventive steps will help avoid the occurrence.

Congestive Heart Failure Types

1. Left-sided Congestive Heart Failure

It is the most common type of congestive heart failure. As the disease progresses, the left ventricle of the heart cannot pump blood efficiently out to the body. With further progression, fluid builds up in the lungs, making it difficult to breathe.

There are two types of left-sided heart failure;

• Systolic Heart Failure - This condition occurs because of the failure of the left ventricle to contract normally. This lowers the force required to push blood into circulation. Without adequate force, the heart cannot pump blood properly.
• Diastolic Failure- It is also known as diastolic dysfunction, which occurs because of the stiffening of the muscle in the left ventricle. As it is unable to relax, the heart cannot efficiently fill with blood between the beats.

2. Right-sided Congestive Heart Failure

This occurs when the right ventricle is unable to pump blood efficiently to the lungs. Blood backs up into the blood vessels, causing fluid retention in the legs, ankles, and abdomen.

Both left-sided and right-sided CHF can occur at the same time. But usually, the onset is on the left side, which then travels to the right when the condition is left untreated.

Symptoms Of Congestive Heart Failure

The early stages of the disease may not cause any symptoms, but as the disease progresses, one may notice gradual changes in the body. These include;

Symptoms - Early Condition	Symptoms - A Worsened Condition	Symptoms - Severe Condition
Fatigue	Irregular heartbeat	Chest pain that radiates to the upper body
Swelling - legs, ankle, abdomen	Cough because of congestion in the lungs	Rapid breathing
Weight gain	Wheezing	Lack of oxygen in the lungs makes the skin appear blue
Increased urge to urinate at the night	Difficulty breathing that may indicate pulmonary edema	Fainting

• Congestive heart failure cough can occur because of the backup of fluids.
• Chest pain radiating to the upper body may also indicate a heart attack.

Symptoms of congestive heart failure in children may include poor feeding, undue sweating, and difficulty breathing.

Causes Of Congestive Heart Failure

Many diseases can impair the heart's pumping efficiency, causing congestive heart failure. The most common causes include;

1. Coronary Artery Disease

This refers to the condition where cholesterol and other fatty substances block the small arteries that supply blood to the heart (coronary arteries). It causes narrowing of the arteries, that restricts the blood flow and damage the arteries.

2. High Blood Pressure (hypertension)

High blood pressure causes the narrowing of arteries making it harder for the blood to flow through them.

3. Excessive Alcohol Intake

Can damage the cells of the heart muscle and causes the weakening of the heart.

4. Disorders Of The Heart Valves

The valves of the heart open and close to regulate blood flow with each heartbeat. In case a heart valve is not opening properly or is leaking blood backward, the heart loses its ability to pump blood efficiently.

Other less common causes include;

• Viral infections of the heart muscle
• Thyroid disorders
• Arrhythmias - Heart rhythm problems
• Certain medications

Congestive Heart Failure Stages

The stages of congestive heart failure;

Stage	Main symptoms
Class I	No symptoms and no limitations during typical physical activity.
Class II	Mild symptoms such as fatigue, palpitations, shortness of breath, and/or angina. Slight limitations during ordinary activity. The patients feel comfortable at rest.
Class III	The patients may feel comfortable at rest but may experience limitations even during light physical activity like walking short distances. Mild exercise may also cause palpitations, fatigue, or shortness of breath.
Class IV	Severe limitations where the patients experience the symptoms even at rest.

How To Diagnose Congestive Heart Failure?

Common tests to diagnose congestive heart failure include;

1. Electrocardiogram (EKG, ECG)

ECG helps in assessing the heart rate, rhythm, and indirectly, the size of the ventricles. The test helps to evaluate the blood flow to the heart muscle.

2. Chest X-ray

It helps to detect enlargement of the heart and fluid in the lungs.

3. Blood Tests

A complete blood count (CBC), electrolytes, glucose, creatinine, and BUN (blood urea nitrogen test) to assess the function of the kidneys.

4. B-type Natriuretic Peptide (BNP)

BNP test is done to know if a patient has shortness of breath because of congestive heart failure or another cause. BNP is a chemical in the ventricles of the heart, which is released when the muscles are overburdened.

5. Echocardiography or Ultrasound Testing Of The Heart

Echocardiography helps assess the anatomy and function of the heart valves and muscles. The test helps to look at the blood flow within the heart and contraction of the heart muscle and measures the percentage of blood ejected with each heartbeat.

Other tests include MRI (to look for damages in the heart with the help of pictures), stress test (to study the performance of the heart at different stress levels), and cardiac catheterization (to detect blockages in the coronary arteries).

Treatment For Congestive Heart Failure

The aim of treatment is to make the heart pump blood more efficiently so that it meets the body’s requirements. Specific treatment depends on the underlying cause. These include;

1. Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors)

ACE inhibitors dilate or widen the blood vessels to increase blood flow.

2. Beta-Blockers

Beta-blockers reduce blood pressure and slow down the rapid heart rhythm.

3. Diuretics

Diuretics reduce fluid content in the body as CHF can cause fluid retention in the body.

4. Surgery

If medications are not effective, the doctor may recommend surgery. The surgical procedures include;

• Angioplasty - To open the arteries that are blocked.
• Heart valve repair surgery - To help the opening and closure of valves properly.

Tips To Prevent Congestive Heart Failure

Although some factors are genetic, lifestyle plays an important role. There are several measures that can lower the risk of congestive heart failure or help in delaying the onset.

• Avoid or quit smoking, secondhand smoke should also be avoided.
• Maintain a healthy and well-balanced diet
• Include lots of vegetables and fruits, whole grains, and lean proteins
• Consume low fat or fat-free dairy products
• Include protein-rich foods
• Avoid high intake of salt (sodium), added sugars, refined grains, and solid fats
• Exercise Regularly - Moderate aerobic exercises help improve heart health. Heart-healthy exercises include walking, swimming, and bicycling.
• Maintain A Healthy Weight – Being overweight can be hard on your heart. Maintain a healthy weight by following a balanced diet and regular exercise.
• Limit alcohol intake
• Reduce stress levels
• Get enough sleep
• Use Medication Properly – If taking medications for high blood pressure, heart disease, or diabetes, take them as prescribed by the doctor.

These simple lifestyle changes can help protect your heart.

The information on congestive heart failure - stages, causes, and treatment can help understand the condition and seek medical attention if required.