Congestive Heart Failure





Lifestyle changes, such as exercising, reducing the salt in your diet, managing stress, treating depression, and especially losing weight, can improve your quality of life.





Heart failure can be chronic — meaning your condition is ongoing — or acute, meaning your condition has started suddenly.


Chronic heart failure signs and symptoms:



Fatigue and weakness

Swelling (edema) in your legs, ankles and feet

Rapid or irregular heartbeat

Reduced ability to exercise

Persistent cough or wheezing with white or pink blood-tinged phlegm

Swelling of your abdomen (ascites)

Sudden weight gain from fluid retention

Lack of appetite and nausea

Difficulty concentrating or decreased alertness


Acute heart failure signs and symptoms



Sudden fluid buildup

Rapid or irregular heartbeat (palpitations)




When to see a doctor




These include:


Chest pain

Fatigue and weakness

Rapid or irregular heartbeat


Reduced ability to exercise

Persistent cough or wheezing with white or pink blood-tinged phlegm

Swelling in your abdomen, legs, ankles and feet

Difficulty concentrating or decreased alertness


You may first find out you have heart failure from an emergency room visit after worsening symptoms. Other heart and lung problems can cause symptoms that are similar to heart failure.


If you have a diagnosis of heart failure, and if any of the symptoms suddenly become worse or you develop a new sign or symptom, it may mean that existing heart failure is getting worse or not responding to treatment. Contact your doctor promptly.






Heart failure can involve the left side, right side or both sides of your heart. Typically, heart failure begins with the left side — specifically the left ventricle, your heart's main pumping chamber.


Types of heart failure


Left-sided heart failure

Most common form of heart failure.



Right-sided heart failure

Often occurs with left-sided heart failure.



Systolic heart failure

The left ventricle can't contract vigorously, indicating a pumping problem.


Diastolic heart failure (also called heart failure with normal ejection fraction)





Coronary artery disease and heart attack. Coronary artery disease is the most common form of heart disease and the most common cause of heart failure. Over time, arteries that supply blood to your heart muscle narrow from a buildup of fatty deposits, a process called atherosclerosis. Blood moves slowly through narrowed arteries, leaving some areas of your heart muscle weak and chronically deprived of oxygen-rich blood.

In some cases, the blood flow to the muscle is just enough to keep the muscle alive but not functioning well. A heart attack occurs if plaques formed by the fatty deposits in your arteries rupture. This causes a blood clot to block blood flow to an area of the heart muscle, weakening the heart's pumping ability.




Faulty heart valves. The valves of your heart keep blood flowing in the proper direction through the heart. A damaged valve, due to a heart defect, coronary artery disease or heart infection, forces your heart to work harder to keep blood flowing as it should. Over time, this extra work can weaken your heart. Faulty heart valves, however, can be fixed if found in time.


Damage to the heart muscle (cardiomyopathy). Some of the many causes of heart muscle damage, also called cardiomyopathy, include infections, alcohol abuse, and the toxic effect of drugs such as cocaine or some drugs used for chemotherapy. In addition, whole-body diseases, such as lupus, or thyroid problems can damage heart muscle.




Heart defects you're born with (congenital heart defects). If your heart and its chambers or valves haven't formed correctly, the healthy parts of your heart have to work harder to pump blood through your heart, which in turn may lead to heart failure.


Abnormal heart rhythms (heart arrhythmias). Abnormal heart rhythms may cause your heart to beat too fast. This creates extra work for your heart. Over time, your heart may weaken, leading to heart failure. A slow heartbeat may prevent your heart from getting enough blood out to the body and may also lead to heart failure.


Other diseases. Chronic diseases such as diabetes, severe anemia, hyperthyroidism, hypothyroidism, emphysema and lupus and a buildup of iron (hemochromatosis), protein (amyloidosis) or inflammatory cells (sarcoidosis) also may contribute to heart failure. Causes of acute heart failure include viruses that attack the heart muscle, severe infections, allergic reactions, blood clots in the lungs, the use of certain medications or any illness that affects the whole body.


Risk Factors


A single risk factor may be enough to cause heart failure, but a combination of factors increases your risk.


Risk factors include:


High blood pressure, Your heart works harder than it has to if your blood pressure is high. Coronary artery disease. Narrowed arteries may limit your heart's supply of oxygen-rich blood, resulting in weakened heart muscle.


Heart attack, Damage to your heart muscle from a heart attack may mean your heart can no longer pump as well as it should.


Irregular heartbeats, These abnormal rhythms can create extra work for your heart, weakening the heart muscle.


Diabetes, Having diabetes increases your risk of high blood pressure and coronary artery disease.

Some diabetes medications. The diabetes drugs rosiglitazone (Avandia) and pioglitazone (Actos) have been found to increase the risk of heart failure. Don't stop taking these medications on your own, though. If you're taking them, discuss with your doctor whether you need to make any changes.


Sleep apnea. The inability to breathe properly at night results in low blood oxygen levels and increased risk of abnormal heart rhythms. Both of these problems can weaken the heart.




Viruses. A viral infection may have damaged your heart muscle.


Alcohol Use, Drinking too much alcohol can weaken heart muscle and lead to heart failure. Kidney conditions. These can contribute to heart failure because many can lead to high blood pressure and fluid retention.








Heart valve problems. The valves of your heart, which keep blood flowing in the proper direction through your heart, can become damaged from the blood and fluid buildup from heart failure.




Heart attack and stroke. Because blood flow through the heart is slower in heart failure than in a normal heart, it's more likely you'll develop blood clots, which can increase your risk of having a heart attack or stroke.


Some people's symptoms and heart function will improve with proper treatment. However, heart failure can be life-threatening. It can lead to sudden death. People with heart failure may have severe symptoms, and some may require heart transplantation or support with an artificial heart device.