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Heart Failure

Congestive heart failure or heart failure results when the heart can't pump enough blood to the body's other organs.

Because the heart isn't pumping hard enough, blood backs up producing tissue congestion. The kidneys cannot properly remove this extra fluid from the body and fluid may build up, particularly in the feet and lower legs causing swelling. The fluid build-up can be in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.

The body becomes congested with fluid, hence the phrase congestive heart failure. Heart failure is a progressive and debilitating illness.

Risk Factors

More than 5 million Americans have heart failure. The most common cause is blockage of the coronary arteries either with or without a previous heart attack. Other causes include:

Coronary heart disease a narrowing of the heart's blood vessels caused by cholesterol and fatty deposits which constricts blood flow to the heart's muscle tissue.

Damage after heart attack - The heart muscle becomes blocked causing damage to the heart muscle.

High blood pressure (hypertension) - Pressure in the blood vessels is too high, the heart has to pump harder than normal to keep the blood circulating.

Infections that affect the heart - When an infection invades the heart it causes the muscle to weaken making the heart work harder.

Severe lung disease - When the lungs do not work properly the heart works harder to get oxygen to the rest of the body.

Damage to heart valves - When the valves do not open or close completely during each heartbeat then the heart muscle has to pump harder to keep the blood moving.

Diabetes - People with diabetes tend to develop high blood pressure and atherosclerosis from elevated lipid levels in the blood. Both which have been linked to heart failure.

Sleep Apnea - a potentially life threatening sleep disorder where tissues in the throat collapse and block the airway causing pauses in your breathing.


Several tests can be done to determine whether or not a person has heart failure. These tests determine whether the heart is working as well as it should. Common tests include chest x-rays, echocardiography, cardiac catheterization, EKG, exercise stress test, Multiple-Gated Acquisition Scanning (MUGA) and blood tests.

Signs and Symptoms

Your healthcare provider is the best person to make the diagnosis. The most common signs of congestive heart failure (CHF) are swollen legs or ankles or difficulty breathing. Another symptom is weight gain when fluid builds up.

Weigh yourself daily, preferably every morning, before breakfast and after urinating, on the ame scale and in the same spot.

CHF usually requires a treatment program including:

  • Rest
  • Proper diet
  • Modified daily activities
  • Drugs such as
    • ACE (angiotensin-converting enzyme) inhibitors and vasodilators to expand blood vessels and decrease resistance allowing blood to flow more easily and makes the heart's work easier or more efficient.
    • Beta blockers - Beta blockers can improve how well the heart's left lower chamber (left ventricle) pumps.
    • Digitalis - digitalis increases the pumping action of the heart.
    • Diuretics (water pills) - help the body get rid of excess salt and water.

When a specific cause of congestive heart failure is discovered, it should be treated or, if possible, corrected. For example, some cases of congestive heart failure can be treated by treating high blood pressure. If the heart failure is caused by an abnormal heart valve, the valve can be surgically replaced.

Most people with mild and moderate congestive heart failure can be treated. Proper medical supervision can prolong an active lifestyle.

When to contact your healthcare provider
  • Sudden weight gain - three or more pounds in one day, five or more pounds in one week, or whatever amount your healthcare provider told you to report.
  • Increased swelling in hands, ankles, feet or abdomen
  • Decreased urination
  • Confusion, dizziness or faintness
  • Nausea or vomiting
  • Increased fatigue
  • Muscle cramps or weakness
  • Abdominal pain
  • Frequent dry, hacking cough
  • Shortness of breath while at rest, not related to exercise or exertion
  • Trouble sleeping (awakening with shortness of breath)
Tobacco Cessation

The use of tobacco in any form is a great health concern. Even if you don't smoke, reduce your exposure to secondhand smoke. If you use tobacco products, prepare yourself to quit as soon as possible.

  • Set a date to stop and mark it on your calendar. Twenty-four hours before the start date make everyone aware of your goal to stop.
  • Remove the smell of tobacco by cleaning your house and car. Remember to get rid of lighters, ashtrays and matches.
  • You can use over-the-counter aids such as nicotine patches and gum. Contact your health insurance provider to see if Nicotine replacement therapy is a covered service.
  • Know what your triggers are that make you want to use tobacco products and be prepared with chewing gum, celery or carrot sticks.
  • Kentucky has a free Quit Now program that helps you quit using tobacco products. You can contact the Quit Now program at (800) 784-8669.


Heart Failure Resources
  American Heart Association  


Last Updated 9/28/2012