Congestive Heart Failure: Symptoms, Treatment & Causes

Congestive heart failure is a cardiac illness in which the heart loses its ability to pump blood effectively to the body. It leads to decreased oxygen getting to different tissues and organs, resulting in symptoms like fatigue, shortness of breath and increased heart rate. 

CHF is most common in people with hypertension, but it can also be influenced by lifestyle habits, like alcohol consumption and smoking, for example. 

Diagnosis of congestive heart failure is confirmed by a cardiologist through a cardiac stress test, a chest x-ray and an echocardiogram. These tests help the doctor to assess heart functioning. It is important to seek medical attention at the onset of symptoms, as early treatment of CHF can be very successful. Normally, the doctor will prescribe antihypertensives and recommended lifestyle improvements. 

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Common symptoms 

The first symptom of CHF is shortness of breath. It tends to worsen with time until the patient feels short of breath even at rest. Generally, breathing can become more difficult when lying down and can cause night-time coughing. 

Other signs and symptoms of congestive heart failure include: 

  • Swelling to the lower extremities and abdomen 
  • Excessive fatigue 
  • Weakness
  • Shortness of breath 
  • Difficulty sleeping 
  • Intense coughing with blood 
  • Loss of appetite and weight gain 
  • Confusion
  • Urinary frequency, especially at night 

In addition, due to decreased circulating oxygen, tissues and organs like the lungs or kidneys can be affected. 

Decreased blood flow that occurs with CHF triggers the heart to work harder to ensure the body is getting enough oxygen. This results in an increase in heart rate, as the heart tries to compensate for decreased oxygen levels. 

This abnormal heart rate can lead to accumulation of fluid within the tissue, leading to swelling in the legs and feet, as well as in the abdomen. 

Treatment options

Congestive heart failure treatment is monitored by a cardiologist. Although treatment can vary with the cause, it usually involves the use of diuretics (like furosemide and spirinolactone) and beta-blockers (like carvedilol, bisoprolol, or metoprolol), which should be taken as prescribed. 

In addition, there are other measures that can be considered, like a balanced diet, decreasing salt intake and exercising regularly. A Mediterranean diet can be a great option for the treatment and prevention and heart disease. Cardiac surgery is usually only considered when medications are not effective. Similarly, if diabetes is contributing to CHF, the doctor may ask the patient to adhere more strictly to a diabetic diet

Possible causes

Congestive heart failure can be caused by any cardiac condition that affects heart function and oxygen delivery. The main causes of CHF include: 

  • Severe coronary artery disease, which when blood vessels become obstructed witty fatty plaques.
  • Heart valve stenosis, which is when heart the valves narrow from aging or rheumatic fever.
  • Cardiac arrhythmias, which are abnormal heart rates that are too fast or too slow.
  • Diastolic dysfunction, which is when the heart is unable to fully relax following a contraction. This is more common in older adults and people with hypertension.

In addition to these causes, CHF can occur due to excessive alcohol intake, smoking, rheumatic illnesses, obesity, diabetes, viral infections, or increased iron deposits in tissues.