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What Is Congestive Heart Failure?

experiencing chest pain

Story at-a-glance -

  • Congestive heart failure, which can be either chronic or acute, affects the ability of the heart muscles to pump properly
  • Also known as heart failure, this condition arises when there's fluid buildup around the heart, causing the heart muscles to pump inefficiently
  • Congestive heart failure can be classified into multiple stages, and the disease’s causes are often idiopathic, or unknown. However, there are triggers that can be traced to other conditions directly affecting the cardiovascular system
  • Doctors can utilize various methods to diagnose congestive heart failure
  • To improve conditions and prevent complications, it’s highly recommended that you consult a doctor or a medical professional immediately

Body function begins and ends with your heart. Roughly the size of your fist, your heart pumps blood, nutrients and oxygen to every cell in your body, while eliminating carbon dioxide and other waste.1 Maintaining good heart health is important, especially as you age, because this organ can be damaged over time, causing impaired function and development of congestive heart failure.

What Is Congestive Heart Failure?

Congestive heart failure is a chronic or acute syndrome that affects the ability of the heart muscles to pump properly.2 Also known as heart failure, this condition manifests when there's fluid buildup around the heart, causing its muscles to pump inefficiently.3

To better understand how congestive heart failure develops, you have to know your heart's anatomy. The heart has four chambers, with the upper half having two atria and the lower half having two ventricles.4

The ventricles pump blood to your body's organ and tissues, while the atria get blood from your body as it recirculates.

Blood circulation begins at the right atrium, moves toward the right ventricle and the left atrium, and finally goes to the left ventricle. After this, blood is circulated back to your body. If these ventricles fail to pump back blood in sufficient amounts to the body,5 blood and other fluids can build up inside your lungs, abdomen and lower body.6

Congestive Heart Failure by the Numbers

Congestive heart failure can affect people of all ages. While it’s more common among middle-aged adults and the elderly, children and young adults may be diagnosed with this syndrome too.7

Around 5.7 million adults in the U.S. have been diagnosed with heart failure,8 and roughly 550,000 new cases occur each year. Nearly 1.4 million people with congestive heart failure are under 60 years old, and in hospital patients 65 years old and above, congestive heart failure is the most common diagnosis. The incidence of congestive heart failure is equally frequent between men and women, although from a racial standpoint, African-Americans are 1.5 times more likely to develop this disease compared to Caucasians.9

Congestive heart failure is a burden to both your health and wallet. An estimated $30.7 billion each year is spent on health care services, medicines and missed days of work related to the disease.10 Furthermore, 11 million physician visits yearly are attributed to congestive heart failure, and this disease is the first-listed diagnosis in 875,000 hospitalizations, said to be more than all forms of cancer combined.11

According to Emory Healthcare, about half of those who develop congestive heart failure may die within five years of diagnosis. Sudden death is common among people with congestive heart failure, occurring at a rate six to nine times higher than that of the general population. It causes approximately 287,000 deaths a year. The silver lining is studies show that death rates from congestive heart failure have decreased on average by 12% per decade for women and men in the past 50 years.12

Common Types of Congestive Heart Failure

The most common type of congestive heart failure is left-sided congestive heart failure. This develops when the left ventricle fails to properly pump blood out to the body and eventually needs to exert more effort to function properly. There are two types of left-sided congestive heart failure:13

  • Systolic heart failure — This develops when the left ventricle fails to contract normally, reducing the level of force available that’ll push blood into circulation. This lack of force means that the heart cannot pump properly. The left ventricle eventually weakens and prompts some blood to flow back into your organs, triggering fluid buildup or swelling in your lungs or other body parts.
  • Diastolic heart failure — Also called diastolic dysfunction, this happens when the muscle in the left ventricle stiffens. Since the muscle can no longer relax, the left ventricle is unable to fill the heart’s lower chamber, decreasing the amount of blood pumped into your bloodstream.

Some patients may also be susceptible to right-sided congestive heart failure. This process affects the right ventricle, causing it to experience difficulty pumping blood into the lungs. Because of this, blood backs up in the veins, causing swelling in your legs, ankles and belly.14

In some cases, patients may have left-sided and right-sided congestive heart failure simultaneously. As Medical News Today highlights, this condition can begin in the left side and travel to the right side if left untreated.15

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What Are the Risk Factors for Congestive Heart Failure?

According to the Mayo Clinic, while a single risk factor can be enough to trigger congestive heart failure, any of these factors may increase your susceptibility for this condition:16

  • Heart attack — If there is damage to the heart muscle because of a heart attack, this can cause the heart to no longer pump as well as it should.
  • Diabetes Diabetics have a higher risk for high blood pressure levels and coronary artery disease that may lead to congestive heart failure. Certain diabetes medications like rosiglitazone (Avandia) and pioglitazone (Actos) can increase a person’s heart failure risk as well.
  • Obesity People who are obese are known to have a higher congestive heart failure risk.
  • Sleep apnea — Characterized by an inability to breathe properly while sleeping at night, this condition may result in low blood oxygen levels and a higher risk of abnormal heart rhythms, both of which can weaken the heart.
  • Alcohol use — Excessive alcohol consumption can weaken heart muscles and trigger heart failure.
  • Tobacco use — Smoking can increase your risk for heart failure by increasing triglyceride levels, prompting blood to become sticky and likely to clot, or weakening cells lining your blood vessels.17
  • Medications — Drugs that may lead to heart failure or heart problems include nonsteroidal anti-inflammatory drugs (NSAIDs), anesthesia medications,antiarrhythmic medications,medications used to treat high blood pressure, blood conditions and neurological conditions.

What Causes Congestive Heart Failure?

The causes of congestive heart failure are often idiopathic, or unknown. However, there are triggers that can be traced to other conditions directly affecting the cardiovascular system. Patients with congestive heart failure develop this condition due to pathophysiological problems, such as weaker hearts caused by an underlying heart or blood vessel problem, or a combination of other problems, such as:18,19

Coronary artery disease — Patients with this condition have narrowing in the arteries that may restrict blood flow, which ultimately can weaken and damage the heart.20

This disease can develop when the coronary arteries that supply blood to the heart are blocked and don’t get enough oxygen to function properly.21

Congenital heart disease or defects — People born with these conditions have hearts that hadn’t developed properly in the womb. As a result, other healthy parts of the heart need to work more to circulate blood properly.

Abnormal rhythms or irregular heartbeat — The heart’s effectiveness as a pump can be reduced because of abnormal heart rhythms that are too slow, too fast or irregular. When this happens, the heart needs to pump harder to combat the rhythm disorders.

If an excessively slow or fast heartbeat is sustained for hours, days or weeks, this can weaken the heart and lead to congestive heart failure.

High blood pressure levels — This makes it difficult for blood to pass throughout the body, causing blood pressure levels to be higher than normal.

Elevated blood pressure levels can raise the workload of the heart’s left ventricle, which pumps blood to the circulatory system. As the ventricle works harder, it may accumulate increased damage and weaken the heart.

Valve conditions — The valves aid in regulating blood flow through the heart by opening and closing to facilitate passage of blood in and out of the chambers.

Having a valve that fails to close properly can cause blood to flow backward into the heart and prompt this organ to work harder than normal to maintain its output.

In some cases, a valve may not open properly, known as a stenotic valve. This leads to significant narrowing of the opening and may force the ventricles to work harder to pump blood.

Cardiomyopathy — The patient has weakened heart muscles because of damage or disease. Weakened heart muscles fail to contract or squeeze as forcefully as they should.

Damage to a heart muscle due to blockage or heart attack — Blockage to your blood supply can lead to a heart attack or myocardial infection. You may feel severe pain in the chest, shortness of breath, nausea, sweating and a feeling of impending doom.

A heart attack can lead to a cardiac arrest or permanent damage to the left ventricle that may cause the area to work less effectively and increase your heart failure risk.

Certain genetic diseases that involve the heart.

Various disorders (albeit less common) wherein the heart muscle is affected by a certain disease.

Infections (commonly from viruses) that may attack the heart for unknown reasons.

Other conditions — Thyroid disease, blood clots in the lungs, hypothyroidism or allergic reactions can all increase your risk.

Lifestyle Habits Can Trigger Congestive Heart Failure Too

Aside from unhealthy habits such as smoking and excessive alcohol consumption, EMedicineHealth notes other lifestyle habits linked to congestive heart failure, such as:22

  • Obesity and lack of exercise, which can trigger high blood pressure levels, diabetes and coronary artery disease
  • High salt intake, which could cause fluid retention
  • Noncompliance with medicines and other therapies

Different Stages of Congestive Heart Failure

After identifying the symptoms, congestive heart failure can be classified using systems conceptualized by the New York Heart Association or the American College of Cardiology and American Heart Association. This will help determine the ideal treatment protocol.23

The New York Heart Association Classification

This takes note of the symptoms of congestive heart failure patients and separates them into four categories:24,25

  • Class 1 — No noticeable symptoms like shortness of breath during physical activities such as walking or climbing stairs.
  • Class 2 — Mild symptoms like angina or shortness of breath after doing normal physical activity may manifest.
  • Class 3 — The patient may be comfortable only at rest. There’s a noticeable limitation in being physically active, as moving too much can trigger symptoms.
  • Class 4 — People in this stage are usually bedbound. They have severe limitations, and even experience the indicators while stationary.

The ACC and AHA Guidelines

The American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines classify patients according to the progression of the disease. Oftentimes, doctors use this system to identify potential risk factors, in order to begin early and more aggressive treatment that’ll help prevent or delay congestive heart failure. The stages of congestive heart failure as listed by are as follows:26,27

  1. Stage A (High risk for developing heart failure) — Also called “pre-heart failure,” the patient has one or more risk factors, which include hypertension, diabetes, metabolic syndrome and a history of alcohol or drug abuse.
  2. Stage B (Asymptomatic heart failure) — The patient has already developed an enlarged or dysfunctional left ventricle, but does not express any symptoms.
  3. Stage C (Symptomatic heart failure) — The patient shows symptoms such as shortness of breath, fatigue and inability to exercise.
  4. Stage D (Refractory end stage heart failure) — The patient experiences symptoms even while at rest, and despite having been given treatment. Cardiac transplants, mechanical devices, more aggressive medical therapy or end-of-life care may be recommended.

As the Mayo Clinic emphasizes, these scoring systems aren't independent of each other, and doctors often use them together to help determine the appropriate treatment. Ask your doctor about your score to learn more about the severity of your congestive heart failure.28 No matter what stage you’re in, have yourself checked as soon as possible if you notice symptoms.

Watch Out for These Symptoms of Congestive Heart Failure

Heart failure can be chronic (ongoing) or acute (sudden and unexpected).29 Patients in the early stages of congestive heart failure may not notice any changes to their health, but as the condition progresses, changes in the body may be felt.30 Initial congestive heart failure symptoms, according to the Mayo Clinic, include:

  • Fatigue
  • Swelling in the ankles, feet and legs
  • Weight gain from fluid retention
  • Increased need to urinate, especially at night
  • Decreased ability to exercise
  • Coughing or wheezing, with white or blood-tinged (seen as pink spots) phlegm
  • Abdominal swelling (ascites)
  • Lack of appetite
  • Nausea
  • Reduced alertness
  • Decreased ability to concentrate

Signs and Symptoms of Congestive Heart Failure in Children and Infants

Common symptoms in young patients include:31,32

  • Poor feeding and weight gain (among infants)
  • Excessive sweating during feeding, playing or exercising
  • Difficulty breathing that may occur alongside rapid breathing, wheezing or excessive coughing
  • Edema, or swelling of the feet, ankles, lower legs, belly, liver and neck veins
  • Tiredness
  • Increased need to take breaks during playtime
  • Falling asleep during feeding
  • Nausea or vomiting
  • Abdominal or chest pain
  • Weight loss
  • Fainting
  • Cough or lung congestion

If These Signs Appear, Seek Medical Care

Medical attention is needed if you or someone you know experiences these severe symptoms of congestive heart failure:33

  • Chest pain that radiates through the upper body
  • Rapid breathing or irregular heartbeat
  • Skin that appears blue (due to possible blood vessel blockage)34
  • Fainting and weakness 
  • Sudden and severe shortness of breath
  • Coughing up pink and foamy mucus

These symptoms may be triggered by life-threatening heart and lung conditions as well, so if you notice them, seek immediate medical attention, since proper diagnosis is crucial.

When to Call for Emergency Help

If you have heart failure and are experiencing new or worsening symptoms, don’t wait until it’s too late to call for help.35 If you suddenly gain or lose 4 pounds or more, call your doctor immediately, especially if you have weight gain accompanied by edema (swelling in your extremities or abdomen). Chest pain, a heartbeat over 120 beats per minute and sudden difficulty breathing are also symptoms to alert your doctor about.

If you have sudden, severe, unexpected chest pain accompanied by nausea, weakness and sweating (sometimes your body will feel cold to the touch, even though you’re sweating), call for an ambulance — this could be a sign of a heart attack.36 Other congestive heart failure symptoms and complications that require immediate attention include:37

  • Restlessness and confusion
  • New or more noticeable irregular heartbeat
  • Sudden weakness or paralysis in your arms or legs
  • Fainting spell with loss of consciousness
  • Constant dizziness or lightheadedness
  • Sudden onset of a severe headache

How Congestive Heart Failure Is Diagnosed

After reporting initial symptoms, a cardiologist will conduct a physical exam and check for abnormal heart rhythms using a stethoscope. They may order you to undergo diagnostic tests to examine other parts of the heart. Other tests that can help confirm an initial diagnosis include:38,39,40

  • Electrocardiogram (EKG or ECG) — This records your heart’s rhythm and shows if there’s heart damage or irregular heart rhythms.
  • Echocardiogram — Sound waves record the heart’s structure, motion and movement. This test checks your heart’s ejection fraction or how well your heart is pumping in that particular period. An echocardiogram can help determine if you have poor blood flow, a heart muscle that doesn’t work properly or another abnormality.
  • Magnetic resonance imaging (MRI) — This involves taking pictures of the heart to see if there are structural abnormalities, and examine its efficiency in pumping blood to the body.41
  • Stress tests — These can show how well your heart performs under different levels of stress. There are many ways stress tests can be performed, but the most common involves the patient walking or running on a treadmill while attached to an ECG machine.
  • Blood tests — These check for infections and a hormone called BNP that may arise alongside heart failure. Blood tests also assist with examining kidney and thyroid function, cholesterol levels and signs of anemia.
  • Cardiac catheterization — This can show blockages of the coronary arteries. It involves a small tube being inserted into a large blood vessel connecting to your heart, usually in your groin42 or leg. At the same time, the physician checks blood flow and pressure in your heart chambers.

Seek medical care as early as possible if congestive heart failure signs appear, to prevent the condition from worsening and complications from developing. Avoid self-diagnosing and talk to your doctor to see if special care is required for your condition.43

Life Expectancy for Congestive Heart Failure

There are factors that can determine the life expectancy of congestive heart failure patients, namely severity of heart failure, age and overall health.44 According to a 2013 Circulation Research article, around 50% of individuals with heart failure live for at least five years, while 10% survive for around 10 years after their initial diagnosis.45

What Are the Known Complications of Congestive Heart Failure?

Proper treatment can aid with improving symptoms and heart function among people with congestive heart failure. However, the Mayo Clinic notes that there are complications that may shorten your life expectancy, such as:46

  • Kidney damage or failure — If left untreated, congestive heart failure may reduce blood flow to the kidneys and cause kidney failure. The patient may need to undergo dialysis.
  • Heart valve problems — An enlarged heart or very high blood pressure caused by heart failure may cause your valves to function improperly. Because the valves are responsible for maintaining blood flow in the proper direction throughout the heart, development of valve problems can be detrimental.
  • Heart rhythm problems or arrhythmias — Having an abnormal heartbeat can be a complication.
  • Liver damage — Fluid buildup may occur because of heart failure, which then puts increased pressure on the liver. This may lead to scarring and make it hard for the liver to function properly.

Better Management of Congestive Heart Failure Is Crucial

While many causes of congestive heart failure cannot be reversed, some measures can help improve symptoms and life expectancy, no matter which stage of heart failure you are in. If you have been diagnosed with congestive heart failure, pay attention to your body and how you feel, and consult a doctor when you’re feeling better or worse to help him or her know the treatment that can work for you. Mayo Clinic suggests these tips to help you manage your condition:47

Keep track of medicines you take — Make a list of the medications you take and show it to any new doctors treating you.

Refrain from stopping your medicines without consulting your doctor first. However, if they trigger uncomfortable side effects, ask your doctor what you can do to stop these complications from worsening.

Avoid taking certain medications unless necessary — Ibuprofen (Advil, Motrin, IB and others), naproxen sodium (Aleve) and diet pills are some examples. They can exacerbate heart failure and lead to fluid buildup.

Exercise caution when taking supplements — Some dietary supplements may interfere with heart failure medications or worsen your condition. If you are taking any supplements or plan to take supplements to address other health concerns, consult your cardiologist first.

Keep track of your weight and bring your records to doctors’ visits — Weight gain can be an indicator of fluid buildup in the body. Your doctor may advise that you take diuretics if your weight has increased by a certain amount within a day or week.

Maintain a record of your blood pressure levels — Consider buying a home blood pressure monitor and keeping track of your blood pressure levels between appointments. Bring this record to the appointment too.

Write down questions for your doctor — Prepare a list for your appointment. Make clarifications so that you’ll understand everything that your doctor recommends you to do.

Keep important contact information on-hand — These include your doctor’s phone number, the hospital’s phone number and directions to the hospital or clinic.

Managing congestive heart failure not only entails an open and honest relationship between you and your doctor, but careful monitoring of your symptoms and lifestyle activities as well. Be honest about following recommendations concerning diet, lifestyle and medications.

Ideal Treatment for Congestive Heart Failure

If you are living with congestive heart failure, your doctor may consider different treatments depending on two factors: your overall health and how the condition has progressed.48 Medications, diet strategies and an exercise or physical activity plan may be some of the first options your doctor will suggest.

The following natural treatments should be among your first options in helping address congestive heart failure. If your condition is more serious, though, surgical procedures may be considered (more on these later):49

Coenzyme Q10 (CoQ10)50 This nutrient plays an important role in your cells’ ability to extract energy from food. Because it’s the hardest working muscle in the body, the heart requires CoQ10 for energy, and one of the largest studies of its kind in the world showed that heart patients who supplemented with CoQ10 had a 43% decrease in cardiovascular death, compared to a placebo group.51 Additionally, a meta-analysis in 2017 reported that taking CoQ10 can help reduce mortality in heart failure.52

Age and statin therapy reduce your body’s CoQ10 levels. If you’re taking statin drugs, consider CoQ10 supplements to maintain your levels of this nutrient and ensure optimal heart health. Ubiquinol (or ubiquinone) is the reduced version of CoQ10 and is more readily absorbed by older people, so if you choose to take a CoQ10 supplement and you are middle aged or in your senior years, opt for ubiquinol.53

Magnesium and potassium54 A study published in the Journal of Clinical Hypertension in 2011 revealed that taking magnesium and potassium supplements together, along with consuming a low-sodium diet, helped reduce blood pressure levels and may be beneficial for overall function and heart disease.55

A Current Hypertension Reports article published in the same year showed that dietary intake of potassium improved heart function by helping offset the rise in blood pressure levels from a high-salt diet.56 The best sources for potassium should come from your diet. Do not take potassium supplements without checking with your doctor to determine the correct dosage.57

Zinc — This mineral contains antioxidant properties that help neutralize free radicals that contribute to development of heart disease. In fact, a 2011 study in Biological Trace Element Research suggested that persons with heart failure often have zinc deficiencies, and that supplementation with zinc may have benefits.58 Strive to get zinc from dietary sources, however, as taking too much zinc in supplemental form can interfere with the body’s ability to absorb other minerals.

Before taking zinc supplements, talk to your doctor to confirm that they would be ideal for your condition. Should you decide to take zinc supplements, opt for those coming from a reputable company that utilizes best-practice quality assurance methods. Ensure that they contain different forms of zinc such as gluconate, citrate and chelate, and that they are free of lead and heavy metals.

Medicines for Congestive Heart Failure Have Certain Caveats

As mentioned earlier, doctors may suggest medicines as a first-line treatment to alleviate congestive heart failure. But while these are conventional remedies, you should have a thorough discussion with your doctor about the pros and cons of these drugs before taking them. Take them only if the natural treatments previously discussed aren’t working. Some of the drugs your doctor may prescribe are:59

Angiotensin-converting enzyme (ACE) inhibitors — These open narrowed blood vessels to improve blood flow, reduce blood pressure and lessen the heart’s workload. Lisinopril (Zestril), enalapril (Vasotec) and captopril (Capoten) are known ACE inhibitors. These drugs should not be taken with the following medicines because it can lead to unwanted side effects:

Thiazide diuretics60

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin and naproxen

Side effects of the ACE inhibitors themselves include dry cough, hyperkalemia (increased blood potassium levels), fatigue, dizziness, headaches and loss of taste. Angioedema or swelling of some areas of your tissues can also develop, although this is a rare side effect that is more common among African-Americans and in smokers.61

Beta blockers — These drugs are given to reduce blood pressure levels and slow your heartbeat. Lopressor or metoprolol, is a known beta blocker given for this condition, among many other types. However, side effects can manifest if you take beta blockers alongside these medications:62,63

Antiarrhythmic medicines

Antihypertensive medicines

Albuterol (Accuneb)64

Clonidine (Catapres)

Antipsychotics such as thioridazine (Mellaril) or chlorpromazine (Thorazine)

Beta blockers’ side effects include fatigue, cold hands or feet, weight gain, shortness of breath, sleeping difficulties and depression. They also can cause triglycerides in your blood to rise65 — which may then trigger a prescription for cholesterol-lowering medicines like statins, which come with their own set of side effects.66

Diuretics — Congestive heart failure can cause the body to retain more fluid,67 so some doctors may recommend diuretics such as thiazide diuretics, loop diuretics (like Lasix) and potassium-sparing diuretics to enable your body to move fluid.

Diuretics can trigger side effects like increasedurination, mineral loss, dizziness, headaches, dehydration, muscle cramps, impotence and joint disorders like gout. They can also affect your blood potassium levels.68 To counteract the potassium loss, your doctor may prescribe a potassium supplement for you, as studies show that combining these with loop diuretics may increase your survival chances.69

Surgical Treatments for Congestive Heart Failure

If medications aren’t effective on their own, the following procedures may be needed to help address congestive heart failure:70

Coronary bypass surgery — This may be recommended if your arteries are severely blocked.

During the surgery, blood vessels from the leg, arm or chest will be removed and connected to unblocked arteries. This allows blood to flow through the heart more freely and avoid the affected area.

A coronary bypass is a major procedure that involves cutting the center of your chest open and splitting your ribs at the breastbone to get access to your heart.71

Heart valve repair — This may be ideal if a faulty valve is to blame for your condition. Certain types of heart valve repair or replacement may now be done without open heart surgery, either using minimally invasive surgery or cardiac catheterization techniques.

Surgeons carry out this “repair” process by modifying the original valve to decrease backward blood flow, reconnecting valve leaflets or discarding excess valve tissue to allow the leaflets to close well.

An annuloplasty, involving tightening or replacing the ring around the valves, can also be done to repair the valve.

Heart valve replacement — This procedure, which entails replacing the affected valve with an artificial or prosthetic valve, may be recommended for patients with faulty heart valves who may not be suitable for heart valve repair.

Cardiac resynchronization therapy (CRT) or biventricular pacing — A biventricular pacemaker sends timed electrical impulses to both the left and right ventricles to help them pump more efficiently.

CRT can be helpful for patients with ventricle problems, especially if both fail to contract simultaneously.72

Implantable cardioverter-defibrillator (ICD) — An ICD, a battery-operated device similar to a pacemaker, is surgically implanted under your chest. It’s composed of a generator that can reach certain areas of your heart since some wires are attached to the device.73

The ICD monitors your heart rhythm. If your heart starts beating a dangerous rhythm or stops beating altogether, electrical pulses or shocks will reset your heart’s rhythm or get it started again.

The ICD can also function as a pacemaker and raise your heartbeat’s speed if it’s too slow, or decrease the speed if it’s too fast.74 If you have heart failure that involves arrhythmia, your doctor may combine a pacemaker with the ICD.75

Heart transplant — This is recommended for severe heart failure cases that cannot be treated with surgery or medications.

A major caveat about this procedure, however, is that some candidates for a heart transplant may need to wait a long period of time before a donor is found.

Heart pumps like ventricular assist devices (VADs) — These are implanted into the chest, and attached to the heart to help it with blood circulation.

VADs are most often used in the left ventricle, although they can also be used in the right ventricle or in both ventricles.76

Heart pumps like VADs can be used by people waiting for a heart transplant. However, VADs are now sometimes used as an alternative to transplantation.

Heart pumps can help people with severe heart failure who aren’t eligible for or are unable to undergo a heart transplant, or who are waiting for a new heart.

VADs can either be transcutaneous or implantable. Transcutaneous VAD has the pump and the power source located outside the body.

The implantable VAD functions via a power source outside the body, but a pump is inserted inside the body. These items are connected via a cable.77

Angioplasty — This is an option for people whose heart failure is caused by coronary artery disease and whose conditions may be worsened due to heart damage or a previous attack.

A catheter is inserted into a blood vessel and threaded into the affected artery. This addresses the narrowing or blockage of a coronary artery delivering blood to the left ventricle.

A tiny balloon or an expandable metal stent is placed in the area of narrowing or blockage, and inflates or inserts the stent.

The theory is that the stent helps expand and push aside cholesterol deposits or plaque responsible for blocking the artery so blood can flow normally.78

However, a 2017 BMJ study showed that although stents improve blood supply, they don’t provide more relief of symptoms compared to drug treatments.79

Be sure to talk to your doctor before undergoing surgery so you’ll be fully informed about the procedure and what to expect from it.

Preventing Congestive Heart Failure

There are techniques that’ll help you lower your risk of congestive heart failure, or at least delay its onset. Start with these two tips:

Stop smoking and avoid secondhand smoke — Quitting smoking will lower your risk for heart disease. However, secondhand smoke can put you at risk for congestive heart failure, too, so if you live with a smoker, ask them to stop or at least smoke outdoors.80

Sleep easy People who struggle with sleep apnea, which causes frequent nighttime awakenings, often have heart troubles.81 Sleep deprivation can cause significant heart strain, including increased blood pressure and heart rate.82 While sleep problems can be caused or exacerbated by a number of different factors, three things that are frequently overlooked are light pollution, exposure to electromagnetic fields and sleep position.

You can try sleeping with your head propped up using a pillow or a wedge if you constantly experience shortness of breath at night. Consider being tested for sleep apnea if snoring or other sleep problems manifest.

Other ways to help minimize your risk of congestive heart failure involve making changes to your diet and lifestyle, limiting alcohol intake83,84 and maintaining a healthy weight.85

How Exercise Can Combat Congestive Heart Failure

A combination of exercises like high-intensity interval training, strength training, stretching and core work can be helpful in minimizing your risk of congestive heart failure. If you already have heart failure, exercise or moderate aerobic activity can assist with keeping the rest of your body healthy and conditioned, reducing the demands on the heart muscle; however, if you have been diagnosed with heart failure, do not begin a new exercise program without first checking with your doctor.86 These other strategies can also improve your overall physical health:

  • Regularly walk barefoot on the earth — Known as grounding, this enables free electrons to be transferred from the earth into your body. The effect is considered a beneficial antioxidant and can assist with addressing inflammation present throughout the body.
  • Avoid excess sitting Reduce your sitting time to only three hours or less a day.
  • Keep moving around — Alongside an exercise program, try to take 10,000 steps a day.

As mentioned, before engaging in exercise or physical activity, consult your doctor to ask about any limitations you may have and to determine what kind of exercise program may be suitable for your condition. You can also check if your local hospital offers a cardiac rehabilitation program that you can join.87

Seeking the advice of a physical therapist who has worked with or is familiar with congestive heart failure can be helpful too, since they can provide you with knowledge about appropriate exercises for your condition and assist you in preventing injuries and complications.88

Reducing Stress Levels Is a Must

Stress can contribute to congestive heart failure. When you’re upset or anxious, the heart beats faster, breathing becomes heavier and blood pressure levels increase. These can increase your risk because your heart is already having trouble meeting the body’s demands.89

The Emotional Freedom Techniques (EFT) is a powerful stress-relieving tool you can try to help lower stress levels. EFT, which has similarities to acupuncture but without the use of needles, is based on the concept that a vital energy flows throughout the body via invisible pathways called meridians. EFT stimulates specific energy meridian points throughout the body when you tap on these areas with the fingertips while voicing positive affirmations.

Research has confirmed that EFT can be powerful in combating stress and anxiety90,91,92 because of its ability to target the brain’s amygdala and hippocampus. Aside from EFT, other ways for you to reduce your stress levels include:93

  • Breathing exercises
  • Guided imagery
  • Progressive muscle relaxation
  • Self-hypnosis
  • Rhythmic movement
  • Mindfulness meditation
  • Yoga
  • Tai chi
  • Massage therapy
  • Biofeedback-assisted relaxation
  • Autogenic training (focusing on physical sensations in your body)
  • Listening to sounds of nature
  • Buteyko breathing (proper breathing techniques)
  • Qigong, a combination of slow movements and deep mental concentration

Talk to your doctor before taking any of these steps and check if there are certain restrictions that you should know about to prevent unwanted side effects and injuries.

What’s the Best Diet for Congestive Heart Failure Patients?

Following a healthy diet is one of the most effective measures to help reduce your chances of being diagnosed with heart disease and congestive heart failure. Fresh and organically grown vegetables that are high in nitrates — such as spinach, beetroots, radishes, carrots and cucumbers — act as potent vasodilators that help lower your blood pressure and preserve endothelial dysfunction.94

Research suggests that switching to a Paleo diet consisting of whole, real food (nothing processed) can also benefit your heart.95

Healthy fats, including unprocessed saturated animal fats, are an important part of a healthy diet too. While saturated fat has been vilified for years, people who want to prevent or address symptoms of congestive heart failure can benefit from these.

Even though many doctors will advise you to eat only low-fat or nonfat foods, numerous studies have debunked the myth that saturated fat is harmful for your body. In a 2013 article, Dr. Aseem Malhotra, a cardiology specialist registrar from London’s Croydon University Hospital, highlights that conventional advice regarding reducing saturated fat intake may raise a person’s risk for cardiovascular health problems.96

A meta-analysis published in the American Journal of Clinical Nutrition in 2010 also noted that a link between saturated fats and increased coronary heart disease or cardiovascular disease cannot be fully established.97 Apart from these study results, saturated fats have been linked to other benefits, namely:

  • Provide building blocks for cell membranes, hormones and hormone-like substances
  • Promote mineral absorption
  • Act as carriers for fat-soluble vitamins A, D, E and K
  • Conversion of carotene into vitamin A   
  • Assist with reduction of cholesterol levels (palmitic and stearic acids)
  • Act as an antiviral agent (caprylic acid)
  • Ensure optimal “clean” fuel for the brain and mitochondria
  • Provide satiety
  • Modulate genetic regulation and prevent cancer (butyric acid)

Omega-3 fats may help decrease inflammation98 triggered by atherosclerosis (inflammation in your arteries) and aid with reducing triglyceride levels.99 Intermittent fasting can also benefit your heart. Dr. Haitham Ahmed, a Cleveland Clinic cardiologist, confirms that fasting “can help lower blood pressure, reduce cholesterol, control diabetes and reduce weight.”100

Foods Ideal for Congestive Heart Failure Patients

One of the best ways to combat congestive heart failure is to eat as much fresh food as possible.101 Incorporate these foods into your diet:

  • Unrestricted quantities of fresh, organic and low-net carb vegetables
  • Moderate portions of high-quality protein from organically raised, grass fed or pastured animals
  • High amounts of healthy fats from sources like avocados, coconut oil, grass fed butter, pastured egg yolks and raw nuts like macadamia, pecans and pine nuts

Other foods you can add to your diet include:

  • Green tea — As highlighted in a 2007 Journal of the American College of Nutrition study, the antioxidant epigallocatechin gallate (EGCG) in green tea may have a heart-protecting ability.102
  • Pomegranate — A 2011 Complementary Therapies in Clinical Practice study highlights that antioxidant chemicals in this fruit can assist with reversing atherosclerosis and reducing blood pressure levels.103
  • Zinc-rich foods — Zinc can help neutralize free radicals that may trigger congestive heart failure. Animal byproducts such as oysters and grass fed beef contain the highest amounts of dietary zinc. Free-range poultry, raw cheese, wild-caught seafood like lobster and Alaskan crab, raw milk, almonds and pumpkin seeds are other good sources of zinc.104

Foods to Avoid if You Have Congestive Heart Failure

Avoid consuming foods high in sugar (including processed fructose) and refined grains, especially if you are insulin- and leptin-resistant. A high-sugar and high-grain diet can promote insulin and leptin resistance, which are precursors of heart disease.

Reduce or avoid drinking alcohol if you have congestive heart failure, as it may trigger interactions with medicines you take, weaken the heart muscle and raise your abnormal heart rhythm risk. In some cases, patients with severe heart failure may also be recommended by a doctor to limit fluid intake.105

When you are seasoning foods, use Himalayan salt, fresh herbs and spices, herbed vinegar, and citrus fruit juices. Minimize your intake of salt from processed foods.106 Avoid herb or spice mixtures containing high amounts of sodium, and stay away from or limit your intake of condiments that contain high amounts of this substance, such as:107

  • Flavored salts
  • Lemon pepper 
  • Garlic salt
  • Onion salt
  • Meat tenderizers
  • Flavor enhancers
  • Bouillon cubes
  • Ketchup
  • Mustard
  • Steak sauce
  • Soy sauce

Do not eat foods with hidden salts, such as:

  • Canned food
  • Processed foods such as gravies, instant cereal, packaged noodles and potato mixes
  • Olives
  • Pickles
  • Soups
  • Vegetables high in salt
  • Processed cheeses
  • Cured meats like bacon, bologna, hot dogs and sausages
  • Fast foods
  • Frozen foods

Checking and reading food labels before buying packaged goods is one of the first steps you can take toward lowering salt intake. When reading labels, check nutrition facts for sodium content per serving and how many servings are present. Ideally, pick foods with a sodium content that’s below 350 milligrams per serving.

Take note of the ingredients list as well. If salt or sodium is listed as one of the first five ingredients, do not buy the item, as this indicates high sodium content. When eating at a restaurant, follow these tips:108

  • Take note of menu terms that may indicate a high sodium content — These include dishes that have been pickled, or cooked in au jus, soy sauce or broth.
  • Request that the cook prepare the dishes without adding salt or monosodium glutamate (MSG) — Ask for sauces or salad dressings to be placed on the side. If you’re eating a salad, add a twist of lemon, a splash of vinegar or a light drizzle of low-sodium dressing.
  • Eat raw vegetables or fresh low-fructose fruits in place of salty snacks.

The Drawbacks of Avoiding Salt

Although limiting or reducing your salt intake can be helpful if you have congestive heart failure, avoiding salt entirely may also lead to possible complications, as highlighted by several studies:

  • Cochrane Database of Systematic Reviews (2003) — In this review, low-sodium diets were linked to increases in LDL cholesterol and triglyceride levels.109
  • Cochrane Database of Systematic Reviews (2011) — According to researchers, salt restriction wasn’t significantly associated with overall mortality or cardiovascular mortality among those with high or normal blood pressure levels. However, salt restriction was linked to an increased mortality risk among congestive heart failure patients.110
  • JAMA (2011) — Results revealed that consumption of less than 3,000 milligrams of sodium daily can increase a person’s risk of death from heart disease.111
  • JACC Heart Failure (2016) — Among subjects who lowered their salt intake, 42.3% of them had a higher risk for either death or hospitalization due to heart failure.112

Pay Attention to Your Sodium to Potassium Ratio

Paying attention to the ratio between sodium and potassium in your diet makes a difference. The body needs potassium to maintain proper pH levels in your body fluids, and potassium plays an integral role in regulating blood pressure levels.

A potassium deficiency may be more responsible for hypertension (a known risk factor for heart-related problems), rather than having excessive sodium levels. Eating processed foods can be a major cause of this imbalance, because they’re low in potassium but high in sodium, and are also loaded with fructose that can raise your risk for hypertension and chronic diseases. When minimizing sodium intake, consume potassium-rich foods such as:

  • Swiss chard
  • Avocado
  • Spinach
  • Crimini mushrooms
  • Broccoli
  • Celery

Fruits like melons, bananas, oranges and apricots are good sources of potassium too, although they must be eaten in moderation because of their fructose content.113

Frequently Asked Questions (FAQs) About Congestive Heart Failure

Q: How do you get congestive heart failure?

A: The causes of congestive heart failure are often idiopathic or unknown. It is a syndrome, or combination of symptoms, caused by numerous chronic conditions including heart disease, that directly affect the cardiovascular system. Having a weak heart can be linked to underlying heart or blood vessel problems, or health problems such as:114,115

  • Coronary artery disease
  • Ischemic cardiomyopathy
  • Congenital heart disease
  • Infections (usually from viruses)
  • Certain genetic diseases involving the heart
  • Prolonged and serious arrhythmias
  • Other conditions such as diabetes, thyroid disease and allergic reactions
  • Disorders (although less common) wherein the heart being is targeted by a disease process
  • Hypertension or (high blood pressure levels)
  • Abnormal rhythms or irregular heartbeats
  • Damaged heart muscle due to blockage
  • Valve conditions

Lifestyle habits can compromise a person’s health and lead to congestive heart failure too:116

  • Smoking and alcohol consumption
  • Obesity and lack of exercise
  • High salt intake
  • Noncompliance with medicines and other therapies

Q: Is congestive heart failure hereditary?

A: Not much is known about the link between congestive heart failure and genetics, but a study published in the journal Science Advances in 2016 may shed light on this topic. Researchers from the University of Texas Health Science Center at Houston revealed that a mutated gene called SLCO1B1 was linked to high levels of blood fatty acid that may strongly predict development of heart failure. Plus, this mutated gene was shown to have a direct effect on heart failure risk.117,118

Q: Can stress bring on congestive heart failure?

A: Stress can worsen existing congestive heart failure. It can cause the heart to beat faster, breathing to become laborious and blood pressure levels to rise. With the heart already having trouble meeting the body’s demands, increased stress can strain the heart further .119

Q: How do you check for congestive heart failure?

A:A cardiologist can help diagnose congestive heart failure. They may ask for your medical history or check for risk factors or symptoms. The cardiologist listens to your heart using a stethoscope and checks for abnormal heart rhythms or congestion in the lungs. Afterward, diagnostic tests such as the following may be recommended to examine the heart’s valves, blood vessels and chambers:120

Electrocardiogram (ECG)


Magnetic resonance imaging (MRI)

Stress tests

Blood tests

Coronary angiogram

Chest x-rays

CT scans

Q: How serious is congestive heart failure?

A: Severity of congestive heart failure can be categorized either according to the symptoms present or the progression of the disease. Two systems conceptualized by the New York Heart Association and the American College of Cardiology and American Heart Association are often utilized by doctors:121,122,123

Q: Is congestive heart failure fatal?

A: Yes, congestive heart failure can be fatal. This is a serious long-term condition that can worsen over time if left untreated, and may severely limit the activities that a patient can do.124

Q: Is congestive heart failure reversible?

A: Most cases of congestive heart failure are irreversible without some type of medical intervention. However, a healthy diet loaded with as many fresh foods as possible is a good way to help counteract some symptoms of this condition. These are the most important components of a healthy diet for congestive heart failure patients:

  • Unrestricted quantities of fresh, organic and low-net carb vegetables and moderate amounts of fruits
  • Moderate portions of high-quality protein from organically raised, grass fed or pastured animals
  • High amounts of healthy fats

On the other hand, lifestyle changes that can help congestive heart failure patients counteract the disease include:125

  • Quitting smoking and avoiding secondhand smoke126
  • Practicing proper sleeping habits
  • Getting sufficient exercise (a combination of high-intensity interval training, strength training, stretching and core work)
  • Reducing stress levels by practicing the Emotional Freedom Techniques (EFT),breathing exercises, yoga, tai chi or massage therapy, to name a few

Q: How is congestive heart failure treated?

A: Supplements such as coenzyme Q10 (CoQ10),127 zinc, magnesium and potassium may help patients with this syndrome.128 Medicines such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and diuretics should be considered a last resort, mainly because of potential side effects and complications linked to them. Lastly, these surgical procedures may be recommended if medicines aren’t effective:129

  • Coronary bypass surgery
  • Heart valve repair or replacement
  • Implantable cardioverter-defibrillators (ICDs)
  • Cardiac resynchronization therapy (CRT) or biventricular pacing
  • Heart pumps
  • Heart transplant
  • Angioplasty130

Q: How long can a person live with congestive heart failure?

A: A 2013 Circulation Research article highlights that around 50% of individuals with congestive heart failure live for around five years after their initial diagnosis, while 10% may live longer by 10 years.131 Factors such as severity of congestive heart failure, age and overall health can determine how long you can live if you have congestive heart failure.132

+ Sources and References