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Understanding Congestive Heart Failure: Causes, symptoms, types, stages and treatment

Dr. Ajay KohliJan 17, 2024

Congestive Heart Failure is a serious condition in which the heart is unable to pump sufficient blood to meet the body’s requirements. It is also known as heart failure and is a long-term condition which only worsens with time. In such cases, the heart has less pumping capacity, which can result in the damaging of organs and the collection of fluid inside the lungs, causing shortness of breath.

Here’s an overview of the disease along with its symptoms, causes and other details.




Causes of Heart Failure

There are several causes that can lead to the development of Congestive Heart Failure. Some of the most common causes are as follows.

  • Coronary heart disease: In this disease, the arteries cannot deliver oxygen-rich blood to the heart. This may occur due to the arteries, which supply blood to the heart, being clogged due to fatty deposits. This condition is called atherosclerosis and may cause chest discomfort which is called angina and lead to heart damage because of heart attack.

  • Cardiomyopathy: This may be a hereditary or acquired condition where the heart muscles get affected, leading to failure of the heart to perform its function properly.

  • Hypertension: Hypertension or high blood pressure can put undue pressure on the heart and this may lead to a heart failure.

  • Arrhythmias: Any problems in the regular beating of the heart such as atrial fibrillation impairs the contraction strength of the heart. A continuously increased heart rate is one of the main causes for the heart to pump blood less efficiently.

  • Congenital heart disease: This is a defect present at the time of birth and affects the normal functioning of the heart.

  • Heart valve disease: Any defect or damage in the valves of the heart will increase strain on the heart and make it weak.

Other than the above disease conditions, Congestive Heart Failure may occur because of metabolic causes. An overactive thyroid (hyperthyroidism) and diabetes are two common endocrine causes that may lead to a heart failure. Apart from this, certain chemotherapy drugs and consumption of alcohol can prove to be toxic to the heart muscle cells and impair their normal function.

Common symptoms of Congestive Heart Failure

Signs and symptoms of Congestive Heart Failure may include the following

  • Shortness of breath

  • Rapid or irregular heartbeat

  • Weakness and fatigue

  • Swelling in the abdomen region

  • Swelling in the legs, ankles, and feet

  • Nausea and lack of appetite

  • Rapid weight gain because of fluid retention

  • Continuous coughing or wheezing, along with white or pink blood-tinged mucus     

  • Difficulty in concentrating or staying alert

  • Chest pain, if heart failure is caused by heart attack

Types of Heart Failure

The condition is segregated into the following types-

1) Left-sided heart failure

  • Heart failure with reduced left ventricular function (HF-rEF): Under such conditions, the left ventricle or the lower left chamber of the heart expands in size and cannot contract easily to pump enough oxygen-rich blood to the rest of the body.

  • Heart failure with preserved left ventricular function (HF-pEF): In this condition, the heart contracts and pumps blood normally. However, the lower chambers or the ventricles become thicker and stiffer than normal because of which they are unable to relax and fill up entirely. As a result of less blood in the ventricles, the heart also pumps out less blood to the rest of the body.

2) Right-sided heart failure: Left-sided heart failure is the most common cause for affecting the right side of your heart as well. It may also take place because of problems in other organs or due to lung issues.

What are the Stages of Congestive Heart Failure?

There are four stages of heart failure: stage A, B, C, and D. The stages differ from each other ranging from the stage of developing elevated risk of heart failure to advanced heart failure.

Stage A: This is the stage of pre-heart failure. It shows that there are greater chances of developing heart failure if you have a strong family history of the same or have one or more of these medical conditions.

  • Coronary artery disease

  • Family history of cardiomyopathy

  • Hypertension

  • Diabetes

  • History of rheumatic fever 

  • Metabolic syndrome

  • History of taking drugs that lead to damage of the heart muscle

Stage B: It is the stage of asymptomatic or silent heart failure. The diagnosis shows systolic left ventricular dysfunction but no symptoms of a heart failure. This stage includes people who have a heart failure as well as reduced EF (HF-rEF).

Stage C: People who fall under this stage currently have or previously had symptoms of heart failure. Some of these symptoms are as follows.

  • Shortness of breath

  • Feeling weak or fatigued

  • Swollen abdomen, feet, ankles, and lower legs (oedema)

Stage D: This is the advanced stage where the symptoms do not get better even with treatment. It is the final stage of heart failure. 

Treatment of Congestive Heart Failure

Although there is no cure for heart failure, the treatment aims at relieving symptoms and preventing further damage. The treatment depends upon the stage and type of heart failure and any underlying conditions. An ideal treatment plan includes the following.

1. Lifestyle modifications: You may be advised to consume less salt (due to water retention) and avoid caffeine (because of irregularities in heartbeat). You may be given advice by your doctor on the types of fluids to be consumed. Exercises should become a part of your daily routine. In addition to these, you should refrain from smoking and consuming alcohol. 

2. Medications: Includes a wide range of drugs.

  • Vasodilators: These are known to expand blood vessels, allow easy blood flow, and reduce blood pressure.

  • ACE Inhibitors: Improves the functioning of the heart and increases life expectancy.

  • Beta blockers: Improves heart functions and chances of living longer.

  • Diuretics: This class of drugs does not allow fluid retention in the body.

  • Digitalis glycosides: Used for strengthening heart contractions.

  • Aldosterone inhibitors: Aids with fluid retention and improves longevity.

  • Anticoagulants: Helps to prevent blood clots.

  • Tranquillisers: Reduces anxiety levels.

3. Surgical procedures: In severe cases, a surgery may be required to open blocked arteries or replace faulty heart valves. In some patients with Congestive Heart Failure, a type of pacemaker called biventricular pacing is required to help both sides of the heart to work in unison. An implantable cardioverter defibrillator stabilises a potentially fatal heart rhythm into a normal one. Ventricular assist devices (VAD) may be used as a bridge in heart transplantation.

Frequently Asked Questions (FAQs)

Here’s a list of common questions and answers related to Congestive Heart Failure.


Does heart failure mean immediate death of the person?

No, it only means that it is unable to meet the body’s requirements due to insufficient pumping capacity. 

Do heart attacks, heart failure, and cardiac arrest mean the same?

No, here’s how they differ.

  • Heart attack: Blockage in the blood vessels supplying blood to the heart.

  • Heart failure: Inability of the heart to sufficiently pump blood throughout the body.

  • Cardiac arrest: Blood circulation in the body stops and no pulse can be felt.

Can heart failure occur without one’s knowledge?

Heart failure may occur without any symptoms except for chronic cough, shortness of breath while lying down, decreased appetite, or general weakness. In chronic conditions, the progress is very unpredictable, and the symptoms worsen over the years.

What are the risk factors for heart failure?

Some of the prominent risk factors for heart failure are diabetes, hypertension, obesity, atherosclerosis, family history, sedentary lifestyle, and consumption of fatty foods.

Can heart failure occur at a younger age?

The risk for heart failure increases with advancing age. However, young people are also susceptible to it, especially if they have a congenital heart disease.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. Please consult a doctor before making any health-related decisions.


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