Living well with Congestive Heart Failure (CHF)

Key Takeaways

1. In CHF, your heart is unable to pump blood efficiently and it fails to meet the oxygen demand of the body. 

2. CHF is a chronic, lifelong condition that requires long-term management and treatment. 

3. Lifestyle modifications, including medication adherence, healthy eating, regular exercise, and smoking cessation, play a crucial role in controlling CHF symptoms and improving overall heart health. 

Congestive Heart failure (CHF) or Heart Failure is a growing health concern worldwide, affecting around 6.4 crore people. As we age, the risk of heart diseases, including CHF goes up. For example, around 1% of people aged 50 years or older are affected by CHF.

This risk doubles with each passing decade of life. According to the World Health Organization, between 2015 and 2050, the world's population aged 60 years and above will almost double, increasing from 12% to 22%.

As more people are growing older, the number of CHF cases is also expected to increase in the future. A recent report suggests that in India, every year there are about 5 to 18 lakh new cases of heart failure. CHF is a common cause of hospitalization among the elderly. Living with CHF can have a significant impact on one's health and well-being.

Congestive Heart Failure (CHF)

Our heart functions as a pump in the circulatory system. It continuously contracts and relaxes to pump blood throughout the body, delivering oxygen and nutrients to various organs and tissues. This pumping action is vital for maintaining overall health and sustaining bodily functions.

Congestive Heart Failure (CHF) or Heart Failure is a serious long-term condition of the heart. The heart is unable to pump efficiently and it fails to meet the oxygen demand of the body. This is due to multiple conditions like weakened heart muscles, narrowed arteries supplying the heart muscles and others. The heart does not stop working completely but works less efficiently, this leads to congestion or buildup of fluids in various parts of the body, such as the lungs, stomach, heart, etc causing symptoms and complications associated with the condition like shortness of breath, low blood oxygen levels, fatigue and swelling.

Complications may also include damage to organs such as the kidney, liver and lungs, irregular heartbeat, heart valve problems and sudden cardiac arrest. 

Heart failure
Congestive Heart Failure

Congestive Heart Failure Types

Heart failure can be broadly classified into 3 types

  • Left-Sided Heart Failure: This happens when the heart struggles to pump blood to all the organs of the body, leading to insufficient oxygen delivery. It can be further classified into two types,
    • Systolic Heart Failure (HFrEF): In this type, the heart's left lower chamber (ventricles) has difficulty contracting during each heartbeat. As a result, the heart cannot pump out enough blood to meet the body's needs.
    • Diastolic Heart Failure (HFpEF): This type occurs when the left ventricle has trouble relaxing between beats, impairing its ability to fill with blood. As a result, the heart cannot properly fill, affecting the amount of blood pumped out.
  • Right-sided Heart Failure: The right lower chamber (ventricle) of the heart is responsible for pumping blood to the lungs for oxygenation. Right-sided heart failure happens when the heart's right ventricle is unable to effectively pump blood to the lungs. This can result in fluid buildup, particularly in the legs and abdomen.
  • High-Output Heart Failure: This is uncommon. In this condition, the heart pumps a large volume of blood but still fails to meet the body's demand for oxygen and nutrients. Some common causes of high-output heart failure include anaemia, Vitamin B1 deficiency, hyperthyroidism, etc.
Heart failure Types
Congestive Heart Failure Types

Congestive Heart Failure Symptoms

The most common signs and symptoms of CHF include

  • Shortness of breath
  • Chest pain
  • Irregular or rapid heartbeat
  • Leg, abdominal or ankle swelling
  • Fatigue or tiredness
  • Dry cough or wheezing
  • Bloated stomach
  • Loss of appetite
  • Nausea
  • Weight gain
  • Dizziness 
  • Frequent urge to urinate at night
Heart failure Types
Congestive Heart Failure Symptoms

Congestive Heart Disease Causes

Congestive heart failure can result from various factors, including:

  • Prior heart conditions such as coronary artery disease, heart attack, heart muscle-related issues, heart conditions present at birth, etc
  • Diabetes
  • Hypertension
  • Kidney issues
  • Thyroid disease
  • High body mass index above 30
  • Tobacco and recreational drug use
  • Excessive alcohol consumption
  • Certain medications, including anti-cancer medications

Congestive Heart Failure Diagnosis

Diagnosing CHF involves a comprehensive evaluation by your doctor. This may include:

  • Medical History: Your doctor will ask about your symptoms, medical history, and any risk factors for heart failure, such as hypertension, diabetes, or previous heart issues.
  • Physical Examination: The doctor will conduct a thorough physical examination, including listening to your heart and lungs with a stethoscope, checking for signs of fluid retention or swelling in different parts of your body, and examining your neck veins.
  • Diagnostic Tests: Various tests may be ordered, including
    • Blood tests to look for specific proteins associated with heart failure.
    • Chest X-rays, CT scans and cardiac MRI to examine the detailed structure of the heart and the lungs.
    • Echocardiogram to evaluate the heart's structure and function.
    • An Electrocardiogram (ECG or EKG) to measure the heart's electrical activity.
    • Ejection fraction to understand the working capacity of your heart.
    • Stress test or TMT test to understand how your heart performs while exercising.
    • Coronary angiogram to look for blockage in the blood vessels supplying the heart.
    • Myocardial biopsy to identify issues with the heart muscle.

Congestive Heart Failure Management & Treatment

Heart failure has no cure. As it worsens, your heart pumps less blood, leading to more complications. The goal of treatment is to prevent progression and complications. 

The management of congestive heart failure (CHF) often involves a combination of lifestyle changes such as cardio exercises and medications. Patients with advanced disease may require heart implant devices and heart surgeries. Regular check-ups with your doctor are recommended to monitor symptoms and adjust treatment as needed.

  • Lifestyle Modifications: These may include
    • Adopting a heart-healthy diet low in sodium and fat.
    • Monitoring and restricting fluid intake.
    • Engaging in a structured exercise program as advised by your doctor.
    • Maintaining a healthy weight for your height.
    • Stress management.
    • Stopping smoking and alcohol intake.
  • Medications: Your doctor may prescribe you medications to reduce fluid build-up in the body, manage blood pressure and sugar, improve heart functions or regulate sodium levels.
  • Medical Devices:
    • Implantable Devices: Such as pacemakers or defibrillators regulate heart rhythm.
    • Cardiac Resynchronization Therapy (CRT): A specialized pacemaker to coordinate heart contractions.
  • Surgical Interventions:
    • Heart Valve Repair or Replacement to repair damaged or faulty heart valves.
    • Coronary Artery Bypass Grafting (CABG) to improve blood flow to the heart muscle.
    • Heart Transplant: In severe cases where other treatments are insufficient.

Who Is More Likely to Develop Heart Failure or Congestive Heart Failure Risks

Risk factors for congestive heart failure (CHF) include:

  • Age over 65
  • Use of tobacco, cocaine, or alcohol
  • Sedentary lifestyle with little physical activity
  • Consumption of high-salt and high-fat foods
  • High blood pressure
  • Diabetes
  • Obesity
  • Serious lung disease, or infections
  • Coronary artery disease or other heart issues
  • History of a heart attack
  • Family history of congestive heart failure

When To See a Doctor

Seek medical help without delay if you experience any of the following symptoms:

  • Chest pain
  • Severe weakness
  • Rapid or irregular heartbeat accompanied by shortness of breath, chest pain, or fainting
  • Sudden, severe shortness of breath, and coughing up white or pink, foamy mucus

Congestive Heart Failure Prevention

While you cannot alter certain risk factors like age, family history, or birth defects, you can positively influence your heart health through lifestyle choices. These steps empower you to take charge of your well-being and enhance your chances of preventing heart failure.

  • Maintain a healthy weight
  • Follow a heart-friendly diet
  • Engage in regular exercise
  • Manage stress
  • Quit tobacco, avoid alcohol and recreational drugs
  • Get yourself treated for other medical conditions that you may have which increase the risk of heart failure

Conclusion

Congestive heart failure (CHF) is a lifelong condition. It requires treatment and management for the rest of your life. Consistent adherence to prescribed medications, lifestyle modifications, and regular medical check-ups is crucial to effectively control symptoms, enhance your quality of life, and maintain overall heart health. 

Remember, you can shape your heart health, and with the right support, you can live a fuller, healthier life. Download the Aware App today and take a proactive step towards a stronger heart.

About the Author

Dr. Satish Madiraju, a renowned cardiologist is passionate about consumer heart health and is on a mission to prevent a million heart attacks. He shares his expertise not only on heart health but also on leadership, digital health, and improving patient experience.
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