What is congestive heart failure?

Written by Rhamises Ragpa

What is congestive heart failure? This condition is also known as heart failure. It is when the cardiac muscle fails to pump blood as efficiently as it should.

This condition is also known as heart failure. It is when the cardiac muscle fails to pump blood as efficiently as it should. Over time, that muscle has grown less able to contract or has a mechanical defect that prevents it from filling with blood.

As a result, it cannot fulfill the needs of the body, and blood returns to that organ quicker than it can be pushed out, clogging the arteries. Blood might back up, and fluid can build up in the lungs, resulting in shortness of breath.

The chambers may respond by either expanding to hold more blood for pumping across the body or stiffening and thickening. This keeps the blood flowing, but the cardiac muscle walls may weaken with time and become unable to pump effectively.

The beating gets quicker to allow for rapid refilling following contraction, but less blood flows in the long term, and the extra effort might induce palpitations.

Furthermore, when the kidneys don’t get enough blood, they start to retain water and salt, which can cause kidney failure. The body becomes congested when fluid builds up in the arms, legs, ankles, feet, lungs, or other organs.

The left ventricle, right ventricle, or both sides of the organ might be affected by CHF. This condition generally begins on the left side of the affected organ, particularly in the left ventricle, which is the major pumping chamber.

It is essential to take note of the Ejection Fraction (EF). This is a measure of the amount of blood the left ventricle pumps out every contraction. And this is important in diagnosing the disease. An EF of 60% means that each pulse pushes out 60% of the total blood volume in the left ventricle.

In diagnosing this condition, your doctor will check your medical history, signs and symptoms, and risk factors like high blood pressure or coronary artery disease. They may listen to your lungs for fluid buildup and the pumping organ for murmurs that are indicative of CHF.

There may even be some tests that are ordered, such as:

  • Chest X-ray
  • Blood tests
  • Echocardiogram
  • Electrocardiogram (ECG)
  • Cardiac computerized tomography (CT) scan
  • Stress Test
  • Magnetic Resonance Imaging (MRI)
  • Myocardial Biopsy
  • Coronary Angiogram

Whether treated or not, this condition is progressive, meaning it grows worse with time. More than 5 million people in the United States have it, and it’s the most prevalent diagnosis among individuals over 65 admitted to the hospital. This is a contributing factor in one out of every nine fatalities.

What are the main causes of congestive heart failure?

Conditions that damage the cardiac muscle can serve as a cause.

  1. Myocardial Infarction – This causes harm to your cardiac muscles. A possible cause is a sudden blockage of the coronary arteries, creating scarring and decreasing the ability to pump correctly. A greater demand for blood flow owing to a permanent block may potentially cause harm.
  2. High Blood Pressure – Your pumping organ has to work harder than it should to pump blood throughout your body if your blood pressure is high. This increased exertion might cause your cardiac muscle to become too stiff or weak to pump blood over time adequately.
  3. Myocarditis – This is the inflammation of your myocardium. A virus, such as the COVID-19 virus, is the most prevalent cause, developing into left-sided CHF.
  4. Nonischemic Cardiomyopathy – It is a disease in your myocardium that shows ventricular hypertrophy or dilation. An obstruction in the coronary artery causes weakening of the cardiac muscle. Genetic disorders, medication side effects, and infections are all possible reasons.
  5. Arrhythmias – Abnormal cardiac rhythms can cause your heart to beat too quickly, putting additional strain on it. However, CHF can also develop because of a sluggish heartbeat.
  6. Faulty Valves – The valves keep blood flowing in the proper direction. A broken valve, caused by a defect, coronary artery disease, or infection, causes a weaker heart.
  7. Cardiac Muscle damage – Damage to the myocardium can have a variety of causes, including specific illnesses, infections, high alcohol use, the toxic effects of drugs like cocaine or chemotherapy treatments, and genetics.
  8. Coronary Artery Disease – The coronary arteries give blood to the cardiac muscle. The blood flow reduces when these become clogged or constricted, and the heart does not receive the necessary blood supply.
  9. Congenital Heart Defect – The healthy parts of your pumping organ have to work harder to pump blood if your heart and its chambers or valves don’t form correctly at birth, which can lead to CHF.

You may also be at risk of CHF if you have these factors:

  1. Obesity
  2. Thyroid Problems
  3. Smoking
  4. Lupus
  5. Diabetes
  6. Anemia
  7. Alcohol use
  8. Sleep Apnea
  9. Smoking
  10. Viruses

What are the 4 stages of congestive heart failure?

In 2001, the American Heart Association (AHA) and the American College of Cardiology (ACC) defined the stages of this disease. These stages show how the illness is progressive and can develop over time.

Stage A. Individuals who are at Stage A are those that are at risk of developing the illness. They have the following conditions:

  1. Diabetes
  2. Coronary artery disease
  3. Hypertension
  4. Metabolic syndrome
  5. Family history of cardiomyopathy
  6. History of alcohol abuse
  7. History of rheumatic fever
  8. History of cardiotoxic drug therapy

Stage B. These are people who had never had symptoms but diagnosed with systolic left ventricular dysfunction. They experienced a prior myocardial infarction, cardiomyopathy, and valve disease.

In diagnosing the disease, an echocardiogram test should give out a result of an ejection fraction that is less than 40%. 

Stage C. These patients have systolic heart failure and have exhibited symptoms in the present or the past. These symptoms are fatigue, shortness of breath, and a diminished ability to exercise.

Stage D. After already receiving the best hospital care, these patients with systolic heart failure still experience advanced symptoms. It is already hard to manage, even with typical treatments.

Another form of classification is from the New York Heart Association (NYHA). It ranks people with regards to your functional limits and the degree of symptoms you experience.

Class I.  There is no effect on your physical activity. During typical activities, you also don’t experience any strange fatigue, palpitations, shortness of breath, or pain.

Class II.  You begin to experience some minor limitations when doing everyday activities. Starting here, you feel mild fatigue, palpitations, pain, or shortness of breath while you perform routine activities. However, you don’t feel any symptoms while you’re resting.

Class III. You already have limits on everyday activities. During less than usual activities, you feel shortness of breath, fatigue, pain, or palpitations. There are still no symptoms at rest.

Class IV.  At this point, you already feel discomfort at rest. When you do any physical activity, it worsens.

What is the life expectancy of someone with congestive heart failure?

If you have CHF, your life expectancy can be nonlinear and dependent on many factors. Many clinicians do not believe they can accurately anticipate a patient’s clinical trajectory in a 6-month time period.

The 1-, 2-, 5-, and 10-year survival rates for all-type CHF are 87 percent, 73 percent, 57 percent, and 35 percent, respectively, as stated by a meta-analysis in 2019. However, the life expectancy of those suffering from CHF has gotten better over time.

The age of a person during diagnosis might influence their prognosis. The 5-year survival rate for those under 65 was about 78 percent, but it was 49 percent for those 75 and over.

Another factor to take note of is your ejection fraction. Your doctor will have to monitor it more closely if your ejection fraction is reduced. If the echocardiogram reports that your ejection fraction drops too low (35% or lower), you will have a higher probability of having a fatal rhythm in that organ.

However, a 2017 study says all patients with CHF, regardless of ejection fraction, had a poor 5-year survival rate of 75.4%. The 2019 meta-analysis found no significant difference in survival rates between people with an ejection fraction of less than 40% and those with above.

Your life expectancy will also be affected by which stage you are at with your CHF. Those 4 stages will show how serious your CHF has become.

Comorbidities, such as coronary heart disease, can influence life expectancy. They were frequent in CHF patients, according to age-adjusted research, and linked to increased mortality rates. Diabetes was found in 28% of fatalities, while the chronic obstructive pulmonary disease was in 16%.

If you have good lifestyle choices, you could extend your life expectancy too. Try to avoid smoking and drinking. Don’t forget to heed your doctor’s advice. Also, take your medications. Control your sodium and fluid intake as well.

Is congestive heart failure curable?

There is no known cure for this illness. However, some treatments can alleviate the symptoms and delay further damage. This will depend on what stage you’re at and the type of CHF, any possible comorbidities or conditions, and the individual patient.

It would help if you started considering lifestyle changes. An increased sodium intake would be bad for fluid retention, so avoid salty food. You should also avoid drinking coffee or caffeinated drinks because of heartbeat irregularities. Also, consider how much fluid you’re drinking as advised by your doctor.

You may also be advised to take the following medication as prescribed by your doctor:

  • Diuretics
  • Vasodilators
  • Aldosterone inhibitors
  • Digitalis glycosides
  • ACE inhibitors
  • Beta-blockers
  • Anticoagulants or antiplatelets
  • Tranquilizers

In some cases, you may not respond well to drug treatments, so you will have to undergo surgical options:

  • Coronary artery bypass graft
  • Pacemaker
  • Percutaneous coronary intervention
  • Cardiac ablation
  • Implantable left ventricular assist device
  • Valve surgery
  • Transplant

Can the heart repair itself after congestive heart failure?

Your pumping organ has the potential to grow new muscle and heal itself in some cases. However, the regeneration rate is so sluggish that it can’t repair the damage done by myocardial infarction. That’s why, in the aftermath of myocardial infarction, scar tissue forms instead of functioning muscle tissue.

These scar tissues aren’t made of cardiomyocytes (the beating muscle cells). Instead, they are made of fibroblasts. They have no pumping ability. Thus, your vital organ will get weaker and weaker over time. However, with the proper treatment from your doctor, this organ can sometimes become stronger.

How do they remove fluid from congestive heart failure?

If the pumping organ in your body is struggling, your kidneys go into overdrive: they activate chemicals that instruct your body to hold on to whatever water it has to boost blood volume. Excess fluid in the body can be fatal because it puts too much pressure on vital organs like the lungs and liver.

You can know that you have excess water retention if you experience weight changes, swollen legs, ankles, and feet, bloating, nausea, fatigue, persistent coughing, shortness of breath, and loose stools.

So, to counteract that fluid buildup, you should take diuretics to remove the excess fluid. These drugs make you urinate more often. There are three common types of them, namely thiazides, loop diuretics, and potassium-sparing agents. Take them according to your doctor’s advice.

Also, don’t forget to watch your fluid and sodium intake. Limit the amount of fluids you drink. Take into account the food you eat because sometimes they have a lot of water in it. Salty food can make you thirsty, making you drink more, so limit your consumption of it. They also cause fluid retention.

Keep tracking your symptoms and take the medications, and visit your doctor regularly. These small changes can help you manage your CHF and fluid retention.

References

Ask the doctor: Does exercise help damaged heart muscle? (2019, June 21). Retrieved from Harvard Health Publishing: https://www.health.harvard.edu/heart-health/ask-the-doctor-does-exercise-help-damaged-heart-muscle

Beckerman, J. (2020, August 22). Congestive Heart Failure and Heart Disease. Retrieved from WebMD: https://www.webmd.com/heart-disease/guide-heart-failure

Blumenthal, R., & Jones, S. (n.d.). Congestive Heart Failure: Prevention, Treatment and Research. Retrieved from John Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/congestive-heart-failure-prevention-treatment-and-research#:~:text=Congestive%20heart%20failure%20(also%20called,is%20about%20to%20stop%20working.

DeSanto, L. (2020, August 3). Heart Failure: Simple Ways to Manage Fluid Buildup. Retrieved from Health Central: https://www.healthcentral.com/slideshow/how-to-fight-fluid-buildup-heart-failure

Heart failure. (n.d.). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142

Heart failure – fluids and diuretics. (n.d.). Retrieved from Mount Sinai: https://www.mountsinai.org/health-library/selfcare-instructions/heart-failure-fluids-and-diuretics

Huff, C. (2021, January 26). Ways to Maximize Your Lifespan With Heart Failure. Retrieved from WebMD: https://www.webmd.com/heart-disease/heart-failure/features/heart-failure-life-expectancy

Johnson, J. (2021, May 28). Congestive heart failure: Life expectancy and stages. Retrieved from MedicalNewsToday: https://www.medicalnewstoday.com/articles/321538

Newman, T. (2021, May 5). What to know about congestive heart failure (CHF). Retrieved from MedicalNewsToday: https://www.medicalnewstoday.com/articles/156849#stages

Paddock, C. (2017, October 5). Severe heart failure may be reversible. Retrieved from MedicalNewsToday: https://www.medicalnewstoday.com/articles/319649#Silencing-the-Hippo-pathway

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