Living with Congestive Heart Failure

By:    Medically Reviewed: Tom Iarocci, MD   Published: August 13, 2014

Receiving a diagnosis of congestive heart failure can be scary but in many cases, you can manage the condition with medication and lifestyle changes.

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The term “congestive heart failure” sounds frightening, as if the heart has stopped beating. This is far from the case.

And while heart failure is serious in all of its forms, living a full life with heart failure means understanding what you are up against, controlling what’s in your power to control, and coping as best you can with what’s not.

“Congestive heart failure is the inability of the heart to sufficiently pump blood to the organs and tissues throughout the body,” says Monica Aggarwal MD, a noninvasive cardiologist at the Heart Center, Mercy Medical Center in Baltimore, Maryland.

As the heart gets weaker, it cannot pump blood as forcefully and it is unable to meet the body’s oxygen demands. This reduced pumping ability can also lead to a backup of blood flow with impact in different parts of the body. “Congestive heart failure can cause a variety of symptoms, such as fluid retention, swelling and shortness of breath,” says Aggarwal. 

Stages of Heart Failure

There are different stages of the condition, classified according to how weak the heart is and symptoms present. “As with many other chronic or progressive conditions in medicine, the symptoms of congestive heart failure range from barely present to barely functional,” says Marc Leavey MD, and internist in Maryland. Different systems are used to classify heart failure.

For example, the New York Heart Association categorizes heart failure into classes based on how much limitation people experience:

Class I: Class I is considered mild congestive heart failure. There are usually no limitations on physical activities. Patients may only have a few symptoms, such as mild fatigue.

Class II: The next class of heart failure is still considered mild, but symptoms, such as shortness of breath, occur with physical exertion.

Class III: People with class III have moderate heart failure and may have significant physical limitations due to symptoms, such as fatigue and shortness of breath.  

Class IV: Class IV is severe heart failure. Patients have symptoms even at rest. Symptoms make carrying out normal physical activity very difficult. 

 

Treatment for Congestive Heart Failure

Treatment for congestive heart failure is usually based on the severity of symptoms and class of the disease. Medical therapy aims to improve symptoms, stop or slow the decline of the heart’s pumping ability and reduce deaths. In most cases, treatment also involves lifestyle changes, such as reducing salt intake, quitting smoking and weight reduction if needed.

“In some instances, treatment for elevated blood pressure or high lipid levels will also be needed. Some specific medications, which may be prescribed include ACE inhibitors and ARB/s or beta blockers,” says Leavey.

Additional treatment for congestive heart failure may include diuretics to reduce fluid retention. A variety of other heart medicines may be used, depending on the individual.

In more severe cases, surgery may be needed to correct or treat the underlying cardiac conditions, including coronary bypass surgery or surgery to replace heart valves.  

Next Steps

For Patients

There are many steps someone with congestive heart failure can take in order to reduce symptoms and manage their condition.

  • “One of the first steps someone with congestive heart failure should do is find a good cardiologist who specializes in heart failure,” says Aggarwal. A good cardiologist will be able to develop a treatment plan, which includes patients taking an active role in their health.
  • Take your medication as prescribed. Staying on top of your medication regimen may prevent symptoms from developing or prevent heart failure from progressing.
  • Work with your doctor to control your symptoms and to feel as well as is possible. Having a chronic disease can lead to depression. Do your best to stay active, visit friends and live life normally. 

For Family Caregivers

If you are caring for someone with congestive heart failure, there are several ways you can help.

  • Accompany your loved one to doctor’s appointments. Information on congestive heart failure can be complex. Take notes and ask questions.  
  • Watch what you cook. If you are doing the cooking, be aware of sodium content in food. Salt restriction is often needed due to possible fluid retention in people with congestive heart failure.
  • “Gently monitor and correct actions that appear to be a counter to good health,” says Leavey. Although constant nagging may get old quick, encouraging healthy lifestyle habits, such as a proper diet and exercise is helpful. 
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