Congestive Heart Failure (CHF)

Written by Brindles Lee Macon | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

What Is Congestive Heart Failure?

Congestive heart failure (CHF) is a chronic condition that affects the chambers of your heart. You have four heart chambers: two atria in the upper half of the heart and two ventricles in the lower half. The ventricles send blood to your organs and tissues and the atria receive blood as it circulates back from the rest of your body. CHF develops when your ventricles cannot pump blood in sufficient volume. Blood and other fluids back up inside your lungs, abdomen, liver, and lower body.

What Are the Most Common Types of CHF?

Left-sided CHF damages your left ventricle (the chamber that pumps blood to the body), and is the most common type of CHF. It can cause fluid to build up in your lungs, which makes breathing difficult.

Right-sided CHF may accompany left-sided CHF, but does not always. Right-sided CHF is when the right ventricle has difficulty pumping blood to the lungs. Blood builds up in your blood vessels, which causes fluid retention in your lower extremities, abdomen, and other vital organs.

What Are the Causes of CHF, and Am I At Risk?

CHF may result from other health conditions that directly affect your cardiovascular system. That’s why it is important to get annual checkups to lower your risk for heart health problems, including:

High Blood Pressure

When your blood pressure is higher than normal (greater than 120/80 mm Hg), it may lead to CHF. High blood pressure occurs when your blood vessels become restricted by deposits of cholesterol and fat or because of your age, making it harder for blood to pass through them.

Coronary Artery Disease

This disease damages your heart’s coronary arteries (the small arteries that supply blood to the heart) by restricting blood flow. Cholesterol and other types of fatty substances block the arteries and cause them to narrow.

Valve Conditions

Your heart valves regulate blood flow through your heart by opening and closing to let blood in and out of the chambers. Valves that do not open and close correctly may force your ventricles to work harder to pump blood.

What Are the Symptoms of CHF?

In the early stages of CHF, you most likely will not notice any changes in your health. But, as your condition gets worse, you will experience gradual changes in your body. You may feel more tired than usual, or experience noticeable weight gain even when your dietary habits have not changed.

Symptoms you may notice first:

  • fatigue
  • swelling in your ankles, feet, and legs
  • weight gain
  • increased need to urinate, especially at night

Symptoms that indicate your condition has worsened:

  • irregular heartbeat
  • a cough that develops from congested lungs
  • wheezing

Symptoms that indicate a severe heart condition that requires immediate medical attention:

  • chest pain that radiates through the upper body (this can also be a sign of a heart attack)
  • rapid breathing
  • skin that appears blue (from lack of oxygen in your lungs)
  • fainting

How Is CHF Diagnosed?

After reporting your symptoms to your healthcare provider, he or she may refer you to a cardiologist (a heart specialist).

The cardiologist will perform a physical examination. The exam may involve listening to your heart with a stethoscope to detect abnormal heart rhythms. To confirm an initial diagnosis, your cardiologist might order specific diagnostic tests to examine your heart’s valves, blood vessels, and chambers.

These tests may include:

  • magnetic resonance imaging (MRI), which takes pictures of your heart
  • stress tests to see how well your heart performs under different levels of stress
  • blood tests to check for abnormal blood cells and infections

What Medications and Treatments Will I Need?


ACE Inhibitors (Angiotensin Converting Enzyme Inhibitors): ACE inhibitors open up narrowed blood vessels to allow for better blood flow. Vasodilators are another option if you cannot tolerate the ACE inhibitor medication.

Beta-Blockers: Beta-blockers can reduce blood pressure and slow a rapid heart rhythm.

Diuretics: Your drug treatment may include taking diuretics to reduce your body’s fluid content. CHF can cause your body to retain more fluid than it should.


If medications are not effective on their own, surgery may be required. Angioplasty, a procedure to open up blocked arteries, is one option. Your cardiologist may also consider heart valve repair surgery to help your valves open and close properly.

What Can I Expect in the Long Term?

Your condition may improve with medication and/or surgery. The earlier your condition is diagnosed, the better your prognosis will be. Your outlook depends on how advanced your CHF is and whether you have other health conditions to treat, such as diabetes or hypertension.

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