What is congestive heart failure?

Congestive heart failure (CHF) is a condition in which the muscles of your heart are no longer able to pump blood effectively. It’s a long-term condition that becomes progressively worse over time. It’s often simply referred to as heart failure, although CHF is specific to the stage of the condition where fluid collects around the heart. This puts it under pressure and causes it to pump inadequately.

There are four stages or classes of CHF, and each is based upon the severity of your symptoms.

You’ll be grouped into class 1 if a weakness has been discovered in your heart but you’re not yet symptomatic. Class 2 refers to those who are largely well, but need to avoid heavy workloads.

With class 3 CHF, your everyday activities are limited as a result of the condition. People in class 4 have severe symptoms even when they’re completely rested.

The symptoms of CHF range in severity depending on what stage of the condition you are in. They are:

  • shortness of breath
  • chest pain
  • fluid in the feet, ankles, or legs
  • bloating
  • nausea
  • abdominal pain
  • fatigue

CHF is usually caused by an underlying condition. Depending on what that is for you and whether or not you have right or left heart failure, you may experience only some or all of these symptoms.

The prognosis for CHF varies greatly between people, as there are many different factors that contribute to what an individual’s prognosis might be.

However, largely speaking, if CHF is discovered in its earlier stages and is properly managed, then you can expect a far better prognosis than if it’s discovered much later. Some people whose CHF is discovered early and treated promptly and effectively can hope to have a nearly normal life expectancy.

According to the Centers for Disease Control and Prevention (CDC), around half of people diagnosed with CHF will survive beyond five years.

It’s been a widely accepted clinical opinion for many years that younger people diagnosed with CHF have a better prognosis than older people. There is some evidence to support this theory.

Elderly people with advanced CHF have a more difficult prognosis. In these cases, it’s less common to live beyond one year post-diagnosis. This could also be because invasive procedures to help the problem aren’t plausible at a certain age.

It can be helpful to reduce fluid within the body so that the heart doesn’t have to work as hard to circulate blood. Your doctors may suggest fluid restriction and for you to decrease your salt intake in order to help with this. They may also prescribe diuretic medications (water pills). Commonly used diuretics include bumetanide, furosemide, and hydrochlorothiazide.

There are also medications available that can help the heart to pump blood more effectively and therefore increase long-term survival. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are the most commonly used medications for this purpose. They can be used in conjunction with other medications.

Beta blockers can also be used to control heart rate and increase the heart’s ability to pump blood.

For people with end-stage heart failure, it’s possible to implant a pump that helps to increase the ability of the heart to squeeze. This is called a left ventricular assisted device (LVAD).

In some people with CHF a heart transplant may also be an option. Many older people are not considered suitable for a transplant. In these cases, an LVAD could offer a permanent solution.

There are many lifestyle changes that a person with CHF can make that have been shown to help slow the progression of the condition.


Sodium causes fluid retention to increase within the body’s tissues. A low-sodium diet is often recommended for people with CHF. It’s also advisable to severely restrict your alcohol consumption, as this can affect your heart muscle weakness.


Aerobic exercise has been shown to improve the overall ability of the heart to function, thereby giving a better quality of life and potentially increasing life expectancy. Plan exercise regimens with help from your healthcare providers so that exercises can be tailored to your individual needs and tolerance levels.

Fluid restriction

People with CHF are often advised to regulate their fluid intake, as this has an effect on the overall fluid retained within the body. People who are taking diuretic medication to eliminate excess fluid can counteract the effects of this medication if they’re consuming too much fluid. People with more advanced cases of CHF are usually advised to limit their overall fluid intake to 2 quarts.

Weight monitoring

Increase in body weight is an early sign of fluid accumulation. Therefore, it’s important for people with CHF to monitor their weight closely. If you have gain 2–3 pounds in as many days, call your doctor. They may want to increase your dose of diuretics in order to control the fluid accumulation before it becomes more severe.

The outlook for CHF is incredibly variable. It largely depends on what stage of the condition you’re in as well as whether you have any other health conditions. Younger people may also have a more promising outlook. The condition can be improved greatly by lifestyle changes, medication, and surgery. Consult with your doctor to determine what the best treatment plan is for you.