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 usually gets worse over time, but treatment can slow the condition.

It’s often 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.

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

An underlying condition usually causes CHF. Depending on what that is for you and whether you have right or left heart failure, you may experience only some or all of these symptoms.

There are many factors affecting the prognosis of CHF. Some of the major factors affecting CHF prognosis include:

  • age at diagnosis
  • alcohol use
  • ethnicity
  • gender
  • stage at diagnosis
  • whether you have any other medical conditions
  • how well you respond to treatment
  • how well you follow your treatment plan

There are four stages or classes of CHF, and each is based on 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.

Class 1usually asymptomatic
Class 2mild symptoms that may limit some activities
Class 3moderate symptoms that noticeably limit everyday activities
Class 4severe symptoms that are noticeable at rest

The prognosis for CHF varies greatly between people, as many factors contribute to an individual’s prognosis.

However, largely speaking, if CHF is discovered in its earlier stages and properly managed, 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.

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.

Older people with advanced CHF have a more difficult prognosis. In these cases, it’s less common to live beyond 1 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 to help with this.

They may also prescribe diuretic medications (water pills). Commonly used diuretics include bumetanide, furosemide, and hydrochlorothiazide.

Some medications can help the heart 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 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 increase the heart’s ability 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 a person with CHF can make that have been shown to help slow the condition’s progression.


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 heart’s overall ability to function, thereby giving a better quality of life and potentially increasing life expectancy.

Plan exercise regimens with help from your healthcare professionals to tailor exercises to your individual needs and tolerance levels.

Fluid restriction

People with CHF are often advised to regulate their fluid intake, affecting the overall fluid retained within the body. People 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

An increase in body weight is an early sign of fluid accumulation. People with CHF need to monitor their weight closely. If you have gained 2–3 pounds in as many days, call your doctor.

They may want to increase your dose of diuretics 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 and whether you have 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.