Congestive Heart Failure Definition, Symptoms, and Treatments

Lifestyle Choices Can Contribute to this Condition

Cardiac stress test
Cardiac stress test. Slobodan Vasic/E+/Getty Images

Definition: Congestive heart failure (CHF) is a condition that occurs when the heart muscle, either the result of weakness or stiffening, is unable to pump blood with sufficient force. As a result, blood begins to back up in other parts of the body because the heart is unable to keep pace with the body's circulatory needs. This includes the liver, abdomen, lower legs and lungs. CHF can be either chronic or acute and occurs on either side of the body, but usually begins on the left where the left ventricle, the primary pumping chamber of the heart, is located.

Types of Congestive Heart Failure

There are four types of congestive heart failure, they are:

  • Left-sided - results in fluid backup in the lungs
  • Right-sided – results in fluid backup in the abdomen, or legs and feet
  • Systolic - the left ventricle cannot contract strongly enough
  • Diastolic - a filling problem because the left ventricle cannot fully relax

Causes of Congestive Heart Failure

An unhealthy lifestyle contributes to congestive heart failure. In addition to heart arrhythmia, infections and diseases, allergic reactions, certain medications, and blood clots in the lungs, other causes CHF include the following:

Congenital Defects

Infants born with a defective heart that has anatomical abnormalities, either the valves or chambers do not work properly.

Coronary Artery Disease

A condition where there is a buildup of fatty deposits in the arteries that supply blood to the heart muscle. This condition is known as atherosclerosis.


The heart is works harder to circulate the blood, thickening the heart muscle. The heart muscle will weaken and no longer pump blood efficiently.

Damaged Heart Valve

A damaged heart valve causes a back-up of blood flow and causes the heart to work harder. Heart-valve damage may be due to congenital defect, a heart infection, or coronary artery disease.


Cardiomyopathy, or damage to the heart muscle, can be the result of an infection such as myocarditis, alcohol or drug abuse, chemotherapy, genetics or disease.

Heart Attack

A heart attack may result in permanent damage to the heart muscle.

Symptoms of Congestive Heart Failure

Symptoms of congestive heart failure include the following:

  • Abdominal swelling
  • Swelling in the extremities - legs, ankles and feet
  • Fatigue and weakness
  • Inability to exercise
  • Increased nocturia
  • Persistent cough or wheeze
  • Phlegm that is pink-tinged
  • Rapid or irregular heartbeat
  • Shortness of breath
  • Chest pain

Diagnosis of Congestive Heart Failure

In addition to a comprehensive medical examination, the following tests may be performed:

Treatment of Congestive Heart Failure

If it is not treated, CHF can lead to kidney failure and death. Medication and surgery are both treatment options.


Medications used to treat CHF include the following:

  • Beta blockers
  • Diuretics
  • Digoxin (digitalis)
  • Aldosterone antagonists
  • Inotropes
  • Angiotension-converting enzyme inhibitors (ACD)
  • Angiotension II receptor blockers

Surgical Treatments

When medication does not resolve the condition, a surgical approach may need to be taken. Types of surgery to treat CHF include the following:

  • Coronary bypass
  • Heart-valve repair or replacement
  • Implantation of cardioverter-defibrillators (ICDs)
  • Cardiac resynchronization therapy (CRT)
  • Implantation of ventricular assistive device (VAD)

Implanting a total artificial heart (TAH) or a heart transplant may be necessary to treat the more severe cases of CHF.