Congestive Heart Failure

The term “heart failure” can be confusing. It doesn’t mean your heart has stopped working. Instead, it means your heart can’t pump blood as well as it should.

Normally, the heart pumps forcefully and frequently enough to keep blood moving throughout your body. But with heart failure, your heart starts to lose its pumping ability. Over time, blood and other fluids build up in certain parts of your body—especially the lungs, legs and feet. 

This fluid build-up is sometimes referred to as congestion. And congestion causes many of the symptoms associated with congestive heart failure. 

The most common symptoms of heart failure include:

• Chest pain
• Fatigue or weakness after any level of activity
• Loss of appetite
• Shortness of breath
• Swelling in the abdomen
• Swollen legs or feet
• Unexplained weight gain

Heart failure is usually progressive. This means your condition—and symptoms—may worsen over time.

Doctors use a four-stage system to determine the best ways to prevent or treat heart failure (and slow its progression). The four stages of heart failure are:

• Stage A. This stage means you have a high risk of developing heart failure. You may be considered high-risk if you have a family history of heart failure or a personal history of smoking. Your risk also increases if you have certain medical conditions. These conditions include diabetes, hypertension (high blood pressure) and coronary artery disease.
• Stage B. This stage is known as pre-heart failure. Your heart is starting to show signs of structural or functional change, but you don’t have symptoms.
• Stage C. In Stage C, you have an official heart failure diagnosis and you’ve started having symptoms. At this point, your symptoms may come and go.
• Stage D. This stage is also known as advanced heart failure. It means you have severe symptoms that impact your quality of life, even with treatment. You may also need frequent hospital care.

No matter what stage of heart failure you’re in, Emory Heart & Vascular offers expert care and support.

With advanced heart failure or Stage D heart failure, standard treatments like medication and cardiac rehabilitation no longer help. You may have shortness of breath and other symptoms, even at rest.

Although it’s frightening to face the possibility of advanced heart failure, you may still have options.  

To help confirm whether you have heart failure or another cardiovascular condition, your doctor will perform (or order) the following:

• A medical history: They’ll ask questions about your symptoms, including how long you’ve had them and how they affect you. They’ll also review your family history of heart problems and your own medical history.
• Physical exam: Your doctor will listen to your heart and lung sounds. They’ll also assess different areas of your body to look for signs of fluid build-up.
• Diagnostic tests: They’ll order one or more tests to check your heart structure and function. These may include an echocardiogram (heart ultrasound), stress test, or coronary angiogram (assesses blood flow in your heart).  

It’s possible to improve your heart health and prevent heart failure, even if you’re considered high-risk. And if you have Stage B or C heart failure, you can take steps to keep it from getting worse.

These steps include:

• Eating a heart-healthy diet
• Exercising regularly
• Getting plenty of rest
• Maintaining a healthy weight
• Managing stress
• Quitting smoking
• Reducing or avoiding alcohol use