Congestive Heart Failure

When you have heart failure, your weakened heart cannot pump enough blood and oxygen to your organs. You may be short of breath, retain fluid, or feel unusually tired. This condition can make everyday activities like walking and climbing stairs more difficult.

What is congestive heart failure?

Congestive heart failure occurs when the heart isn’t pumping blood as efficiently as it should. As a result, the flow of blood to the vital organs decreases and causes the pressures in the heart to increase. This prevents the heart from pumping enough blood that supplies the oxygen and nutrients to meet the body’s needs. Congestive heart failure can be caused by a number of conditions that damage the heart muscle, such as coronary artery disease, heart attack, cardiomyopathy, and high blood pressure. 

Congestive heart failure versus heart failure

Heart failure when associated with congestion or fluid retention is referred to as congestive heart failure. The fluid retention can be in the lungs (pulmonary congestion or pulmonary edema), legs, ankles, liver (hepatic congestion), or the abdomen (ascites).

Types of heart failure are:

Left-sided heart failure

The heart’s left ventricle is the most important chamber that is responsible for delivering blood and oxygen to all organs. When the left ventricle fails, the function of all organs is affected. There are two types of left-sided heart failure:

Systolic (HFrEF)

This occurs when the heart muscle doesn’t contract with enough force, which leads to less oxygen-rich blood being pumped through the body. 

Diastolic (HFpEF)

With this condition, the heart contracts normally, but the left ventricle is stiff, causing pressure, inside the heart to rise. 

Right-sided heart failure

The heart’s right ventricle works to pump blood into the lungs to be filled with oxygen. During right-sided heart failure, the right ventricle loses its ability to pump. This causes the blood to back up into the veins. Right-sided heart failure typically results in fluid retention and swollen feet, ankles, and legs.  

Acute heart failure

Acute heart failure, also referred to as decompensated heart failure, is a life-threatening condition with rapidly developing symptoms that require immediate medical care. With acute heart failure, the heart struggles to deliver enough oxygen to meet the body’s needs. 

Dr.  Stephen Bailey of AHN Cardiovascular Institute in a surgery suite at Allegheny General Hospital

"Being cared for in a system where clinicians are actively engaged in clinical trials and multi-center collaborations is key."

Stephen Bailey, MD — System Chair, Department of Thoracic and Cardiovascular Surgery

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What is cardiogenic shock?

Cardiogenic shock means that there is sudden, severe loss of heart function that results in dangerously low blood pressures, and inability of the heart to pump enough blood to get oxygen to vital organs and tissues. This condition can result in life-threatening organ dysfunction.

Cardiogenic shock can occur as a result of:

  • A massive heart attack.
  • Heart surgery.
  • Cardiomyopathy (a disease that makes it harder for the heart muscle to pump blood).
  • Chronic heart failure.

When a patient is in shock, time is of the essence. At AHN, a team of experts specializing in cardiogenic shock will act quickly to:

  • Make a rapid diagnosis and start therapy right away.
  • Decide on the right course of care for the best chance of survival.
  • Use proven decision-making pathways.

This process has made huge improvements in helping more patients survive cardiogenic shock.

Congestive heart failure symptoms and stages

Some people may not encounter any symptoms of heart failure. Those who do, however, could experience symptoms that are either constant, intermittent, or progressive, including: 

  • Shortness of breath with exercise, or at rest, caused by congested lungs. 
  • Wheezing or coughing caused by congested lungs. 
  • Swollen feet, ankles, legs, and abdomen caused by fluid retention. 
  • Rapid weight gain due to fluid retention. 
  • Loss of appetite or nausea.
  • Dizziness and confusion due to less blood flow to the brain. 
  • Feeling weak or fatigue due to less blood circulating to major organs. 
  • Rapid or irregular heartbeats (palpitation) from the heart trying to pump more blood into the body.
  • NT-proBNP levels that are higher than normal.

Based upon the severity of symptoms, people with congestive heart failure are categorized using the New York Heart Association (NYHA) Functional Classification system. It places people in one of four classes based on how much they are limited during physical activity.

Class I

There are no limitations to physical activity. Regular physical activity does not cause fatigue, shortness of breath, or palpitation.

Class II

There is slight limitation of physical activity, though the person is comfortable at rest. Regular physical activity results in fatigue, palpitation, or shortness of breath. 

Class III

There is a noticeable limitation of physical activity, though the person is comfortable at rest. Less than regular activity causes fatigue, palpitation, or shortness of breath.

Class IV

The person is unable to carry on any physical activity without discomfort, and there are symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

There are also four stages of systolic heart failure. It’s important to note that, typically, heart failure cannot be reversed, and you can only progress to more advanced stages over time, including: 

Stage A

This includes people at high risk for developing systolic heart failure, also referred to as pre-heart failure. 

Stage B

This category involves patients diagnosed with systolic left ventricular dysfunction. At this stage, patients usually aren’t experiencing signs and symptoms of heart failure. 

Stage C 

This is classified as patients diagnosed with systolic heart failure who have current or prior symptoms. 

Stage D 

This refers to patients diagnosed with systolic heart failure who are experiencing advanced symptoms after receiving medical care.

While there isn’t a cure for this progressive disease, you can enjoy a better quality of life with a number of treatments available at Allegheny Health Network (AHN) Cardiovascular Institute.

Heart failure care at AHN: Why choose us?

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