Congestive heart failure, or heart failure, is a long-term condition in which your heart can’t pump blood well enough to meet your body’s needs. Your heart is still working. But because it can’t handle the amount of blood it should, blood builds up in other parts of your body. Most of the time, it collects in your lungs, legs and feet.
Think of it like a shipping department that can’t keep up with getting all the shipments where they need to go. The shipping department is always running behind and things pile up. When things pile up, they cause issues.
Sometimes, you may have mild symptoms of congestive heart failure or none at all. This doesn’t mean you don’t have heart failure anymore. Symptoms of heart failure can range from mild to severe and may come and go.
Unfortunately, congestive heart failure usually gets worse over time. As it worsens, you may have more or different signs or symptoms.
How is congestive heart failure treated?
Your treatment will depend on the type of heart failure you have and, in part, what caused it. Medications and lifestyle changes are part of every heart failure treatment plan. Your healthcare provider will talk to you about the best treatment plan for you.
There’s no cure for heart failure. As congestive heart failure gets worse, your heart muscle pumps less blood to your organs, and you move toward the next stage of heart failure. Since you can’t move backward through the heart failure stages, the goal of treatment is to keep you from moving forward through the stages or to slow down the progression of your heart failure.
Stage A treatment
Treatment for people with Stage A heart failure includes:
Regular exercise, such as walking every day.
No tobacco products.
Treatment for high blood pressure (medication, low-sodium diet, active lifestyle).
Treatment for people with Stage B heart failure includes:
Treatments for Stage A.
Angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) if your EF is 40% or lower.
Beta-blocker if you’ve had a heart attack and your EF is 40% or lower (if you aren’t already taking one).
Aldosterone antagonist if you’ve had a heart attack or if you have an EF of 35% or less.
Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease (valve repair or replacement) or congenital heart disease.
Stage C treatment
Treatment for people with Stage C HFrEF includes:
Treatments from Stages A and B.
Beta-blocker.
Aldosterone antagonist.
Sodium-glucose transport 2 inhibitors (SGLT2i).
Hydralazine/nitrate combination if other treatments don’t stop your symptoms and you’re African American.
Medications that slow your heart rate if your heart rate is faster than 70 beats per minute and you still have symptoms.
If the treatment improves or stops your symptoms, you still need to continue treatment to slow the progression to Stage D.
Stage D treatment
Treatment for people who have Stage D heart failure includes treatments for Stages A, B and C. In addition, it includes evaluation for more advanced treatment options, including:
Treatment for people with Stage C and Stage D heart failure and preserved EF (HFpEF) includes:
Treatments for Stages A and B.
Medications for the treatment of medical conditions that can cause heart failure or make it worse, such as atrial fibrillation, high blood pressure, diabetes, obesity, coronary artery disease, chronic lung disease, high cholesterol and kidney disease.
Diuretic (“water pill”) to reduce or relieve symptoms.
It’s very important for you to manage your other health conditions, such as:
Some conditions have signs and symptoms similar to congestive heart failure. If you have new or worsening nonurgent symptoms, tell your healthcare provider.
Complications/side effects of the treatment
Complications of congestive heart failure treatments may include:
You’ll also have a physical exam. Your provider will look for signs of congestive heart failure and diseases that may have made your heart muscle weak or stiff.
What are the four stages of congestive heart failure?
Heart failure is a chronic condition that gets worse with time. There are four heart failure stages (Stages A, B, C and D). They range from having a high risk of developing heart failure to having advanced heart failure.
Stage A
Stage A (pre-heart failure) means you’re at a high risk of developing heart failure because you have a family history of congestive heart failure or you have one or more of these medical conditions:
History of taking drugs that can damage your heart muscle, such as some cancer drugs.
Stage B
Stage B (pre-heart failure) means your left ventricle isn’t working well and/or is structurally abnormal but you’ve never had symptoms of heart failure.
Stage C
People with Stage C heart failure have a congestive heart failure diagnosis and currently have or previously had signs and symptoms of the condition.
People who have Stage D HFrEF (heart failure with reduced ejection fraction) have advanced symptoms that don’t get better with treatment. This is the final stage of heart failure.
What tests will be done to diagnose congestive heart failure?
Common tests to identify congestive heart failure, its stage and its cause include:
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