What Exactly is CHF? 

Congestive heart failure or CHF is fluid buildup in the lungs, abdomen, legs, and feet. This happens when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is a serious condition, but it does not mean that the heart has stopped beating.Heart failure can result from a weak heart that does not have enough squeeze to push blood out (called systolic heart failure)  or it can result from a stiff heart which does not let enough blood into the heart to be pumped out (called diastolic heart failure). It is possible to have both systolic heart failure (weak heart) and diastolic heart failure (stiff heart) at the same time.

According to the CDC:

  • About 6.5 million adults in the United States have heart failure
  • Heart failure was a contributing cause of 1 in 8 deaths 
  • Heart failure costs the nation more than $30 billion a year 

Heart failure is progressive which means it gets worse over time and becomes more difficult to manage its symptoms. 

Many foods containing excessive salt can contribute to deterioration of existing heart failure by fluid retention and elevated blood pressure. 

What are the risk factors?

Certain medical conditions can increase the risk for developing heart failure, including

  • Coronary artery disease (CAD) 
  • Prior heart attacks
  • Diabetes 
  • High blood pressure (hypertension)
  • Arrhythmias (irregular, fast or slow heartbeats)
  • Valvular heart disease 
  • Cardiomyopathy (heart muscle becomes weak enlarged or stiff)
  • Congenital heart defects (heart problems present at birth)
  • Other Conditions Related to Heart Disease 

Unhealthy lifestyle or behaviors can be detrimental to health in general and they also significantly increase risk for developing heart failure.
The worst unhealthy behaviors include:

  • Severe weight gain or obesity from excessive calories
  • Smoking tobacco-even second hand
  • Eating foods high in fat, cholesterol, and  salt (sodium) 
  • Not getting enough physical activity
  • Excessive alcohol intake



What are the Symptoms?

The symptoms vary from person to person. Even within the same person the signs and symptoms can change depending of what else is happening, the medications they are taking, and the condition of their other medical problems.

The most common symptoms include shortness of breath due to congestion of the lungs with fluid. Other parts of the body also become congested such as the feet, ankles, and stomach. Other symptoms to watch out for include:

  • Breathlessness from minimal activities
  • Trouble breathing when lying down
  • Waking up breathless suddenly at night
  • Needing more and more pillows to sleep without breathlessness
  • More fatigue and tiring easily
  • Frequent coughing and throat clearing
  • Coughing up more mucus or pink, frothy sputum
  • Dry, hacking cough when lying flat in bed
  • Swelling of feet, ankles or legs
  • Getting up more frequently at night to urinate
  • Lack of appetite and nausea for no reason
  • Cold legs and arms
  • Difficulty thinking clearly or concentrating 

Heart failure is a progressive condition, which means it not only gets worse over time but it becomes more difficult to manage and treat the symptoms. Seeking early evaluation is essential.

How is it evaluated? 

The first goal is to determine if the symptoms are really from heart failure and not something else like a heart attack or kidney disease. For this reason a battery of lab tests initially ordered to rule out other conditions.

If the initial battery of tests is inconclusive more specific lab test for are performed. In addition to bloodwork other initial tests include a twelve-lead electrocardiogram (EKG) and chest x-ray. Other tests such as a stress test, cardiac catheterization, or cardiac MRI may also be obtained depending on the suspected cause. 

However of all the tests you will get, none provide as much information about the heart as an echocardiogram or echo. This test uses ultrasound waves to measure the heart’s function and general health.  From this one test we can learn about:

  • Systolic function of the heart (pumping strength) measured as “ejection fraction”
  • Diastolic function of the heart (relaxing ability)
  • Health of heart valves and rule out any obstruction of blood flow (called stenosis) or backward leakage of blood (call regurgitation)
  • Pressure inside the heart
  • Cardiac output or how much blood the heart is able to supply
  • Condition of the the inner and outer layer of the heart (call pericardium)
  • Whether there has been any previous heart damage from a a heart attack can also be determined buy an echocardiogram