Yasmine Ali, MD, is board-certified in cardiology. She is an assistant clinical professor of medicine at Vanderbilt University School of Medicine and an award-winning physician writer.
Congestive heart failure—often referred to as heart failure—is the term used to describe what happens when the heart is unable to pump enough blood to meet the body’s needs. Heart failure should not be confused with cardiac arrest, in which the heart stops beating entirely. Instead, heart failure is the inadequate functioning of the heart muscle.
The condition can either be acute, meaning it occurs rapidly and generally on a short-term basis, or chronic, which means it occurs over the long term.
The symptoms of heart failure can vary depending on the location of heart damage, which may occur on the heart’s ride side (right-sided heart failure), left side (left-sided heart failure), or both (biventricular failure). Symptoms for each differ somewhat, but those common to all three conditions include fatigue, dizziness, swelling in the legs, and shortness of breath, especially with exercise.
In heart failure, the strain put on heart muscles over a long period of time hampers efficient blood flow to the point that fluid builds up in the heart and lungs and, eventually, in the extremities. Heart failure may be caused by cardiovascular conditions that weaken the heart, such as heart attack, coronary artery disease, or hypertension, as well as by other diseases and conditions.
Heart failure is usually diagnosed with an echocardiogram, which is an ultrasound of the heart that shows heart function. Measuring brain natriuretic peptide, or BNP, has also gained attention in recent decades because it can be performed using a blood test. Both tests, along with symptoms, may be used to establish or rule out a diagnosis of heart failure.
With appropriate lifestyle changes and medical treatment, you can live with congestive heart failure for many years. Adopting a heart-healthy diet and increasing physical activity are examples of lifestyle changes that will improve your heart and health. However, if left untreated, heart failure can cause blood to build up in the body, leading to swelling (edema) in the legs and lungs and, eventually, organ failure.
The New York Heart Association (NYHA) Functional Classification identifies four stages of congestive heart failure, based on the level of symptoms. Class I indicates no limits on physical activity due to symptoms. Those with Class IV heart failure have no ability to be active, with symptoms of heart failure at rest.
Angiography is a common medical procedure used to visualize blood flow within the body and help diagnose various medical conditions. It also allows the opportunity to intervene and treat blockages and other abnormalities, especially those that affect the heart and brain.
Between heartbeats, when the heart is not actively pumping blood into the arteries, the cardiac ventricles relax momentarily so they can refill with blood in preparation for the next contraction. This ventricular relaxation is called “diastole,” and the blood pressure during diastole is called diastolic blood pressure.
The electrocardiogram—also referred to as an ECG or EKG—is a non-invasive diagnostic test that evaluates your heart’s electrical system. It uses metal electrodes to detect the electrical charges generated by your heart as it beats, which are then graphed. The patterns help your doctor understand your heart’s rate and rhythm and identify some types of heart disease, including heart attacks.
The implantable cardioverter defibrillator (ICD) is a surgically implanted medical device that monitors your heart rhythm and automatically delivers lifesaving treatment should you develop the dangerous heart arrhythmias known as ventricular fibrillation or ventricular tachycardia. ICDs are recommended for people who are known to have a high risk of sudden death from cardiac arrest.
In a myocardial biopsy, also called a heart biopsy, doctors use a very fine needle to take a sample of heart tissue. It is used to detect heart inflammation (myocarditis), as well as to evaluate rejection status after a heart transplant.
A pacemaker is a small but sophisticated electronic device that is implanted under the skin to help regulate the heartbeat. Pacemakers are often used to treat cardiac arrhythmias. In addition, in heart failure, a specialized pacemaker called a cardiac resynchronization therapy device can significantly improve cardiac function and symptoms.
The measurement of a person’s blood pressure is recorded as two different numbers—systolic blood pressure and diastolic blood pressure. When the heart is actively beating (an event called “systole”), the ejection of blood into the arteries causes blood pressure to rise. The peak blood pressure reached during cardiac contraction is called systolic blood pressure.
American Heart Association, Classes Of Heart Failure.
National Institutes of Health, U.S. National Library of Medicine. Myocardial biopsy. MedlinePlus. Updated January 5, 2021.