Heart failure

Heart failure, also known as congestive heart failure (CHF) occurs when your heart can’t pump enough blood to keep up with the body’s needs. Your heart is still beating, but it may:

• Be too weak to pump blood effectively
• Not fill with enough blood 

Heart failure is a progressive disease that gets worse over time. It occurs in stages:

• Stage 1: Symptoms are barely noticeable.

• Stage 2: You experience abnormal shortness of breath and heart pounding (palpitations) during physical activity.

• Stage 3: There is some discomfort even when sitting still. Physical activity, like walking up stairs, becomes increasingly challenging. Afterward, you are unusually tired.

• Stage 4: Heart failure symptoms are at their worst and get in the way of everyday life. Once-simple activities, such as getting dressed, become nearly impossible. 

At Advocate Heart Institute, you have access to an exceptional level of care. We are one of the most comprehensive congestive heart failure programs in the U.S. Our offerings include the best available tests and treatments. We also emphasize education and prevention, which helps more patients maximize their well-being. Read, print or save the booklet in English, Spanish or Polish now.

Types of congestive heart failure

CHF typically occurs on the left side of the heart. There are two types:

• Preserved ejection fraction (diastolic heart failure): The heart’s pumping action functions correctly. But the bottom chambers do not relax between heartbeats preventing them from filling with blood.
• Reduced ejection fraction (systolic heart failure): The heart’s pumping action does not function as it should. This reduces levels of oxygen-rich blood pumped out to the rest of the body.

Right-sided heart failure can also occur. It is a complication of high blood pressure in the lungs (pulmonary hypertension). This makes the heart work harder than it should to pump oxygen-poor blood out to the lungs. Find out more about pulmonary heart disease.

Symptoms of congestive heart failure

Heart failure symptoms vary depending on the stage and may include:

Causes of congestive heart failure

Conditions that damage the heart cause heart failure. They may come on suddenly (acute) or occur over time (chronic).

Acute congestive heart failure causes

Acute heart failure is a complication of a severe medical condition, such as: 

• Certain heart rhythm conditions, including ventricular fibrillation
• Viral heart disease (myocarditis)
• Allergic reactions that cause the body to go into shock
• Pulmonary embolism
• Heart attack (myocardial infarction)

Chronic congestive heart failure causes

Ongoing cardiac conditions that can cause the heart to fail include: 

• Cardiomyopathy, which affects heart muscle tissue
• Certain heart conditions that are present at birth (congenital heart disease)
• Coronary artery disease 
• Structural heart disease including valve disorders

Other medical conditions that strain the heart and can cause CHF include:

• Diabetes
• Kidney disease
• Obstructive sleep apnea
• Thyroid disease

Diagnosing congestive heart failure

Advocate Hospital was among the first in the country with a heart failure screening program. This service helps people with heart failure risk factors receive timely tests and treatments. Learn more about our congestive heart failure clinic. 

If you are experiencing heart failure symptoms, we perform a comprehensive assessment. Find out more about heart and vascular testing and diagnosis.

Your assessment may include: 

• Echocardiography: This test assesses heart functioning, including the percentage of blood leaving the heart with each beat (ejection fraction). It helps determine the type of heart failure.
• Electrocardiogram (EKG): An EKG records the heart’s electrical activity and may show signs of arrhythmias or heart damage.
• Imaging studies: These tests include CT scan, MRI or nuclear test. A nuclear test uses small amounts of radioactive substance to make structures easier to view. Imaging studies help doctors assess heart structures such as valves and blood vessels. 
• Lab tests: When heart tissue is stressed, it releases a protein, brain natriuretic peptide (BNP). A blood test helps us check levels of BNP. We also use these tests to assess liver and kidney function.
• Stress test: Doctors evaluate the heart’s electrical activity while you perform light physical activity, like walking on a treadmill.

Treating congestive heart failure

Congestive heart failure treatments can lessen the effect of symptoms on your daily life. The options that are right for you depend on the diagnosis and stage. Your care may include:

Medications

We may recommend drugs that:

• Remove excess fluid from the body
• Relax narrow blood vessels
• Slow your heart rate making it easier to pump blood
• Make your heartbeat stronger enabling more oxygen-rich blood to reach organs

Surgery

Advocate Heart Institute excels in lifesaving heart failure surgery. Our cardiovascular surgery team performs a high volume of procedures giving you the best chances for good results. 

Surgical options for CHF include:

• CardioMEMS™ HF System: This implantable device detects changes in heart pressure that indicate worsening heart failure. Doctors use this information to adjust therapies to your changing needs.
• Ventricular assist device (VAD): A tiny implantable pump helps the heart’s lower chambers do their job. This enables more blood to circulate through the body. 
• Heart transplant: If other congestive heart failure treatments are unsuccessful, you may need a heart transplant. This procedure replaces a diseased heart with a healthy one from a donor.

Lifestyle changes

Adopting healthy habits can help you manage factors that contribute to atherosclerosis and lower your risk of complications. These preventive care habits include:

• Quitting smoking and other forms of tobacco use

• Eating a healthy diet 

• Staying physically active

• Reducing stress levels through relaxation and other techniques

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