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Congestive heart failure is common. About 5.7 million people in the United States experience heart failure. It results in about 300,000 deaths each year.
*Source: National Heart, Lung, and Blood Institute

Congestive Heart Failure Overview

Congestive heart failure, or heart failure, describes a condition in which the weakened or stiff heart cannot pump enough blood to the rest of the body or with enough force to supply the body’s needs. As a consequence, the heart fails to take blood from the lungs, oxygenate it, and send it to the tissues depending on oxygen-rich blood for their metabolism. The term “heart failure” does not mean that your heart has stopped and should not be confused with a heart attack or cardiac arrest. However, heart failure is a serious condition that requires medical attention.

Heart failure is a chronic, long-term condition that can affect either the right or left side (i.e. left or right ventricles) of the heart, but most commonly affects the left side first. Failure is present when:

  • Your heart muscle cannot pump, or eject, the blood out of the heart efficiently. This is called systolic heart failure, or
  • Your heart muscle is stiff and does not easily fill up with blood. This is called diastolic heart failure.

When the heart’s pumping action decreases, blood may back up in other parts of the body, causing fluid to build up in the lungs, the liver, the gastrointestinal tract, and the arms and legs. Swelling, or edema, can result, most commonly in the legs and ankles. Heart failure may also affect your kidneys and lower their ability to dispose of sodium and water, thus leading to more swelling.

The most common cause of heart failure is believed to be coronary heart disease or coronary artery disease, a narrowing of the small blood vessels that supply oxygenated blood to the heart. Failure can result when an infection weakens heart muscles, a disorder called cardiomyopathy.

Other problems that may lead to heart failure include:

  • Congenital heart disease
  • Heart attack
  • Heart valve disease
  • Some types of abnormal heart rhythms (arrhythmias)
  • High blood pressure
  • Diseases such as emphysema, diabetes, severe anemia or hyperthyroidism


Many patients do not exhibit symptoms in the early stages of congestive heart failure. But when symptoms do develop, they most often begin slowly, a sign of a chronic or ongoing condition. Sometimes, it may be an acute condition, meaning that it starts suddenly after a heart attack or other heart-related problem. Chronic heart failure symptoms include:

  • Shortness of breath (dyspnea) with activity or when you lie down
  • Fatigue, faintness and weakness
  • Swelling (edema) of feet and ankles
  • Bloating in the abdomen (ascites)
  • Rapid or irregular heartbeat or pulse
  • Persistent cough or wheezing with white or pink blood-tinged sputum
  • Weight gain due to fluid retention
  • Loss of appetite, indigestion

Acute heart failure symptoms are similar to those of chronic heart failure, but are more pronounced or may start and worsen suddenly. They may also include:

  • More pronounced pulsing of heartbeat (palpitations)
  • Sudden fluid buildup
  • Sudden, severe shortness of breath
  • Chest pain, if your heart failure is caused by a heart attack

Some patients with heart failure only exhibit symptoms – particularly chest pains – in conjunction with other severe conditions such as an abnormal heart rhythm (arrhythmias), angina, myocardial infarction, anemia, hyperthyroidism, infections with high fever or kidney disease.

Risk Factors

A single risk factor may be enough to cause heart failure, but a combination of factors increases your risk. Such factors include:

  • Persistent uncontrolled high blood pressure
  • Coronary artery disease
  • Heart attack
  • Sustained arrhythmia
  • Diabetes and some related medications
  • Sleep apnea
  • Congenital heart defects
  • Viruses
  • Excessive alcohol use
  • Kidney issues