Chronic/Congestive Heart Failure

The heart is a muscle. It pumps oxygen-rich blood to all parts of the body. When you have heart failure, the heart can’t pump as well as it should. Blood and fluid may back up into the lungs, and some parts of the body don’t get enough oxygen-rich blood to work normally. These problems lead to the symptoms you feel.

Because of heart failure, not enough blood leaves the heart with each beat. There are two types of heart failure. Both affect the ventricles’ ability to pump blood. You may have 1 or both types.

Systolic heart failure. The heart muscle becomes weak and enlarged. It can’t pump enough blood forward when the ventricles contract. Ejection fraction is lower than normal.

Diastolic heart failure. The heart muscle becomes stiff. It doesn’t relax normally between contractions, which keeps the ventricles from filling with blood. Ejection fraction is often in the normal range.

What is ejection fraction?

Ejection fraction (EF) measures how much blood the heart pumps out (ejects). This is measured to help diagnose heart failure. A healthy heart pumps at least half of the blood from the ventricles with each beat. This means a normal ejection fraction is around 50% or more.

How heart failure affects your body

When the heart doesn't pump enough blood, hormones (body chemicals) are sent to increase the amount of work the heart does. Some hormones make the heart grow larger. Others tell the heart to pump faster. As a result, the heart may pump more blood at first, but it can't keep up with the ongoing demands. So, the heart muscle becomes more damaged. Over time, even less blood is pumped through the heart. This leads to problems throughout the body.

Causes of heart failure

The most common cause of heart failure is coronary artery disease, or narrowing of the small blood vessels that supply blood and oxygen to the heart. Others causes are untreated high blood pressure, congenital heart disease, heart attack or infection. Having certain diseases may make you more likely to develop heart failure.

Symptoms often begin slowly. They only may occur after you are very active. Over time, you may notice breathing problems. Note that heart failure may also begin suddenly; after a heart attack for example.

Common symptoms are:

  • Cough
  • Fatigue, weakness, faintness
  • Loss of appetite
  • Need to urinate at night
  • Pulse that feels fast or irregular, or a sensation of feeling the heart beat
  • Shortness of breath when you are active or after you lie down
  • Enlarged liver or abdomen
  • Swollen feet and ankles
  • Waking up from sleep after a couple of hours due to shortness of breath
  • Weight gain


Certain procedures may help in some cases of heart failure. They are done to treat health problems that are affecting your heart. These procedures are not the best options for all patients. If any of them can help you, your doctor can give you more details.

Treating Artery and Valve Problems
If you have coronary artery disease or valve disease, procedures may be done to improve blood flow. This helps the heart pump better, which can improve heart failure symptoms:

  • Cardiac catheterization helps detect clogged blood vessels. X-ray dye is injected into the heart through a catheter (thin tube). Then, an angiogram (special type of X-ray) is taken of the blood vessels.
  • Angioplasty and stenting expand narrowed arteries. These procedures are done during cardiac catheterization.
  • Bypass surgery allows blood to flow around a clogged artery.
  • Valve surgery repairs or replaces faulty valves so blood can flow properly through the chambers of the heart.

Treating Heart Rhythm Problems
Certain devices may be attached to the heart to regulate a slow or abnormal heart rhythm. This helps take strain off the heart:

  • A pacemaker is a small electronic device that treats a slow heartbeat.
  • An ICD (implantable cardioverter defibrillator) is a device that treats fast heart rhythms when they become life-threatening.
  • Cardiac resynchronization therapy (CRT) is a treatment that stimulates the heart’s lower chambers (ventricles) so their contractions are more efficient, pumping more blood with each beat. This therapy is delivered by a pacemaker.

In Severe Cases
For a few people who are very sick, a heart transplant may be an option. A heart transplant is very serious and not an option for all patients. Your doctor can tell you more.

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Symptoms and Screenings for Chronic/Congestive Heart Failure

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Causes and Preventions for Chronic/Congestive Heart Failure

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Education and Resources for Chronic/Congestive Heart Failure

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Support groups for Chronic/Congestive Heart Failure

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Vidant Health can connect you to health care professionals to help you understand your condition and guide you through the treatment process. Let’s chat.

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