Heart failure is a serious, chronic condition in which the heart is not able to pump enough blood throughout the body. To compensate, the heart may work harder by enlarging the heart chambers, thickening the heart walls or beating faster. This works for a while, but eventually the heart loses pumping capacity and cannot keep up. Blood then backs up into the liver, abdomen, ankles, feet or lungs. Symptoms subsequently develop, such as fatigue, shortness of breath and leg swelling. Additional signs of CHF include a persistent cough, sudden weight gain, lack of appetite, nausea and irregular heartbeat.

Risk factors for developing CHF include high blood pressure, coronary heart disease, heart attack, diabetes and viruses. Anyone can develop CHF, but it is more common in African Americans, men and people age 65 and older. To diagnose the condition, your physician usually will take a complete health history, perform a physical examination and order certain tests. Tests may include a chest X-ray to look for an enlarged heart and fluid in or around the lungs; an electrocardiogram to check heart rhythm; or an echocardiogram to observe heart structure and blood flow.

Treatment for CHF depends on what causes it, how severe it is and your overall health. Medical device options include: 

• An implantable cardioverter-defibrillator to monitor heartbeats and shock the heart back to normal if it starts beating at a dangerous rhythm.
• A biventricular pacemaker to send timed electrical impulses to the heart’s lower chambers so they pump in a coordinated rhythm.
• A left ventricular assist device attached to the damaged heart to help it pump.

Surgery may be recommended if CHF is caused by an underlying condition. A damaged heart valve may be repaired or replaced, or bypass surgery may be performed to treat severely narrowed arteries.

Medications are used for most patients to help manage the condition. Commonly prescribed drugs include:

• Angiotension-converting enzyme (ACE) inhibitors to widen blood vessels and help improve blood flow.
• Digitalis to strengthen heart muscle contractions.
• Beta blockers to lower blood pressure and reduce heart rate.
• Diuretics to decrease fluid levels in the body through increased urination.

Lifestyle changes also play a crucial role in helping to prevent CHF from worsening and relieving some of the symptoms. Your doctor may recommend that you stop smoking, monitor your weight, exercise, reduce stress, get plenty of sleep, and limit sodium, fats, cholesterol, fluids and alcohol. If you notice any changes in symptoms, contact your doctor immediately. By working closely with your physician you can stay on track and live more comfortably with CHF.