BHC home - health and medical information for consumers

Health and medical information for consumers, quality assured by the Victorian government (Australia).

10 February, 2010

Home > Fact sheets by category > Diseases and conditions > Heart > Conditions > Congestive heart failure.

Health information

Resources and tools

Healthy eating

Find help

Congestive heart failure

Congestive heart failure is present when the heart cannot pump enough blood to satisfy the needs of the body. Weakened chambers allow blood to pool inside the heart and nearby veins. This triggers fluid retention, particularly in the lungs, legs and abdomen.

The major causes of heart failure include coronary heart disease, hypertension, cardiomyopathy and other heart diseases. Of these, coronary heart disease (usually accompanied by a history of past heart attacks) is by far the most common. The major factors that contribute to coronary heart disease include:

Obesity
A diet high in saturated fats and cholesterol
High blood pressure
Diabetes
Smoking
Physical inactivity.

Congestive heart failure is more common in the elderly. The survival rate for people with this disorder depends on the severity of their condition. Treatments include medication, lifestyle changes and (sometimes) surgery.

Symptoms
Symptoms of congestive heart failure include:

Undue breathlessness during activity
Breathlessness at rest or on doing light exercise
Muscular fatigue, tiredness
Swelling of ankles or legs
Swelling of abdomen
Unexplained coughing and wheezing.

The failing ventricles
The heart is a double pump made up of four chambers. Deoxygenated blood from the veins enters the right upper chamber (right atrium or auricle), is passed to the right lower chamber (right ventricle), and then pumped to the lungs. Oxygenated blood from the lungs enters the left upper chamber (left atrium or auricle) and then enters the left lower chamber (left ventricle). The blood is then pumped around the body, under pressure, via arteries.

In a person with congestive heart failure, the left ventricle does not empty properly. This leads to increased pressure in the atria (upper chambers) and the nearby veins. This backlog of blood triggers fluid retention (oedema) in the lungs, abdominal organs and legs. This affects the kidneys, hinders their function and leads to retention of salt and water, causing oedema. In some people with heart failure, rather than failed pumping of the blood from the left ventricle, there is failed relaxation of the left ventricle. This also leads to blood pooling under backpressure.

A variety of causes
Congestive heart failure can be caused by several conditions, including:

Past heart attacks from coronary heart disease - leading to scarring in the heart muscle. This is the most common cause for congestive heart failure.
High blood pressure (hypertension) - the high pressure in the arteries means that the heart must keep pumping more forcefully. It may not be able to keep it up.
Heart valve disease- damaged heart valves may allow the blood to flow backwards or may obstruct forward flow.
Congenital heart disease - heart abnormalities may be present from birth, such as defective valves or abnormal communications between heart chambers.
Cardiomyopathy - this condition is characterised by enlargement of the heart muscle, where the left ventricle enlarges to compensate for poor contraction.
Myocarditis- viruses or other infections may damage the heart muscle.
Heart arrhythmia - rapid heartbeat with irregularity, over a long period of time, can also lead to inefficient contraction and heart failure.
Thyroid disease - the thyroid gland produces too much of its hormone, thyroxine; this increases the work of the heart and can lead to heart failure.

Contributing factors
The symptoms of congestive heart failure can be worsened by a number of factors, including:

Anaemia
Too much salt or alcohol in the diet
Pregnancy
Some infections
Kidney diseases
Lung diseases.

Diagnosis methods
Congestive heart failure can be confirmed with a variety of tests, including:

X-rays
Echocardiography
Exercise stress test
Electrocardiogram (ECG)
Lung function tests
Angiography
Blood tests.

Treatment options
Treatments for congestive heart failure may include:

Medications - such as diuretics (to remove excess fluid), ACE inhibitors (to open up blood vessels, reduce blood pressure and reduce sodium retention and water retention), digitalis (to help the heart pump more effectively), vasodilators (to open up blood vessels) and certain beta blockers (to slow the heart rate and reduce its work).
Addressing the underlying disorder - for example, treatment of high blood pressure.
Lifestyle changes - such as regular gentle exercise, losing excess body fat, stopping smoking, adhering to a low fat and low salt diet, restricting alcohol and having adequate rest.
Surgery- to replace narrowed or leaking heart valves.
Coronary bypass surgery - in some cases.
Heart transplants - in extreme cases.

Where to get help

Your doctor
Heartline Information Service Tel. 1300 362 787

Things to remember

Congestive heart failure refers to the heart’s inability to pump enough blood to satisfy the needs of the body.
The major cause of congestive heart failure is coronary heart disease, along with a history of past heart attacks.
Treatment includes medications, lifestyle changes and surgery.

You might also be interested in:
Blood pressure (high) - hypertension.
Circulatory system.
ECG test.
Heart arrhythmia and palpitations.
Heart attack.
Heart disease - risk factors explained.
Heart disease and food.

Want to know more?
Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)