What is Congestive Heart Failure or CHF – Symptoms and Causes

Congestive heart failure as the name resembles it is failure of heart due to congestion in the body. Before understanding congestive heart failure, we need to understand the pumping of heart muscles and blood circulation in the body by the heart.

Heart is an important body organ that pumps blood throughout the body. Heart is the pumping machine that flow blood to each and every body cell. Blood transport oxygen and nutrition to body cells for their smooth working.

Heart is divided into four chambers, Upper two chambers are Atriums and lower two chambers are Ventricles. Ventricles pumps blood to body organs and Atriums receives blood from your body to send it back to lungs for filtration.

Heart muscles also needs blood, oxygen and nutrition to work smoothly. The tubes that supplies blood to heart muscles are called coronary arteries.

Heart’s normal pumping capacity is 55-60%. It means if 100% blood comes to the heart, it pumps 60% blood to the body and remaining 40% heart takes for its working. The amount of blood heart pumps to the body is called as Ejection fraction or LVEF (Left ventricular ejection fraction), In simple words it is also called as “Heart pumping, Heart function, Heart Working, Heart pumping capacity or Heart working capacity.

When the ventricles can’t pump enough amount of blood to body organs, heart pumping decrease below 30-35%, and blood and fluid backs up in body then Congestive heart failure develops and the patient develops many alarming symptoms.

Symptoms of Congestive Heart Failure –

1. Severe breathlessness.
2. Swelling or Edema on legs, ankles, face, thighs and other body parts 
3. Swollen Lungs
4. Fluid build-up in Lungs face, legs and other body parts
5. Restlessness and uneasiness
6. Tiredness or Fatigue– Not able to walk a small passage
7. Cough and Wheezing
8. Irregular heart beat
9. Chest heaviness and chest pain
10. Lack of appetite

Causes of Congestive Heart Failure –

There are several causes for congestive heart failure, the main reasons are –

1. Heart Attack / Severe Coronary Artery Disease – A heart attack causes damage to heart muscles and the affected area may damage permanently. The amount of damaged area depends upon the severity of heart attack. A severe heart attack or series of heart attacks cause big damage to heart muscles and heart pumping decreases below 30% and congestive heart failure develops.

• Cardiomyopathy – Cardiomyopathy is a medical condition related to heart muscles, in this disease heart muscles become thick and rigid. Heart become dilated and enlarged. Heart muscles can’t able to work efficiently and the pumping capacity of heart muscles effected and heart function starts decreasing. Heart load increases and heart has to work faster to pump blood to body. When heart function becomes less than 25-30% The fluid starts build-up in body and congestive heart failure develops.

As per the heart response many types of cardiomyopathy may generate- Dilated   Cardiomyopathy, Hypertrophic Cardiomyopathy, Arrhythmogenic right ventricular dysplasia.

Transthyretin amyloid cardiomyopathy (ATTR-CM)

• Congenital Heart Defects –  Sometimes it happens with some persons develops heart failure due to by birth heart defects

• Post-Partum Cardiomyopathy – It happens with some women, after delivery cardiomyopathy develops that can cause congestive heart failure. In some rare cases CHF develops during pregnancy or before delivery.

• High Blood Pressure – Hypertension increases the load on heart and it disturbs heart natural rhythm. That again can cause CHF.

• Diabetes – It happens that persons with prolong history of diabetes do not feel or feel less coronary artery disease symptoms even when there is severe coronary disease or a small heart attack. This in the long run can develops congestive heart failure.

• Heart Valve Disease –  There are 4 valves in the heart that work in a systematic way to pass blood through them. If any valve develops any defect, that cause problem in blood flow again it disturbs the natural heart working and can cause congestive heart failure.

There are so many other reasons that are not listed here can also cause CHF.

A medical test which is called an Electrocardiogram or ECHO test is done to find out the heart pumping capacity, valves and heart chambers status and any cardiac related dysfunction of heart or to rule out a Congestive Heart Failure condition

Written by: Dr. Chetan Sharma

EECP Specialist, Heart & Lifestyle Expert

Supported by Mr. Abhijeet Gautam