10 CHF (congestive heart failure) facts
We will now go through 10 top tips for congestive heart failure (CHF). ‘Congestive’ largely means ‘chronic’, i.e. long-term.
1. What is congestive heart failure (CHF)?
Heart failure is a condition in which the heart muscle is weakened and cannot pump as well as usual. It is common and affects 10% of the population. It is also called congestive cardiac failure, or CCF.
Typical symptoms include shortness of breath, swelling of the ankles and legs (sometimes abdomen and face), and tiredness.
2. What are causes of CHF?
For most patients it is caused by ischaemic heart disease (IHD; which causes heart attacks and angina). Other causes include problems with the heart valves, and abnormalities you are born with (congenital heart disease). Also 20% of the population have high blood pressure (hypertension), which is linked to IHD and heart failure.
3. What are risk factors for CHF?
Although heart failure may strike at any age, it is more common in people as they get older, making age an important risk factor. The risk of heart failure increases after the age of 65.
Other risk factors include the following:
- High blood pressure (hypertension)
- Family history of enlarged heart (familial cardiomyopathy)
- Diabetes
- Obesity
- Obstructive sleep apnoea (OSA)
- Severe lung disease (cor pulmonale).
- Chronic kidney disease (CKD)
4. What are symptoms of CHF?
- Shortness of breath with activity or when lying down
- Fatigue and weakness
- Swelling in the abdomen, legs, ankles and feet – and sometimes the face
- Persistent cough or wheezing with white or pink blood-tinged sputum.
5. How do doctors diagnose CHF?
This is done through characteristic symptoms (e.g. shortness of breath and ankle swelling) and signs (e.g. crackly sounds in the lower area of chest at the back, on examination). An ECHO (echocardiogram; a sound picture of the heart) is often done to confirm the diagnosis and find the cause. A chest x-ray and ECG are usually done as well.
6. What are the medical treatments (tablets) for CHF?
There are a wide range of medicines, operations and other procedures that are used to treat chronic heart failure.
Diuretics (water pills) make you pass more urine and help relieve ankle swelling and breathlessness caused by heart failure. There are many different types of diuretic, but the most widely used for heart failure are furosemide and bumetanide.
Other drugs used include ACE inhibitors (e.g. ramipril), beta-blockers (e.g. bisoprolol), a water tablet called spironolactone, and now SGLT2 inhibitors (e.g. dapagliflozin).
7. What are the surgical treatments for CHF?
Even though medicines are the main treatment for heart failure, for some people procedures and surgery may help. Operations that may be needed in heart failure include:
- Pacemaker and/or ICD
- Heart valve surgery
- Coronary artery bypass
- Heart transplant (you may need to be referred to a specialist regional hospital for that).
The NHS website has alot more on the treatment of heart failure here.
8. What can I do to improve my heart failure?
- Take your tablets as prescribed.
- Fluid restriction. Many patients with heart failure are asked to restrict their fluid intake – sometimes to 1.5 or even 1 litre a day. Ask your doctor if you need to limit your fluids, and how much you can drink each day. Remember, it isn’t just what you drink that counts. Ice, ice cream, fruits and soup all add up. Weigh yourself every morning. Quick weight gain (as well as shortness of breath, cough and ankle swelling) can be a sign of worsening heart failure – as fluid is building up in your body. If this is the case, you need to see your GP or heart failure consultant or specialist nurse.
- Lifestyle changes. It is also good idea not to smoke, keep trim, exercise and keep your alcohol consumption down
9. What can the NHS do for my heart failure?
- GP. Many patients can be looked after by an NHS GP alone. But if things are not settling you should be referred to a hospital cardiology consultant.
- Hospital cardiology consultant. Ask your GP to refer you to the local hospital cardiology unit (there will be one). Then when you see a consultant (or their deputy, called a registrar) who specialises in heart disease, only let them discharge you when you feel your breathing is OK, and heart failure is stable. In the meantime, ask for review every 3-6 months – this can be virtual. Many heart doctors subspecialise, e.g. heart failure or problems with the heart rhythm. Make sure you are under the care of the right one. Ask them. They can also get you to see a hospital (or community based) heart failure specialist nurse, and/or refer you to a dietitian.
- Heart surgery. Ask your consultant if heart surgery may help. If so (or if they are not sure), ask them to refer you to a cardiac (heart) surgeon.
- GP Practice Nurse. Many GPs have a practice nurse that runs a ‘long-term condition’ clinic (e.g. for CKD and diabetes). Ask for three monthly review there. Some of them work with a clinical pharmacist who can fulfil a similar role.
10. What is the outlook (prognosis) for CHF?
Even though heart failure is a long-term condition, people with can live long and full lives with it. Although there’s no cure for heart failure, you can stop your condition getting worse by taking your medicines, attending appointments and changes to your lifestyle.
The outlook is not as bad as the name sounds. 80-90% of people live for one year, 50% to 60% for five years, and 30% at 10 years.
Summary
We have described 10 CHF (congestive heart failure) facts. If you follow all the advice above, you will get better care – and your breathing and other symptoms of heart failure will improve.
Other resources
10 CKD facts
10 IHD facts
10 diabetes facts
10 cholesterol facts
Last Reviewed on 27 May 2024