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St. Joseph's General Hospital Elliot Lake


Heart Failure

Symptoms of CHF

  • shortness of breath,
  • feeling tired (fatigue) and leg weakness when you’re active,
  • swelling in your ankles, legs, and abdomen,
  • weight gain,
  • the need to urinate while resting at night,
  • rapid or irregular heartbeats (palpitations),
  • a dry, hacking cough,
  • a full (bloated) or hard stomach, loss of appetite or upset stomach (nausea).

There may be times that symptoms are mild, or there may not be any symptoms at all. This doesn't mean you no longer have CHF, as symptoms can range from mild to severe and may come and go.

Unfortunately, this condition usually gets worse over time and as it worsens, you may have more or different signs or symptoms. It’s important to let your Doctor or Primary Healthcare Provider know if you have new symptoms or if your symptoms get worse.

Causes of CHF

Although the risk of heart failure doesn’t change as you get older, you’re more likely to have heart failure when you’re older. Many medical conditions that damage the heart muscle can cause heart failure: 

  • coronary artery disease,
  • heart attack,
  • cardiomyopathy,
  • heart issues present at birth (congenital heart disease),
  • diabetes,
  • high blood pressure (hypertension),
  • arrhythmia (abnormal heart rhythms, including atrial fibrillation),
  • kidney disease,
  • being overweight,
  • tobacco and recreational drug use,
  • medications.

Diagnosis of CHF

To determine if you have CHF, your Doctor or Primary Healthcare Provider needs to know about your symptoms and medical history and will ask you about questions about:

  • Other health conditions you may have, such as diabetes, kidney disease, chest pain (angina), high blood pressure, high cholesterol, coronary artery disease, or other heart problems.
  • If you have a family history of heart disease or sudden death.
  • If you smoke or use tobacco.
  • How much alcohol you drink.
  • If you’ve had chemotherapy and/or radiation.
  • The medications you take. 

Your Doctor or Primary Healthcare Provider will also conduct a physical exam to look for signs of Congestive Heart Failure and diseases that may have caused your heart muscle to become weak or stiff.

  • blood tests,
  • NT-pro B-type Natriuretic Peptide (BNP) blood test,
  • cardiac catheterization,
  • chest X-ray,
  • echocardiogram (echo),
  • magnetic resonance imaging (MRI),
  • electrocardiogram (EKG or ECG),
  • Multigated Acquisition Scan (MUGA scan),
  • stress test.

Prevention of CHF

Although you can’t control some risk factors like age or family history, you can change your lifestyle to give yourself the best chance of preventing Congestive Heart Failure such as:

  • maintaining a healthy weight,
  • eating foods that are good for your heart,
  • exercising regularly,
  • managing stress,
  • abstaining from using tobacco products,
  • abstaining or limiting consumption of alcohol,
  • abstaining from using recreational drugs,

Taking care and monitoring other medical conditions that can increase your risk such as:

  • Diabetes,
  • kidney disease,
  • Anemia,
  • high blood pressure,
  • thyroid disease,
  • Asthma,
  • chronic lung disease.

Treatment of CHF

Your treatment will depend on your specific type of heart failure, as well as the underlying cause(s). Medications and lifestyle behaviors are part of every treatment plan. Your Doctor or Primary Healthcare Provider will talk to you about the best treatment plan for you.

As CHF worsens, your heart muscle pumps less blood to your organs, and you move toward the next stage of heart failure. The goal of treatment is to keep you from moving forward through the stages or to slow down the progression of your heart failure.

  • regular exercise, being active, walking every day,
  • stopping the use of tobacco products,
  • treatment for high blood pressure (medication, low-sodium diet, active lifestyle),
  • treatment for high cholesterol,
  • abstaining from drinking alcohol or using recreational drugs,
  • prescription for angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB) if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions,
  • prescription for a beta-blocker if you have high blood pressure.
  • treatments listed in Stage A,
  • prescription for angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) (if you aren't already taking one),
  • prescription for a beta-blocker if you’ve had a heart attack and the effectiveness of your heart pumping (ejection fraction) is 40% or lower (if you aren't already taking one),
  • prescription for an aldosterone antagonist if you’ve had a heart attack or if you have diabetes and the effectiveness of your heart pumping (ejection fraction) is 35% or less,
  • possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease (valve repair or replacement) or congenital heart disease.
  • treatments listed in Stages A and B,
  • prescription for a beta-blocker,
  • prescription for an aldosterone antagonist if a vasodilator medicine (ACE-I, ARB or angiotensin receptor/neprilysin inhibitor combination) and beta-blocker don't relieve your symptoms,
  • prescription for hydralazine/nitrate combination if other treatments don't stop your symptoms,
  • prescription for a medication that helps to slow your heart rate if your heart rate is faster than 70 beats per minute and you still have symptoms,
  • a diuretic ("water pill") may be prescribed if symptoms continue,
  • restriction of sodium (salt) in your diet,
  • tracking your weight every day – tell your healthcare provider if you gain or lose more than four pounds,
  • possible fluid restriction,
  • possible cardiac resynchronization therapy (biventricular pacemaker),
  • possible implantable cardiac defibrillator (lCD) therapy,

The usual treatment plan for people who reach CHF Stage D includes treatments listed in Stages A, B and C as well as more advanced treatment options, including: 

  • heart transplant
  • ventricular assist devices,
  • heart surgery,
  • continuous infusion of intravenous inotropic drugs,
  • palliative or hospice care.

Living with CHF

With the right care and treatment plan, many adults still enjoy life even though Congestive Heart Failure limits their activities. How well you feel depends on:

  • how well your heart muscle is working,
  • your symptoms,
  • how well you respond to your treatment plan,
  • how well you follow your treatment plan.

Care for yourself by: 

  • taking your medications,
  • being active,
  • following a low-sodium diet,
  • tracking and reporting new or worsening symptoms to your Doctor or Primary Healthcare Provider,
  • keeping regular follow-up appointments with your Doctor or Primary Healthcare Provider.