What Causes Congestive Heart Failure?

Several factors can cause congestive heart failure including high blood pressure, coronary artery disease, cardiomyopathy, diabetes, and others.

Heart failure is a condition in which the heart is unable to pump blood to body tissues efficiently. Congestive heart failure is a chronic disease that progresses with time if left untreated. Heart failure can occur due to diseases of the heart, the blood vessels supplying oxygen and nutrients to the heart, or sometimes from factors outside the heart (extracardiac causes). A healthy lifestyle plays a role in the treatment and prevention of congestive heart failure.

Based on the symptoms and the amount of effort required to provoke them, the New York Heart Association (NYHA) has divided degrees of heart failure into four classes:

• Class I: Patients have no limitation of physical activity.
• Class II: Patients have a slight limitation of physical activity.
• Class III: Patients have marked limitations of physical activity.
• Class IV: Patients have symptoms even at rest and are unable to carry on any physical activity without discomfort.

Several factors can cause congestive heart failure. They include:

• Coronary artery disease (disease of the arteries that supply blood to the heart)
• High blood pressure
• Cardiomyopathy (disease of muscle of the heart)
• Valvular heart diseases (diseases of the valves present in the heart)
• Diabetes
• Diseases of the covering of the heart
• Arrhythmia (irregular heartbeat)
• Severe infections
• Anemia
• Thyroid disease
• Vitamin deficiencies
• Drugs, such as hydroxychloroquine
• Chronic diseases of the lungs
• Obesity
• Smoking
• Birth defects of the heart
• Kidney diseases
• Alcohol use

The initial stage of congestive heart failure may not cause symptoms. As the disease progresses, the symptoms become more obvious and interfere with activity. Symptoms of heart failure include the following:

• Breathlessness
• Difficulty in breathing on lying down
• Chest pain/heaviness
• Pounding, irregular or fast heartbeat (palpitations)
• Cough
• Fatigue
• Weakness
• Increased or decreased urine frequency
• Loss of appetite
• Weight loss
• Nausea
• Distended abdomen
• Pain abdomen
• Swelling especially of the feet and legs
• Pale or bluish skin
• Fainting
• Noisy breathing
• Weight gain
• Confusion
• Memory impairment
• Anxiety
• Headaches
• Sleep disturbances
• Bad dreams or nightmares

• Arrhythmia (disorders of heart rhythm)
• Kidney damage
• Liver damage
• Damage to heart valves
• Damage to heart muscles
• Fluid in the lungs
• Death

The prognosis after heart failure depends on many factors:

• Severity or stage of congestive heart failure
• Age of the patient
• Promptness and adequacy of treatment
• Lifestyle measures
• Genetics
• Presence of other diseases like diabetes and high blood pressure
• Addictions like smoking and alcohol

Although heart failure is a serious condition, it does not mean that the heart stops functioning altogether. With proper management, persons who have congestive heart failure can lead nearly normal lives, depending on its severity. Besides the required medical and surgical interventions, it is important to eat healthy, stay active as possible, and refrain from alcohol, smoking, and drug abuse. According to the U.S. Centers for Disease Control and Prevention (CDC), almost half of the patients with congestive heart failure live beyond 5 years.