Congestive Heart Failure: Can You Spot the Signs?

Congestive heart failure, when the heart cannot pump blood to meet the demands of the body, is a top concern for nearly 6 million Americans, according to the National Heart, Lung, and Blood Institute (NHLBI). But would you know how to spot the signs of congestive heart failure in your own body?

Congestive heart failure (also referred to as CHF or sometimes just heart failure) is an inability of the heart to pump blood throughout the body or to fill with enough blood, according to the Institute. Some people have both of these problems. Heart failure can strike just the right side of the heart, but most cases involve a weakening of both the left and right chambers.

Travis Murphy, MD, an emergency medicine attending physician at the University of Florida in Gainesville, says congestive heart failure is a common sight in hospital emergency rooms and can manifest in several ways as a result of a variety of factors. "Either the heart doesn't pump strongly enough or becomes too stiff," Dr. Murphy says. This can be due to valve problems or infections, a heart attack or heart muscle infection like viral myocarditis, he says. A blood clot in the lungs can also cause extra strain on the heart, leading to heart failure.

The NHLBI cites many conditions that can slowly overwork, damage and eventually severely weaken the heart. Those include diabetes, high blood pressure and a narrowing of the arteries due to coronary heart disease (also known as ischemic heart disease).

Congenital heart defects and the onset of irregular heartbeats (arrhythmia) may also contribute to the onset of heart failure, the NHBLI warns. Heart failure can also result from the enlargement, thickening or stiffening of the heart, a condition known as cardiomyopathy. Alcohol and drug abuse also heightens risk, as can some cancer treatments, such as chemotherapy and radiation.

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Realizing you have congestive heart failure can be difficult, in part because the condition, in its early stages, may trigger only minimal symptoms or no symptoms at all, Dr. Murphy says. When symptoms do arise, it's often an indication of an already progressed weakening of the heart.

Such symptoms, he notes, would include severe shortness of breath when engaging in even minimal activity, such as walking short distances or climbing a set of stairs. At that point, someone with congestive heart failure may only feel comfortable when resting. Other telltale signs, he notes, include chest pain, tightness and pressure.

A buildup of bodily fluids may also occur, "which often manifests as leg swelling starting from the ankles and progressing upwards," says Dr. Murphy. "That said," he adds, "some people don't have such prominent swelling in their legs and end up holding the extra water in their abdomen, depending on what other medical problems they may have."

Sudden weight gain (along with other CHF symptoms) can be a tip-off that your body is storing excess fluid, according to the American Heart Association. The Mayo Clinic highlights additional symptoms, such as a rapid or irregular heartbeat, increased urination at night, fatigue, general weakness, difficult concentrating, reduced alertness, a persistent cough (sometimes with phlegm), a lack of appetite and nausea.

By the time CHF reaches an advanced stage, people are usually severely limited in terms of their capacity to move, says Dr. Murphy. They will likely experience symptoms even while at rest. And most end up bedbound.

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"If individuals experience these signs or symptoms, they should seek medical attention," advises Gregg C. Fonarow, MD, director of the Ahmanson-UCLA Cardiomyopathy Center.

And Dr. Murphy offers some specific guidance as to what to do if you or a loved one suspect heart failure: "The first step would be to get the person into a comfortable position," Dr. Murphy says. "Usually sitting upright is more comfortable. And consider calling for help with 911 if the patient is unable to catch their breath." If you don't call 911, call a doctor or head straight to the ER, he says.

There's no cure for CHF. But with proper treatment and changes in lifestyle, people with congestive heart failure can prevent their condition from worsening, says the NHLBI. That's why it's so important to keep your doctor appointments, take your medicines and follow your doctor's diet and exercise recommendations.