A Look At The 3 Types Of Congestive Heart Failure | Cardiovascular Disorders and Diseases articles | Body & Health Conditions center

Congestive heart failure is a medical condition characterized by weak heart muscle that makes this vital organ pump blood around the body less and less efficiently. It is a progressive health issue that describes a stage of fluid build-up, primarily in the heart and lungs, but in other organs too. There are two main types of systolic congestive heart failure, depending on which ventricle of the heart is affected. Additionally, left-sided diastolic heart failure represents the third type.

1. Systolic left-sided heart failure

Systolic left-sided heart failure is one of the two types of heart failure that can affect the heart’s ability to pump blood. In these patients, the left ventricle is too weak to pump out enough blood into the aorta, the the largest artery that supplies all organs with oxygenated blood.

If the condition is left untreated, it will progress and eventually lead to the right-sided heart failure.

Left-sided heart failure is called heart failure with reduced ejection fraction (the percentage of blood ejected from the left ventricle). Doctors will typically perform cardiac ultrasound imaging to determine the ejection fraction, as well as other important parameters, such as the diameters of heart chambers, thickness of the heart muscle, and flow rates through different parts of the heart and large blood vessels.

For reference, normal value of left ventricle ejection fraction is between 50 and 70 percent. However, that does not rule out the possibility of other types of heart failure, despite having a normal ejection fraction. Also, important to note is the fact that values under 40 percent mean that you are suffering from systolic heart failure.

Treating left-sided systolic heart failure

Some of the most common drugs prescribed to people with left-sided systolic heart failure include inotropes, diuretics, beta-blockers, ACE inhibitors, ARN inhibitors, and calcium-channel blockers. In most cases, people with heart failure need to use a combination of two or more of these drugs to properly regulate heart function. Treatment of the underlying condition that led to heart failure is also necessary. Surgical procedures, such as coronary artery bypass and stent placement, could be required.

2. Left-sided diastolic heart failure

If systolic heart failure meant that your heart couldn’t contract properly in the systolic phase, diastolic heart failure means that it cannot relax between heartbeats — in the diastolic phase. This happens because the left ventricle walls become very thick and the cavity narrows, which makes it incapable of filling up with blood prior to the upcoming systole.

Diastolic heart failure is also known as heart failure with preserved ejection fraction and is also diagnosed after a cardiac ultrasound. Epidemiological studies suggest that this type of heart failure is more frequent in elderly patients, with slightly higher incidence in women than in men.

The pathophysiology of diastolic heart failure is still a controversial topic, meaning that there is still disagreement among scientists about certain features related to this type of heart failure. The diagnosis can sometimes be hard, especially because of the preserved ejection fraction. Luckily, there are guidelines which cardiologists can use to make the proper diagnosis.

Treating left-sided diastolic heart failure

When it comes to treating diastolic heart failure with medication, three categories of drugs are used to solve different problems:

Coronary artery disease. If coronary artery disease is causing the heart failure, you might be prescribed calcium channel blockers, beta-blockers, or ARBs. In some cases, people also receive nitroglycerin, a fast-acting vasodilator.
Fluid build-up. Congestive heart failure is a stage characterized by fluid build-up. Treatment paths may follow the prescription of diuretics, which are also known as "water pills", to remove excess fluid from your body.
Other conditions. If a person’s diastolic heart failure is caused by other conditions, such as elevated blood pressure, doctors might offer medication to keep these problems under control.

3. Right-sided congestive heart failure

Left-sided congestive heart failure might be more common, but it’s important for you to know about right-sided heart failure as well. The human heart is divided into four chambers — two on the right side and two on the left.

The right ventricles of people who experience right-sided congestive heart failure are unable to pump blood to the lungs. When this occurs, the blood backs up in the veins, which eventually leads to swelling of the legs, ascites (free fluid in the abdominal cavity), and an accumulation of fluid in other organs.

Treating right-sided congestive heart failure

The treatment path for right-sided congestive heart failure requires discovering the underlying conditions that have led to this health issue and treating those. These underlying diseases are the same as for the left-sided heart failure, but the most common direct cause of right-sided congestive heart failure is untreated left-sided heart failure.

Doctors will typically prescribe a combination of drugs together with lifestyle changes, which include following a healthier diet and engaging in carefully-planned physical activity. Since high cholesterol levels, high blood pressure, and diabetes are the three major risk factors for heart disease, you will most likely receive treatment for them in case you have also been diagnosed with congestive heart failure.

Conclusion

Generally speaking, there are two types of congestive heart failure: left-sided and right-sided. However, left-sided heart failure has two more subcategories which are important to define because their pathophysiology is different.

The prognosis and outcome of any type of congestive heart failure depends primarily on the stage in which the diagnosis has been made, and on sticking to the appropriate treatment plan. Losing excess weight in obese patients and changing lifestyle habits in consultation with cardiologists, nutritionists, and physical medicine specialists can significantly contribute to an improved quality of life and decreased progress of congestive heart failure.