Numerous cardiac conditions — like coronary artery disease, valvular dysfunctions, and cardiomyopathy — can weaken the heart to the point where it becomes unable to pump blood efficiently and you end up with congestive heart failure.
Congestive heart failure: Types
In left-sided congestive heart failure, by far the most common type of congestive heart failure, the left ventricle no longer pumps blood around the body efficiently. Left untreated, left-sided congestive heart failure can cause a fluid build-up in the lungs, which makes it difficult for people to breathe.
Left-side heart failure is divided into two categories:
- Systolic heart failure strikes when the left ventricle can’t contract strongly enough, so blood is pumped around the body with insufficient force.
- In diastolic heart failure, the muscle in the left ventricle is stiff and incapable of relaxing, which prevents normal blood build-up in the heart in between two heartbeats.
Congestive heart failure can occur in the right ventricle, too. In this scenario, the heart cannot pump blood into the lungs, causing it to back up in the venous system and leading to fluid retention in your abdomen and other organs (ascites).
It’s also common for congestive heart failure to start in the left ventricle and then advance to the right ventricle, as blood builds up in the lungs and block functional blood supply to the lungs. This, in turn, leads to pulmonary hypertension followed by right-sided heart failure.
Congestive heart failure: Stages
The progression of congestive heart failure can be defined in two different ways — in accordance with the The New York Heart Association’s classification, or the system of stages the American College of Cardiology and American Heart Association laid out.
Let’s take a look at the New York Heart Association’s classes:
- Class I is generally symptom-free; even when you engage in physical activities, you won’t feel any pain or discomfort.
- Class II is characterized by a few symptoms when exercising — shortness of breath, palpitations, and fatigue are all possible — but no symptoms when resting.
- Class III describes people who feel comfortable at rest, but who develop symptoms even at the slightest hint of physical activity — shortness of breath, fatigue, or heart palpitations.
- Class IV may have symptoms even at rest, or are unable to engage in physical activity without experiencing discomfort.
The staging system jointly laid out by the American College of Cardiology and American Heart Association (ACC/AHA) is defined by four stages:
- Stage A, which is is considered pre-heart failure. Patients will have a high risk of heart failure, but don’t yet have structural heart disease or symptoms of heart failure.
- Stage B patients have structural heart disease, but no symptoms of heart failure.
- Stage C features both structural heart disease and symptoms of heart failure.
- Stage D is persistent heart failure that needs to be managed with specialized interventions.
Congestive heart failure: Causes
A series of medical conditions can lead to congestive heart failure:
- High blood pressure.
- Valve problems. Your heart valves are responsible for regulating blood flow; they open and close to control blood flow in and out of the heart’s chambers. When the valves don’t function as they’re supposed to, your heart has to work faster and harder to pump blood.
- Coronary artery disease. High cholesterol levels, hypertension, obesity, and glucose intolerance (diabetes) are all risk factors for coronary artery disease, which can in turn lead to congestive heart failure.
Congestive heart failure: Prevention
When you are still in the first stages of congestive heart failure, you can do plenty of things to improve your health and quality of life. Since coronary artery disease often lies at the root of heart failure, the lifestyle changes required are similar to those recommended for people who have experienced a heart attack or are at risk of having one.
- Eating a healthy and balanced diet rich in whole grains, fruits, and vegetables becomes even more important when your heart health is at stake. Opt for lean cuts instead of fatty meats, avoid processed and fast foods, don’t consume too much sugar or salt, and eat foods rich in good cholesterol (like fish, olive oil, or walnuts).
- Exercise more often. This brings two benefits. It helps keep weight under control and contributes to better blood flow and a healthier heart. Even if you’re older or have medical conditions that won’t allow intense exercise, walking every day, biking, or mild aerobic sessions can improve your condition. You can start off slowly, and if your health allows it, gradually increase the intensity of your exercise.
- Avoid vices. Smoking, drinking alcohol, and recreational drug use can all contribute to heart disease. Smoking is strongly linked to artery and heart damage, alcohol can cause you to gain weight and contributes to sleep disruptions and high blood pressure, and recreational drugs (like cocaine or meth) cause the heart to beat out of tune.