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Congestive Heart Failure: Stages And Types
Systolic congestive heart failure is a serious condition that occurs when the heart does not pump blood effectively. There are 4 stages of congestive heart failure.
Congestive heart failure may happen when the heart muscle is too weak or when another health problem prevents it from circulating blood efficiently. Over time, systolic congestive heart failure, or heart failure (HF), can lead to dysfunction of other organs due to inefficient pumping.
This article discusses how HF progresses over time and explains the outlook for people with this condition. It also examine the causes, symptoms, treatment options, and stages.
There are four different stages of systolic heart failure: A, B, C, and D.
When the condition progresses to the next stage, a person's chance of surviving decreases.
People with stage A HF do not yet have dysfunction of the pumping activity of the heart but have a high risk of developing HF due to related conditions, such as chronic high blood pressure, diabetes, and coronary artery disease.
SymptomsA person usually has no symptoms of HF at this stage but may experience symptoms of their chronic conditions, including:
People with this stage HF have no problems with the structure of the heart or how their heart works. Treatment should focus on managing risk factors.
Structural heart disease develops at this stage, such as reduced pumping function of the heart, which can lead to an enlarged left ventricle. It can also result from a previous heart attack.
SymptomsMost people at stage B still do not show symptoms of HF.
OutlookA doctor may prescribe medication at this stage for the management and prevention of future problems. It is common for a doctor to prescribe ACE inhibitors/ARB or ARNI and beta blockers at this stage.
People at this stage will show symptoms of HF linked to underlying structural heart disease, including fatigue or breathlessness. These symptoms usually occur due to problems with the squeezing function of the left ventricle, or the pumping chamber of the heart.
Stage C HF also includes people who no longer show symptoms but are currently undergoing treatment for previous symptoms, such as those who spent time in the hospital with heart failure exacerbation.
SymptomsCommon symptoms include:
A doctor will definitely prescribe medication at this stage for the management and prevention of future problems. It is common for a doctor to prescribe diuretics, ACE inhibitors/ARB/ARNI and beta blockers, mineralocorticoid receptor blockers, or SGLT2 inhibitors at this stage.
A doctor also may consider implantable cardioverter-defibrillators and cardiac resynchronization therapy at this stage.
At stage D, people will have advanced structural heart disease and display significant symptoms, even when they are at rest.
SymptomsSymptoms may include:
This stage is severe and may require advanced specialized treatment. Such as mechanical circulatory support, continuous inotropic infusion to make the heart squeeze harder, cardiac transplant, or hospice care.
The most common type of HF is left-sided HF. The left side of the heart must work harder to move the same volume of blood around the body. This may cause a fluid buildup in the lungs and make breathing difficult as it progresses.
These fluids give congestive heart failure its name.
There are two kinds of left-sided HF.
With systolic heart failure, the left ventricle cannot contract normally, limiting the heart's pumping ability. The stages of HF only refer to systolic heart failure and not the other types.
With diastolic heart failure, the muscle in the left ventricle stiffens. If the muscle cannot relax, the pressure in the ventricle increases, causing symptoms.
Right-sided HF is less common. It occurs when the right ventricle cannot pump blood to the lungs. This can lead to blood backing up in the blood vessels, which may cause fluid retention in the lower legs and arms, abdomen, and other organs.
A person can have left-sided and right-sided HF at the same time. However, HF usually begins on the left side and can affect the right side if a person does not receive effective treatment.
Symptoms of HF range from mild to severe but may get worse over time if not managed medically.
Lifestyle strategies can reduce the risk of developing HF and can also slow its progress.
To prevent or slow the progression of HF, people should take the following steps:
People who already have HF should take the following steps to prevent further progression:
Without treatment, HF can be fatal. Even with adequate treatment, HF may get worse over time, triggering dysfunction of other organs throughout the body.
HF is more likely to occur in people with other conditions or lifestyle factors that weaken the heart.
Risk factors for HF include:
A doctor or cardiologist will perform a physical exam. This involves listening to the heart, checking for fluid retention, and looking at the veins in the neck to see if there is extra fluid present in the heart. They may order other diagnostic tests, including:
Different medications can help symptoms of and prognosis in HF. These include:
People with advanced HF might need more intensive treatment. Medical procedures that may help include:
Implantable devicesA surgeon might implant a medical device, such as:
A doctor may recommend other procedures for treating HF, including:
Not everyone with HF is an appropriate candidate for a transplant, and people often have to wait a long time before having one.
Heart surgery can be dangerous and invasive but is sometimes necessary, in combination with medications, to help treat HF in the best possible way.
Systolic congestive heart failure occurs when the heart does not pump blood effectively. It may happen for a variety of reasons such as a weak heart muscle or underlining health problems.
There are several stages of systolic congestive heart failure and each stage requires a different treatment. Lifestyle changes, medication, and surgery are typical methods of treatment.
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What Is Heart Failure?
Heart failure occurs when your heart is unable to pump an adequate supply of blood to the body. It may require ongoing treatment to keep your body's major functions working properly.
Approximately 6.2 million people have heart failure in the United States, according to the Centers for Disease Control and Prevention (CDC).
Heart failure happens in the ventricles, which are two chambers located in the lower part of your heart. They're responsible for pumping blood out of your heart.
Heart failure can be classified by the side of the heart that's affected (left or right). Both sides are often affected.
Congestive heart failure (CHF) is sometimes used synonymously with heart failure since the symptoms of both right and left sided heart failure include congestion.
In right sided heart failure, there is congestion with fluid buildup in the abdomen and lower extremities. In left sided heart failure, fluid builds up in the lungs.
Heart failure is a serious health condition that requires immediate medical treatment. Early treatment decreases your risk of complications over time.
The most common symptoms of heart failure include:
Other symptoms of heart failure may include:
Heart failure is a chronic condition. This type of condition requires ongoing, lifelong management.
However, you may experience acute heart failure, which is when symptoms come on suddenly. This is sometimes referred to as heart failure exacerbation or flares.
It may happen as an initial symptom when heart failure is diagnosed for the first time. Or, it may happen on top of chronic heart failure when your symptoms worsen.
Heart failure may affect the left or right side of your heart.
Left sided heart failureLeft sided heart failure occurs when the left ventricle in the bottom left of your heart doesn't pump blood out efficiently. Heart failure in this ventricle prevents your body from getting enough oxygen-rich blood.
There are two types of left sided heart failure:
Systolic heart failure is more common in males. Diastolic heart failure is more common in females.
Right sided heart failureThe right ventricle is located in the bottom right side of your heart. It's responsible for pumping blood to your lungs to collect oxygen.
Left sided heart failure usually triggers right sided heart failure. The accumulation of blood in the lungs makes the right ventricle work harder. This can stress the right side of the heart and cause it to fail.
Heart failure happens when your heart muscle gets weak or stiff. This may then block or reduce blood flow to the heart.
The most common cause of heart failure is coronary artery disease (CAD). It happens when fatty deposits build up in your arteries, reducing the supply of blood and oxygen to the heart.
Other conditions that may increase your risk of developing heart failure include:
Certain behaviors may also increase your risk of developing heart failure, including:
A will doctor start by performing a physical exam and assessing your medical history to check for signs of heart failure.
They may also use an echocardiogram. This test is the most effective way to diagnose heart failure. It uses sound waves to create detailed pictures of your heart. An echocardiogram can help a doctor evaluate the damage to your heart and how it's functioning.
Other tests to help diagnose heart failure or its underlying causes include:
Treating heart failure depends on the severity of your condition and the type of heart failure you have.
Early treatment can improve symptoms fairly quickly. However, you should still get regular testing and follow up with a healthcare professional at least every 6 months.
The main goal of treatment is to increase your life span, prevent complications, and improve your quality of life.
MedicationMedications may treat early stages of heart failure. They can help relieve your symptoms and prevent your condition from worsening.
Certain medications are prescribed to:
These medications can include:
Speak with a doctor before taking new medications. People with heart failure should avoid some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin). These can worsen fluid retention in heart failure.
SurgeryYou may require surgery if you have heart failure. Options include:
You may require surgery to implant a device to help monitor your heart rhythm.
PacemakersThese small devices are placed into the chest to help control heart rhythms. They may slow your heart rate when the heart is beating too quickly, or increase your heart rate if it's beating too slowly.
Biventricular pacemakers are sometimes used for cardiac resynchronization therapy. These may help your heart chambers pump in sync.
Left ventricular assist device (LVAD)An LVAD helps your left ventricle pump blood out to the rest of your body.
Implantable cardioverter defibrillator (ICD)This battery-powered device keeps track of your heart rate. It shocks your heart if it detects an abnormal heart rhythm. This restores the heart rate to a normal rhythm.
Doctors suggest an ICD for people with an ejection fraction of less than 30–35%. An ejection fraction refers to how much blood your heart pumps out of the left ventricle with each contraction. A normal range is 55–70%.
Some lifestyle measures can help treat heart failure and prevent the condition from developing.
These may include:
Untreated heart failure can eventually lead to CHF, which could be life threatening. This is when blood builds up in other areas of your body. You may experience fluid retention in your limbs and organs, such as the liver and lungs.
Additional complications of heart failure include:
The four stages of heart failure are A, B, C, and D. These indicate the severity of your symptoms and the function of your heart as your condition progresses:
The authors of a 2019 review of studies found that approximately 60% of people were alive 5 years after their chronic heart failure diagnosis. After 10 years, approximately 1 in 3 people were still alive.
Survival rates are just estimates. Your outlook depends on several factors, such as age, lifestyle habits, other medical conditions, and stage at diagnosis.
What are the serious signs of heart failure?The most common signs of heart failure include:
Congestive heart failure (CHF) is another term used for heart failure. It emphasizes the congestion that occurs due to a backup of blood flow, which causes fluid retention, swelling, and pulmonary edema (fluid in the lungs).
Heart failure happens when your heart is unable to pump enough blood throughout your body.
It's typically a chronic condition that requires ongoing treatment to prevent complications and increase your quality of life.
Your outlook and treatment of heart failure varies depending on the type of heart failure you have. Early treatment is key in preventing the most serious cases of heart failure.
Meal Plans For Heart Failure: What To Try And What To Avoid
Changing your diet can help reduce symptoms and exacerbations of heart failure. This may include increasing plant-based foods and lean meats while decreasing salt, as well as alcohol and other fluids.
If you've received a diagnosis of heart failure, your doctor will prescribe medications to help treat it. In some cases, they might recommend surgery or medical devices to help your heart beat properly.
Your doctor might also encourage you to make changes to your lifestyle, including your diet. A nutrient-rich diet can promote good overall health, no matter which type of heart failure — systolic or diastolic — you have.
Read on to learn about meal plan options and dietary changes that might help you manage heart failure.
The DASH diet is an eating plan designed to lower blood pressure. It's rich in plant-based foods and heart-healthy fats. So is the Mediterranean diet, an eating pattern that's common in many Mediterranean countries.
Following the DASH diet or the Mediterranean diet might help you meet your nutritious eating goals. It's possible to choose low sodium foods while following these diets, especially if you limit how many processed and prepackaged products you eat.
To learn more about these diets, talk with a doctor or dietitian, if you have access to one. They can help you learn about the potential upsides and downsides of different eating patterns.
To meet your body's nutritional needs, it's important to eat a wide variety of foods that are rich in vitamins, minerals, fiber, and other essential nutrients. At the same time, it's best to limit your consumption of foods that contain a lot of calories but few nutrients.
The American Heart Association (AHA) recommends eating a diet rich in plant-based foods, such as:
You can also get many essential nutrients from lean animal products, such as:
When you eat a lot of salt or sodium, it causes your body to retain fluids. When fluids build up in your body, it increases your blood pressure and puts more strain on your heart.
In heart failure, this is particularly important because sodium can make heart failure symptoms worse. It can also have long-term effects on your kidneys and heart.
The AHA generally recommends limiting your sodium intake to 1,500–2,300 milligrams (mg) daily.
That said, it's important to note that the evidence for restricting sodium even further in cases of heart disease is actually inconclusive. One 2023 study has even found that it had the potential to increase the risk of death in people with heart failure.
Your doctor will need to determine how much sodium you should consume based on your specific condition and type of heart failure — systolic or diastolic.
Sodium is naturally found in many foods, including seafood, poultry, red meat, dairy products, and plant products. But the biggest source of sodium is salt, which is added to many homemade dishes and most processed foods.
To help reduce the amount of sodium in your diet:
To help you learn how to cut back on sodium and make other changes to your diet, your doctor might refer you to a dietitian.
If you have heart failure, depending on your specific symptoms, your doctor may encourage you to track and limit the amount of fluids that you drink each day at a rate of 30 milliliters per kilogram of body weight (1/2 ounce per pound).
You need to consume enough fluids to stay hydrated. However, drinking too much fluids may raise your blood pressure and strain your heart if you have heart failure.
Ask your doctor how many cups of fluids you should drink each day. In some cases, they might prescribe diuretics, commonly known as water pills, to help your body get rid of excess fluids.
To help protect your heart and blood vessels, your doctor might encourage you to limit your consumption of alcohol, if you drink.
The British Heart Foundation says that people with a heart condition can still drink in moderation, but some heart conditions may require you to eliminate alcohol entirely.
Drinking too much alcohol can raise your risk of heart attack, stroke, and other health concerns. Note that the Dietary Guidelines for Americans for 2020–2025 say that moderate alcohol intake equals 2 drinks or fewer daily for males and 1 drink or fewer daily for females.
If you drink, ask your doctor whether it's safe for you to drink moderate amounts of alcohol.
In some cases, losing weight can be beneficial because it can help reduce the stress on your heart.
That said, most people need to eat fewer calories to lose weight, and it's important not to restrict your nutrition too severely either.
Ask your doctor whether it's a good idea for you to restrict your calorie intake to lose weight and, if so, how many calories you should reduce from your daily intake. If you need help cutting calories while making sure you're still getting all the needed nutrients, your doctor may refer you to a dietitian.
Your dietitian can help you learn how to make nutrient-rich food choices while trimming calories. They can also help you learn how to choose lower calorie foods that leave you feeling full and satisfied.
What should I not eat or drink with heart failure?The AHA recommends limiting your consumption of red meat, sweets, and other foods that are high in saturated fat, trans fat, cholesterol, sodium, or refined sugar.
What is a cardiac diet menu plan?You can consult with a dietitian if you feel like a defined meal plan will work better for you. They can help you develop a daily or weekly menu containing meals that include all the necessary nutrients.
However, you also don't necessarily need to follow a specific diet or prescribed meal plan to eat in a way that supports your heart health. You can simply add healthy foods into your daily routine and make heart-smart choices at every meal.
What is a healthy breakfast for heart failure patients?Oatmeal is a heart-healthy choice for breakfast, and you can add variety with spices, fruit, or nuts. Here are four heart-healthy breakfasts that take 20 minutes or fewer to make, including oatmeal.
What is the best meat for heart failure?The best meat to eat with heart failure includes poultry, fish, and lean cuts of red meat like pork or beef.
Eating a nutrient-rich diet is important for supporting your physical and mental health. If you have heart failure, your doctor may also encourage you to limit your consumption of salt, alcohol, and other fluids. To help make changes to your diet, they may refer you to a dietitian.
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