Understanding Congestive Heart Failure

Diane's family - Dad had congestive heart failure

Source: Diane Atwood

For many summers, my parents would rent a camp for a week and host a family reunion. The older they got, the more they looked forward to connecting with their eight kids and multitude of grandchildren. When our week began, one of the first things on the agenda was to decide which night we’d have a lobster feed. Dad loved his lobsters and would do everything in his power not to let anything get in the way of lobster night. Not even symptoms of congestive heart failure. Symptoms he knew well, because he had been through it before and was supposed to monitor himself every day.

What is congestive heart failure?

Congestive heart failure is a chronic, progressive condition that happens when the heart can’t pump enough blood to the rest of the body. The human body is mostly water, so when the heart pumps blood, it also pumps water. When it can’t pump properly, the body fills with water and accumulates in the ankles, feet, legs and abdomen.

Heart failure can develop when the heart is damaged or weakened because of other health problems. Like many elderly people, my dad had several health issues.

Health issues that can lead to congestive heart failure

  • Coronary artery disease
  • Previous heart attack
  • High blood pressure
  • Faulty heart valves
  • Damage to the heart muscle
  • Inflammation of the heart muscle
  • Congenital heart defects
  • Abnormal heart rhythms
  • Chronic diseases such as diabetes, severe anemia, thyroid disease, emphysema, lupus, and excess iron in the blood (hemochromatosis)

Statistics from the Framingham Heart Study show that congestive heart failure is twice as common in people with high blood pressure and five times greater in people who’ve had a heart attack. We’re seeing an increase in new cases partly because more people with heart disease are surviving and living longer, which increases their odds of developing congestive heart failure.

When the heart can’t pump normally, it will usually try valiantly to compensate.

  • It gets bigger.
  • It becomes more muscular.
  • It pumps faster.

The rest of body joins in the struggle.

  • Blood vessels narrow to keep blood pressure up.
  • Blood is diverted away from less important organs and tissues to make sure enough gets to vital organs — the brain and heart.

The body can compensate for years but eventually, it wears out and symptoms develop.

Symptoms of congestive heart failure

  • Shortness of breath
  • Persistent coughing or wheezing
  • Excess fluid in the feet, ankles, legs, or abdomen
  • Frequent fatigue
  • Lack of appetite
  • Confusion
  • Increased heart rate

Platter of lobsters

That summer, now several years past, my dad was experiencing most of those symptoms, except perhaps lack of appetite. He never said a word and we didn’t notice anything wrong until after he had devoured his lobsters. At that point, he ran out of steam and was clearly having difficulty breathing. He kept insisting that nothing was wrong and weren’t those lobsters delicious — all the way to the emergency room.

Generally, congestive heart failure can be treated with medications, such as a diuretic to get rid of extra fluid, and lifestyle changes, but in some people, the heart can become so damaged over time that a heart transplant is necessary.

Lifestyle changes for congestive heart failure

  • Quit smoking
  • Lose or maintain weight
  • Track daily fluid intake
  • Avoid alcohol
  • Avoid or limit caffeine
  • Eat a heart healthy diet
  • Avoid extra sodium
  • Do some kind of physical activity
  • Try to manage stress
  • Monitor blood pressure
  • Get adequate rest


Although that one summer his love of lobsters got the best of him, my dad, who passed away of lung cancer in 2009, tried to be careful and regularly monitored his symptoms. With age, he needed help with things like checking his weight every day, monitoring his blood pressure and getting a little exercise.

If you need help keeping congestive heart failure under control, Advantage Home Care provides patient education materials to its clients. Caregivers can also assist with medication reminders, weight monitoring, exercise programs, meal planning and preparation, as well as monitoring diet and eating habits. Check out the website for a complete list of services.

Our Aging in Place blog is written by Diane Atwood, who also writes the blog Catching Health with Diane Atwood.

Categories: Blog and Dealing with Chronic Illness.


  1. […] Congestive heart or respiratory failure […]

  2. […] in the hospital for about a week when she had the stroke. I didn’t know it at the time, but congestive heart failure is a risk factor for […]

Leave a Reply

Your email address will not be published. Required fields are marked *