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Congestive heart failure is a progressive failure of the heart to pump that may occur so gradually that patients overlook the early symptoms. New medications, surgical advances and innovative devices that assist a failing heart can slow the disease's progression and, in some cases, correct or cure the condition. The earlier the diagnosis, the sooner treatment can improve your health and prolong your life.

When the heart cannot pump blood around the body as normal, congestive heart failure can occur. Heart pump function involves two phases: systole and diastole. During systole, the heart muscle contracts, causing the left ventricle to push oxygenated blood out to the body and the right ventricle to push unoxygenated blood into the lungs to receive oxygen. After the contraction, the ventricles relax and allow the heart muscle to prepare for the next systole. This relaxation phase/refilling phase of the cardiac cycle is called diastole.

Heart pump function can be abnormal because of weakened ventricle muscles that reduce the blood volume pumped out during systole. COVID, other viruses, irregular heart rhythm, coronary artery disease, high blood pressure, injuries such as heart attack and several other cardiovascular conditions can cause the weakness.

A stiffening of the ventricle muscles can decrease effective heart pumping. 

In this situation, it can require more time for the ventricle to refill with blood or fill incompletely during the diastole phase between heartbeats.

The condition can lead to fluid buildup in the lungs and/or abdomen and legs. Several health issues can cause ventricle muscles to stiffen, including COVID, radiation, abnormal valve function, high salt diets, uncontrolled hypertension, diabetes, heart valve abnormalities, rhythm disturbances such as atrial fibrillation and some inherited disorders can also cause this condition.

Who is most at risk for congestive heart failure?

Heart failure is most common in people over 65. Aging can stiffen the heart muscle, and older people often have chronic health conditions that contribute to heart failure. Chief causes include high blood pressure, diabetes, coronary artery disease and kidney disease.

Other high-risk groups for heart failure:

  • African Americans are more likely to have heart failure and to develop symptoms at a younger age than other races. They have more hospital visits because of the condition and are more likely to die from heart failure.
  • Women are more prone to diastolic heart failure than men.
  • People who are overweight have higher rates of heart failure because excess weight makes the heart work harder.
  • People who have had a heart attack, which damages and weakens the heart muscle.
  • A family history of heart failure.

What are the symptoms of heart failure?

The earliest symptoms of heart failure are often very subtle, but dangerous to ignore. Some warning signs include fatigue, shortness of breath with activity or when lying down, swelling in the legs, rapid or irregular heartbeat, reduced ability to exercise, persistent cough or wheezing with white or pink blood-tinged mucus. These symptoms are also seen in other medical conditions.

How to avoid heart failure?

See your physician regularly to help identify and correct health issues that could lead to congestive heart failure in the future. The best way to avoid heart failure is carefully managing those conditions if they develop, including:

  • Stop smoking. Better yet, don't start. Smoking damages arteries and can cause heart failure.
  • Choose a heart-healthy diet. Avoid or restrict saturated fat, trans fat, sugar or sodium. Eat fruits and vegetables, low-fat dairy, lean protein such as chicken without the skin, and "good" fats such as those found in olive oil, fish and avocadoes.
  • Lose pounds if you're overweight. Along with diet, regular exercise helps achieve this goal and is also great for your heart.
  • Abstain from alcoholic beverages or drink only in moderation. A maximum of 2 drinks a day for men and 1 drink in a day for women.

If you have another type of heart disease or related condition, follow your treatment program. There are treatments for congestive heart failure that can normalize heart function or reduce the symptoms. Ongoing care and adherence to prescribed medications can make a big difference.

Lynn Swisher, MD, joined Ithaca Cardiology Associates in 1998, adding specialized skills in pacemaker implantation to the cardiology team. She has board certification in echocardiography and under her direction, the Cayuga Medical Center Echocardiography Laboratory became accredited. She can be reached at the Cayuga Heart Institute of CMA (607) 882-9068.

Members of the editorial and news staff of USA TODAY Network were not involved in the creation of this content.

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