Posted on: December 30, 2015 at 1:01 pm
Last updated: September 22, 2017 at 3:46 pm

At the fundamental level, the heart is a pump. Blood is pumped from the heart to the lungs to get oxygen, sent back to the heart, and then sent everywhere else in the body. Unfortunately, the heart is not invulnerable. It can be subject to numerous forms of distress that impede its ability to function properly and put someone’s life at risk.

“Heart attack,” “cardiac arrest,” and “heart failure” are terms that are sometimes used interchangeably, especially in television and movies. Medically, however, the three are very specific terms that refer to different conditions. And one of them, heart failure, is the leading cause of hospitalizations for people over the age of 65. Before heart failure can be properly explained, however, a bit of clarification is in order.

• A heart attack is when something is physically obstructing the blood flow to the heart. If the blockage is not removed quickly, portions of the heart will begin to die. This can be analogized as a “plumbing problem.” It is not always fatal, but can cause long-term damage if not resolved quickly.

• During cardiac arrest, an irregular heartbeat (arrhythmia)


• Lastly, congestive heart failure is when the heart is able to pump blood, but is doing so weakly. This can be compared to a “mechanical problem.” Despite the rather sudden-sounding name, this is actually a chronic condition.

What Happens During Congestive Heart Failure?

The heart has four chambers: the atria (the upper two chambers of the heart) and two ventricles in the lower half. The atria receive blood and the ventricles send it back out. In congestive heart failure (CHF), the ventricles are unable to pump a sufficient volume of blood. Congestive heart failure has two subtypes: left-sided and right-sided, depending on which of the ventricles is pumping improperly. The two can occur in tandem or on their own. Left-sided CHF is more common. In both forms of CHF, blood will build up in the blood vessels and result in fluid retention. The location this happens in depends on which ventricle is affected, as they send blood to different areas.

Symptoms of Congestive Heart Failure

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Many of the symptoms of congestive heart failure are the same across both types. Initial symptoms—mainly fatigue from reduced blood flow and fluid retention—causes an increased need to urinate (polyuria). that tends to happen especially at night. The retained fluid may also cause weight gain. Since the body’s need for oxygen and nutrients increases during physical activity, an inability to tolerate exercise or other forms of exertion can appear as well.

In left-sided CHF, the blood supply to the lungs is the most affected. Fluid will build up in the lungs over time (edema)

In right-sided CHF, the blood supply to the lower extremities is affected. The fluid retention results in swelling in the ankles, feet, and legs. The swelling will be most noticeable after a period of sitting. In right-sided CHF, pitting edema can develop. This is when pressing down on the skin in the swollen areas leaves a mark that stays visible for a few minutes before fading.


As heart failure progresses, a noticeably irregular heartbeat (palpitations) can be felt and a racing pulse can occur. At the most severe stages, patients can develop radiating chest pain, rapid breathing, blue-tinged skin from lack of oxygen, and fainting spells.

Causes of Congestive Heart Failure

CHF requires that something either damages or weakens the ventricles, so it can result from a few different cardiovascular conditions, among other factors.

Cardiomyopathy: This is a catch-all term for any damage to the heart that is not caused by blood flow or arterial problems. It is a progressive condition where the heart is abnormally enlarged, stiff, or thickened. This compromises the ability to pump blood and can lead to congestive heart failure. Cardiomyopathy can be caused by certain infections, alcoholism, or drug use.

Heart attack: As mentioned initially, a heart attack is when an obstruction causes part of the heart to begin to die. If not treated quickly enough, long-term damage—such as a weakened ventricle—can occur.


Valve conditions: The heart valves open and close to regulate the amount of blood that passes through the heart. Damage, disease, or genetic conditions can result in valves that do not function correctly. This can strain the ventricles and impair their pumping ability.

High blood pressure: Increased blood pressure, regardless of the cause, can result in thickening of parts of the heart muscle. This is specifically called left ventricular hypertrophy.

A diagnosis is made by a combination of blood tests, stress tests, chest x-rays, heart ultrasound, and angiograph.

This article was republished with permission from

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