Capital Cardiology Associates

What is Heart Failure?

If you experience shortness of breath or fatigue, it’s time to see your doctor

More than 200,000 US cases of heart failure are diagnosed per year, typically affecting patients between the ages of 41-60, and those above 60 years old. Most of these people are men. However, women are more likely to die from heart failure when the condition goes untreated. The term “heart failure” makes it sound like the heart is no longer working at all and there’s nothing that can be done. Actually, heart failure is a term used to describe a heart that cannot keep up with its workload.

Heart failure is a serious medical condition, and usually there’s no cure. It is usually managed with medications and healthy lifestyle changes. Early detection and treatment allow many people with heart failure lead a full, enjoyable life.

“One question I get from patients is, ‘Is heart failure the same as congestive heart failure?’ Yes, it is,” shared Dr. Robert Benton, board-certified cardiologist with Capital Cardiology Associates. Dr. Benton’s specialties include Clinical Cardiology and Echocardiography. During a recent episode of HeartTalk presented by Capital Cardiology Associates, Dr. Benton explained congestive heart failure.

Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. “When we use the word, ‘congestive,’ think of water in your chest, preventing you from breathing,” began Dr. Benton. “Congestive heart failure is really a term that describes not being able to provide enough cardiac output of blood for the needs of the body and/or a type of heart failure where the heart squeezes well, but its very stiff and your heart runs at a high failing pressure. Think of your heart as a water pump, the energy needed to go into it is less if you can run that pump at a low pressure as oppose to a high pressure. As we get older, the pressure in your heart goes up because the heart muscle gets stiff.”

Model of a normal heart beating

Different Types of Congestive Heart Failure

There are three types of congestive heart failure. Left-side ventricle is the most common, as the left side of your heart muscle pumps blood to the rest of your body. Dr. Benton described how your heart is like a pump and what happens when your heart fails to pump blood properly. “With each heartbeat, usually you squeeze out between 55 to 75 percent of the amount of blood in the left ventricle, the most important chamber, that’s the red blood. When you have congestive heart failure with depressed heart muscle function, that might be as low as 10%. Imagine that your heart is like a big, globy bag just squeezing a little bit and there’s not enough blood coming out of that heart to supply you with the needs of your body.” The two types of congestive heart failure on the left-side are: systolic heart failure and diastolic failure. In systolic, the left ventricle fails to contract normally.

In diastolic failure, patients experience the opposite problem: the heart doesn’t relax between beats. “The heart functions well, in fact, it might squeeze out more blood than needed per heartbeat, not 65% but 85%,” stated Dr. Benton. “This is usually a disease of aging. Imagine your muscle in your heart is like a chamber. The blood is in the middle, the heart muscle is around the outside. The muscle becomes thicker and stiffer as you get older. It squeezes okay but it doesn’t relax okay. If the heart, when it fills, does not relax well, the filling pressure in the heart goes up, and that goes into the lungs. You can actually have a heart that squeezes well, but the chamber is small because the walls are so thick and there is not much space left in the middle. What you are left with is not enough blood for the rest of your body.”

Right-sided CHF occurs when the right ventricle has difficulty pumping blood to your lungs. “We might see that your abdomen increases in girth because there is water collecting in your abdominal cavity, or water in your legs, that is called peripheral edema,” Benton reported.

Congestive Heart Failure Symptoms

The most common symptoms are shortness of breath or fatigue. “I see that in most of the patients that come to my office,” said Dr. Benton. “They will look at me and say, ‘I’m tired.’ And I’ll ask them, ‘are you just tired from life or just tired when you walk?'” Fatigue is the most common reason why a person goes to their doctor.

“When you come to a cardiologist and complain of fatigue or shortness of breath, you are going to get a full evaluation, a full markup,” declared Dr. Benton. “We want to get a complete picture of everything, not just your heartbeat. There are a myriad of things that can cause congestive heart failure: thyroid issues, lack of vitamins, blockages, poor lifestyle or diet. Getting your complete workup, that’s routine for us so that we can determine your heart health and other medical issues that effect your heart function.”


Your doctor has many different treatment options depending on your overall health and how far your condition has progressed. “Your situation could have to do more with being overweight or out of shape, it could be because of your coronary arteries — if there is a blockage it can cause a lack of blood flow, starving your heart from oxygen and that cause much bigger problems,” states Dr. Benton. “There are many things that can cause congestive heart failure with depressed muscle function like a heart attack that destroys heart muscle, drinking too much alcohol, viral infections, diabetes, hypertension, coronary disease — blockages in the arteries where the heart muscle becomes starved for blood and doesn’t function well. We can treat this with certain types of medicines like a water pill (diuretic); there are drugs (ACE inhibitors and beta-blockers) that help with blood flow or lower pressures in the heart, helping the heart muscle function more efficiently.”

There are also surgical options. A balloon angioplasty is a nonsurgical procedure where a balloon is inflated inside the narrowed aorta to expand the blood vessel. Your cardiologist may also suggest a coronary stent (a tube), which is placed in the coronary arteries that supply the heart, to keep the arteries open in the treatment of coronary heart disease.

Your doctor will also suggest lifestyle changes: a heart healthy diet, avoiding alcohol or quitting cigarette smoking, and getting at least 30 minutes of activity or exercise per day.

The primary goal is to improve your heart’s health. Heart failure leads to congestive heart failure which brings an increased danger of heart attack. Because heart failure is most often a chronic condition, your symptoms will likely get worse over time. The key is to identify and begin treatment early. “As a cardiologist, I think of the effects of congestive heart failure on the heart itself. Remember, the heart’s job is to supply blood to all of the organs in your body,” said Dr. Benton.

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.