What Is Congestive Heart Failure?

Congestive heart failure (CHF) is a complex and chronic condition that affects millions of people worldwide, challenging both patients and healthcare providers. Often misunderstood as the heart "stopping," CHF occurs when the heart's ability to pump blood effectively is compromised, leading to a cascade of symptoms that can significantly impact quality of life.

Here, Dr. Gregory Macaluso, Heart Failure and Transplant Cardiologist and Director of the Heart Failure Clinic at Silver Cross Hospital, shares important information about the causes, symptoms, and innovative approaches to managing CHF—empowering patients and caregivers with the knowledge needed to navigate this journey with confidence.

What Causes Congestive Heart Failure?

Per Dr. Macaluso, congestive heart failure is the number-one diagnosis admitted to the hospital next to the newborn baby. The condition can have various causes, with high blood pressure and coronary artery disease being the most common in the United States. Contributing to that is a poor diet, sedentary lifestyle, and generally being overweight. Less frequent causes include genetic conditions, viral infections—even the common cold—and, in some cases, the cause remains unknown.

“We now have the ability to identify certain genes through genetic testing, and we can actually determine if those genes have been passed on to your children before they have symptoms. I think you should see a heart failure specialist to help determine that,” encourages Dr. Macaluso.

The age CHF tends to develop is in a person’s sixties. However, younger people can also have the disease. “Younger patients may experience it from a virus that's affected the heart. So, they contract one of the common viruses, like a cold virus, that can attack the heart. Other reasons may be that they were born with what's called a congenital abnormality, or an abnormality of the heart muscle and tissues, that was unrecognized until later down the road,” explains Dr. Macaluso.

Symptoms, Treatment Options, and Expected Outcomes

Symptoms of congestive heart failure often include shortness of breath (dyspnea), particularly during activities like climbing stairs or walking. Some patients may also experience shortness of breath while lying flat, which improves when sitting upright. Swelling in the lower extremities or even total body swelling can also occur. These symptoms may indicate heart failure from various causes and should prompt a visit to a physician for further evaluation.

When diagnosed with congestive heart failure, treatment focuses on identifying and addressing the underlying cause. If blocked arteries are responsible, interventions like bypass surgery, stents, or balloons may be necessary alongside guideline-directed medical therapy. This therapy involves a combination of four different classes of medications aimed at improving heart muscle function. A cardiologist like Dr. Macaluso, especially a heart failure specialist, can guide patients through these treatment options.

With treatment, individuals can go on to live normal, healthy lives. “Having heart failure is as bad as being diagnosed with many of the common cancers. It is a deadly diagnosis. If we can put people into remission or improve them, that is really our goal. By and large, we see many more people we can improve with proper treatment than those who go down the road of ongoing failure and need interventions like end-stage therapies,” assures Dr. Macaluso.

In order for treatment to truly succeed, though, Dr. Macaluso reinforces it requires a multidisciplinary approach. “We really work hand in hand with different subspecialties of cardiology, general cardiologists, interventional cardiologists, and electrophysiologists to figure out the right medical and device therapy that can help you live longer, better lives,” he adds.