What is congestive heart failure?

Heart failure, sometimes referred to as congestive heart failure or CHF, affects over 6 million adults in the United States. Heart failure is a type of heart disease in which your heart can’t pump enough oxygenated blood to meet the needs of your body’s other organs. With this condition, the heart isn’t keeping up with the demands of the body either at rest or during exercise.

In addition to affecting how well your heart pumps blood, heart failure interferes with normal kidney function. When the kidneys cannot properly eliminate sodium and waste from the body, the body retains excess fluid.

The specially trained advanced heart failure cardiologists at The Ohio State University Wexner Medical Center in Columbus, Ohio, are experts in delivering excellent congestive heart failure care, close to home. Our physician team is specially trained in advanced heart failure and heart transplantation to give those we treat access to highly specialized care.

Heart failure causes

Heart failure or congestive heart failure can lead to irreversible damage. In some cases, you may even need to undergo a heart transplant or mechanical cardiac support, such as a ventricular assist device. The condition often runs in families, so it’s important to know your family history and if you have any risk factors. Heart failure is usually a sign of an underlying heart problem, such as:

• Anemia (low iron levels)
• Cardiac arrhythmias
• Cardiomyopathy
• Chronic lung disease
• Congenital heart defects
• Coronary artery disease
• Diabetes
• Drug-induced heart failure
• Excessive sodium (salt) intake
• Heart valve disease
• Hemorrhage (bleeding)
• High blood pressure
• Infections of the heart valves or heart muscle
• Previous heart attacks 
• Pulmonary embolism

What are the symptoms of heart failure?

The signs and symptoms of congestive heart failure can vary from person to person. Symptoms may be mild or severe, occur constantly or come and go. It’s also possible for someone to not show any symptoms of heart failure. If you have any of the below symptoms or develop new symptoms, you should talk with your doctor:

• Cough or wheezing – dry, hacking and persistent
• Feeling tired (fatigue)
• Inability to physically handle exercise
• Loss of appetite or upset stomach
• Rapid or irregular heartbeat (palpitations)
• Shortness of breath when active or at rest
• Swelling of the legs and feet
• Weight gain – especially in a short amount of time

What are the types of heart failure?

The type of heart failure you have is determined by where – either the right side or left side – the failure occurs on your heart. It’s also possible for both sides of your heart to fail at the same time.

Left-sided heart failure

The left side of your heart pumps oxygen-rich blood to the rest of your body. Left-sided heart failure occurs when this area no longer functions properly. There are two types of left-sided heart failure. This condition can lead to right-sided heart failure.

• Systolic heart failure (heart failure with reduced ejection fraction) – The left ventricle is too weak to pump blood out to the rest of your body.
• Diastolic heart failure (heart failure with preserved ejection fraction) – The muscle becomes stiffer than normal, preventing your heart from filling with blood easily.

Right-sided heart failure

Right-sided heart failure occurs when the right side of your heart can’t pump enough blood to your lungs. This causes blood to build up in your veins, increasing pressure, as well as results in the swelling of lower extremities. Right-sided heart failure can be caused by left-sided heart failure.

Heart failure treatment options

Ohio State's Heart and Vascular Center treats thousands of heart failure patients every year. Our approach to treatment is to start with the simplest, least invasive steps, such as medication, lifestyle changes and sleep apnea evaluation.

If symptoms persist, we move up to more invasive procedures only as needed. For those requiring advanced treatment, Ohio State is the only program in the region able to offer all of these procedures:

• Artificial heart pumps
• Ventricular assist devices (VADs)
• Heart transplant

Here, your care is managed by a multidisciplinary team of heart specialists and nurse practitioners who work in collaboration with nurses, pharmacists, social workers, dietitians, heart surgeons and cardiac rehabilitation specialists to provide both routine care and advanced treatment options not found elsewhere in central Ohio.

Treatment for congestive heart failure depends on the cause of the disease, and your team of specialists will decide which combination of treatments is right for your unique situation.

Treatment with medications

Treating heart failure with medication may help improve the health of your heart and reduce the effect of symptoms on your life. Depending on your symptoms, your heart doctor may recommend one or more of the following medications:

• Aldosterone blockers
• Angiotensin converting enzyme (ACE) inhibitors
• Antiarrhythmic medications
• Beta-blockers
• Digoxin
• Diuretics
• Nitrates
• Vasodilators

Additionally, your cardiologist may prescribe other medications to increase heart strength, control rhythm problems and increase pumping action.

Surgery to treat heart failure

While we consider less-invasive solutions first, there are some surgical procedures our doctors may recommend, including:

• Biventricular pacemaker/cardiac resynchronization therapy
• Coronary artery bypass graft (CABG)
• Heart transplant
• Implantable cardioverter defibrillator
• Mitral valve repair
• Mitral valve replacement
• Ventricular assist devices (mechanical circulatory support devices, artificial heart pumps)
• Ventricular restoration surgery (surgical ventricular restoration)

Why choose Ohio State for heart failure care?

If you have any type of heart failure, you need an experienced team on your side that can get the condition under control and provide you relief from your symptoms.

• Heart and vascular experts at Ohio State are highly experienced, seeing a large number of patients each year.
• Our subspecialty-trained team offers the latest in diagnostic and treatment options for congestive heart failure.
• For central Ohioans, Ohio State allows you to keep your care local to Columbus throughout the entire spectrum of treating your condition. You don't have to travel outside of Columbus for your regular appointments, advanced procedures or follow-up care. For those who live outside Columbus, care can be coordinated between specialists at Ohio State and your local care providers.
• Ohio State patients also have the opportunity to stay with one care team from diagnosis to transplant care and even follow-up care well beyond transplant surgery.
• Plus, Ohio State is home to the Frick Center for Heart Failure and Arrhythmia, the first center of its kind in the nation treating patients who suffer from the complexities of both heart failure and heart arrhythmia.
• We completed our first heart transplant in 1986. Hundreds of heart transplants later, our program remains central Ohio’s only adult heart transplant program.
• Ohio State is certified to implant the temporary CardioWest™ Total Artificial Heart, which serves as a bridge to transplant for the most critically ill people.
• Ohio State is home to a team of subspecialist cardiologists who are specifically trained in advanced management of heart failure and heart transplant, dedicating their time to perfecting treatment for those individuals.
• Patients at Ohio State are often the first to benefit from heart and vascular research done right here at The Ohio State University. If you’ve already been diagnosed with congestive heart failure and are looking for a second opinion, our heart experts may be able to help. Ohio State is home to a team leading research and clinical trials to improve treatment of heart failure that may not be available elsewhere.