What Is Congestive Heart Failure

Congestive heart failure is a scary diagnosis nobody wants to hear, but what is the condition, and how do you manage it?

Plenty of people are affected: Roughly 5.7 million Americans are living with congestive heart failure, with 670,000 new cases diagnosed each year, according to the American Heart Association (AHA).

But in reality, having heart failure doesn’t mean that your heart will never work properly again. Just like there’s more than one reason for heart failure, there are several medical treatments available to help you live well with the condition, according to the National Heart, Lung, and Blood Institute (NHLBI).

To better understand how to prevent and manage heart failure, it is important to learn what it is, its stages, symptoms, causes, treatments, and the measures you can take to help lower your risk of developing the condition.

What is Congestive Heart Failure?

Congestive heart failure occurs when your heart muscle is too stiff, weak, or damaged to pump enough blood to meet your body’s needs, according to the NHLBI.

The condition can manifest itself in one of two ways:

Acute heart failure comes on suddenly
Chronic heart failure develops over time

Both can lead to additional medical conditions, especially if left untreated. These include liver or kidney damage, irregular heartbeat, cardiac arrest, and heart valve disease.

What Are the 4 Stages of Congestive Heart Failure?

According to the National Center for Biotechnology Information, the four stages of congestive heart failure are:

Stage A: A high risk for developing heart failure is present, but there are no symptoms or structural damage to the heart.
Stage B: Structural damage to the heart is present with no symptoms.
Stage C: Both structural damage and symptoms are present.
Stage D: This is end-stage heart failure, which requires advanced treatment interventions such as a heart transplant.

What Causes Congestive Heart Failure?

The causes of heart failure depend on the type that you have, states the NHLBI. Most typically, the condition occurs on the left side of your heart, which pumps oxygen to the rest of your body.

The measure for this pumping efficiency is known as “ejection fraction.”

These genetically inherited heart conditions can all cause left-sided heart failure because they lower ejection fraction:

heart attack
coronary heart disease
heart valve disease
irregular heartbeat

For those with normal ejection fraction, left-sided heart failure is most typically caused by:

high blood pressure
obesity
diabetes
other conditions that stiffen the heart chambers

Right-sided heart failure is usually caused by left-sided heart failure.

The Black Community and Congestive Heart Failure

Heart failure hits Black Americans especially hard. Research shows that Black men and women have significantly higher rates of hospitalization for heart failure compared to their white counterparts. Black people are hospitalized for heart failure up to 2.5 times more often than whites, according to the National Library of Medicine.

Studies from WebMD also show that Black adults are more likely to face aggressive social and medical risk factors like high blood pressure, limited access to care, and systemic bias, which can worsen outcomes.

Quick Tip:
🧠 Know your heart’s risk. Ask your provider to check not just your blood pressure, but how often you’ve been hospitalized or had symptoms. Getting into the habit of regular check-ins, especially earlier in life, can help catch or slow heart failure before it becomes a serious problem.

Congestive Heart Failure Symptoms

Since symptoms are not yet present in Stages A or B, it may be difficult to know if you have heart failure. For this reason, the AHA recommends having regular screening tests administered by your doctor. These screenings consist of blood pressure readings, cholesterol profiles, blood sugar measurements, and body mass index (a measurement of height and weight) readings.

Once symptoms of heart failure appear, they may differ depending on whether you have left-sided or right-sided heart failure, according to the NHLBI.

Left-sided symptoms include:

Shortness of breath
Weakness
Coughing
Extreme tiredness
Difficulty sleeping in a horizontal position
Blue-tinted fingers and lips
Trouble concentrating

Right-sided heart failure symptoms include:

Excessive urination
Nausea
Loss of appetite
Weight gain
Swelling of the extremities
Abdominal pain

Congestive Heart Failure Treatment

The Cleveland Clinic states that heart failure treatment options depend on the stage you’re experiencing.

Typical Stage A and Stage B treatments include diet, exercise, and lifestyle changes, such as quitting smoking and drinking. Medications to treat cholesterol, blood pressure, diabetes, and certain heart conditions may also be administered. In Stage B, surgical interventions are sometimes recommended, such as removing blockages or repairing heart valves.

People with Stage C and Stage D heart failure may be prescribed medications to slow their heart rate, as well as additional dietary and lifestyle restrictions. Sometimes a cardiac defibrillator is surgically implanted to help regulate the heart.

What to Expect When Diagnosed With Congestive Heart Failure

Getting a heart failure diagnosis can shake you up, but it’s not a one-way ticket to bad news. Once you understand what’s happening in your heart, you and your care team can work together to protect it.

Most people start with medication, lifestyle changes, and follow-up appointments every few months.

You might notice more energy once the right meds kick in, or less swelling as your body releases extra fluid.

The biggest shift is usually mindset: learning to pay attention to your symptoms, taking your meds on time, and showing your heart a little more love every day.

With consistency, it becomes a routine, and plenty of people go on to live full, active lives.

How to Prevent Congestive Heart Failure

A recent study of nearly 9,500 people that was published in the Journal of the American College of Cardiology revealed that those who smoked cigarettes had twice the rate of heart failure as nonsmokers.

“We hope our results will encourage current smokers to quit sooner rather than later since the harm of smoking can last for as many as three decades,” senior study author Dr. Kunihiro Matsushita, said in a news release that accompanied the study.

In addition to quitting smoking, the U.S. Centers for Disease Control and Prevention also recommends eating a healthy diet, managing your weight, exercising consistently, taking your medications as directed, and getting regular health screenings and medical checkups to help prevent heart failure.

How Long Does Congestive Heart Failure Last?

How long someone lives with heart failure depends on the stage they’re in, how early it was caught, and how committed they are to treatment.

Some people manage heart failure for decades with good medication, healthy habits, and regular check-ins.

Others may need more advanced treatments if their symptoms continue or worsen.

Think of it this way: heart failure is a condition you learn to manage, not a countdown clock.

Questions to Ask Your Doctor

Walking into an appointment prepared can make you feel more confident and in control. Here are a few smart questions to jot down and bring with you to your doctor’s appointment:

What stage of heart failure am I in, and what does that mean for my everyday life?
Which medications do I need, and what side effects should I look out for?
What lifestyle changes will give me the biggest benefit right now?
How often should I check in with you, and what symptoms should make me call sooner?

What Foods Should I Avoid with Congestive Heart Failure?

Salt is the big one. Too much sodium makes your body hold on to fluid, which strains your heart.

Try to limit processed foods, fried foods, and anything super salty.

Go for fresh veggies, fruit, whole grains, and lean protein.

Think of it as feeding your heart what it needs to keep loving you back.

A Final Word on Congestive Heart Failure

Heart failure is serious, but it doesn’t mean your life is on pause. With the right care and consistency, your heart can surprise you in the best way.

Take your medications every day, keep your salt intake low, move your body in ways that feel good, and pay attention to changes in your breathing or weight.

And don’t hesitate to lean on your care team. No question is too small when it comes to your heart. The more you speak up, the better they can help you stay stable, strong, and living the life you want.

Your heart is still working for you. Give it what it needs to keep going.

By Cara Jones, BDO Staff Writer | Published November 13, 2025