Congestive Heart Failure
Congestive heart failure is heart failure accompanied by fluid build-up in the lungs, legs or abdomen because filling pressures are elevated.
Key takeaways
- Breathlessness when lying flat, rapid weight gain, leg swelling and abdominal fullness can indicate increasing congestion.
- Diuretics remove excess fluid and improve symptoms but do not replace therapies that modify the underlying heart failure.
- Kidney function, potassium, blood pressure and daily symptoms guide safe adjustment; more diuretic is not always the answer.
The listings below are not a complete heart-failure regimen; ejection fraction, cause, rhythm and organ function determine treatment.
Confirming congestion and cause
Examination, natriuretic peptide testing, chest imaging and echocardiography help separate heart failure from lung, kidney or venous disease. Coronary disease, valve problems, high blood pressure, cardiomyopathy and arrhythmia are common causes that may need specific treatment.
Relieving fluid and protecting the heart
Loop diuretics are adjusted to restore a stable fluid state, with weight and laboratory monitoring. Guideline-directed medicine for reduced ejection fraction uses several complementary classes that improve outcomes. Sodium and fluid advice is individual, and sudden self-directed dose changes can cause dehydration or kidney injury.
When to seek urgent care
Seek emergency care for severe breathlessness at rest, blue or grey lips, chest pain, fainting, confusion, pink frothy sputum or inability to lie flat because of breathing.