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Overview

Congestive heart failure (CHF) or cardiac failure (CCF) occurs when the heart can no longer pump blood quickly enough. This causes fluid to build up particularly in the liver, lungs, hands and feet. The legs may develop swelling that gets worse when the person stands and improves when they lie down. If the lungs are involved, it can cause shortness of breath and coughing, especially during exercise such as walking up stairs or when lying down flat in bed. CHF may occur in those who have had a previous heart attack or who have high blood pressure, narrowed arteries to the heart, infections, or congenital heart disease. However in a large number of cases the cause may not be identified (“idiopathic”).

A combination of tests may be used to diagnose the condition, including physical examination, electrocardiogram (ECG), an echocardiogram and chest x-ray. Laboratory tests are used to a lesser extent, but may include urinalysis to determine if there is kidney failure and blood tests to check for electrolyte balance, liver function and kidney function, since symptoms of kidney or liver disease may be similar to those of CHF.

New tests, BNP or NT-proBNP (B-type natriuretic peptide), can be used to help diagnose CHF. These are substances produced by the ventricles (the main pumping chambers of the heart). Levels of BNP are raised in CHF, and it is a useful test in patients with suspected heart failure when the diagnosis is uncertain. However, in Australia a Medicare rebate is only available if the test is ordered on a patient presenting to a hospital emergency department with shortness of breath. 

CHF is usually a progressive disease. Treatment is aimed at stabilising the condition and improving the symptoms. This usually includes lifestyle changes such as controlling salt and fluid intake, stopping smoking and limiting or ceasing alcohol. Regular medications including beta-blockers, ACE inhibitors and diuretics are also important in patients with CHF in order to relieve symptoms and prolong life. 


Last Review Date: March 6, 2017