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Congestive Heart Failure - Understanding The Different Stages!

Written and reviewed by
MCH DNB (CTVS), Advanced fellowship, MS
Cardiothoracic Vascular Surgery, Delhi  •  22 years experience
Congestive Heart Failure - Understanding The Different Stages!

Congestive heart failure (CHF) is a chronic and progressive condition that reduces the pumping efficiency of the heart. There will be a buildup of fluid around the heart over a period of time. This fluid accumulation then will be seen in the abdomen, legs, lungs, and liver. This could be a life-threatening situation that requires immediate attention. Read to know to more about stages, causes, symptoms, and treatment of this condition.


There are 4 stages of heart failure, which is based on history and presenting.

  • Stage A: These people have a strong family history of hypertension, diabetes, or heart problems and have a fat-rich diet and history of alcohol or drug abuse, smoking.
  • Stage B: These people have the disease but have no symptoms. They may have hypertension, which needs to be controlled.
  • Stage C: They have definite cardiac symptoms like fatigue and shortness of breath even with walking or bending over. These patients need to monitor lifestyle including diet, exercise, and alcohol usage.
  • Stage D: Even after treating CHF, these patients continue to have symptoms and require lifestyle changes, medications, and even surgical intervention in some.


In its initial stages, CHF will not present with any symptoms. Gradually, there will be symptoms which can be constant or intermittent.

  • General fatigue and weakness: Reduced blood supply to the vital organs reduces overall energy levels in the patient.
  • Faster heart beats: Since the efficiency has reduced, the heart muscles work harder to meet the body demands, causing faster heart rate.
  • Shortness of breath: Due to congestion of the lungs, their efficiency is reduced and so the person gets short of breath much easily than before. There is also difficulty breathing, especially when lying flat or at rest. There could be associated dry cough and wheezing, especially at night.
  • Fluid retention: The abdomen, ankles, and legs could be swollen, also resulting in weight gain, nausea, increased nocturnal urination. The internal examination would reveal fluid in the liver and other vital organs too.

Treatment: CHF requires a combination of lifestyle changes, medications, and in some cases surgical intervention.

  • Changes like quitting smoking, dietary modifications, exercise based on the severity of CHF would be essential.
  • Medications like beta blockers and angiotensin-converting enzyme inhibitors to improve blood pressure, cholesterol-controlling drugs, and diuretics to manage fluid retention would be advised.
  • Angioplasty or value repair surgeries may be required if more severe abnormalities are detected.

Though it cannot be cured, the onset can be delayed and the severity of symptoms reduced with lifestyle changes. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

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