Congestive Heart Failure

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Congestive heart failure (CHF) is a term for heart failure in which the body’s fluid regulation is overwhelmed, causing fluid (congestion) to build up in the tissues. In the lungs, this congestion causes breathlessness and, in severe cases, pulmonary oedema. In the body’s periphery, it causes swelling of the ankles and legs (peripheral oedema) and, in advanced cases, ascites (fluid in the abdomen) and an enlarged liver due to venous congestion.

The term congestive heart failure describes the clinical presentation rather than a distinct disease separate from heart failure. Not all heart failure is congestive: some patients present primarily with low output (fatigue, poor exercise tolerance, cardiogenic shock) without prominent fluid overload, particularly in the acute setting.

Congestive heart failure is treated with diuretic medications (to remove excess fluid through the kidneys), alongside disease-modifying therapies addressing the underlying reduced cardiac function, including ACE inhibitors, beta-blockers, and aldosterone antagonists. In the context of cardiac arrest, congestive heart failure both predisposes patients to arrhythmia and can develop acutely as a consequence of a cardiac event.

For a comprehensive description of heart failure, its causes, investigations, and treatment, see Heart Failure.

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