Congestive heart failureIntroduction

Heart failure, also called congestive heart failure, is a condition in which the heart can no longer pump enough blood to the rest of the body.

Heart failure is often classified as either systolic or diastolic:

  • Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well.
  • Diastolic heart failure means that your heart’s pumping chamber does not fill up with blood.

Both of these problems mean the heart is no longer able to pump enough blood out to the rest of your body, especially when you exercise or are active.

As the heart’s pumping action is lost, blood may back up in other areas of the body, producing congestion in the lungs, the liver, the gastrointestinal tract, and the arms and legs. As a result, there is a lack of oxygen and nutrition to organs, which damages them and reduces their ability to work properly.

Perhaps the most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart.

Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies.

Heart failure (HF) is a major public health issue, with a prevalence of over 5.8 million in the USA, and over 23 million worldwide, and rising. The lifetime risk of developing HF is one in five.

HF represents a considerable burden to the health-care system, responsible for costs of more than $39 billion annually in the USA alone, and high rates of hospitalizations, readmissions, and outpatient visits.

HF is not a single entity, but a clinical syndrome that may have different characteristics depending on age, sex, race or ethnicity, left ventricular ejection fraction (LVEF) status, and HF etiology. Furthermore, pathophysiological differences are observed among patients diagnosed with HF and reduced LVEF compared with HF and preserved LVEF, which are beginning to be better appreciated in epidemiological studies.

A number of risk factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes, among others, have been identified that both predict the incidence of HF as well as its severity1.

Those with CHF likely have reduced bone mass density2, in part due to use of a loop diuretic3.

Page last edited: 06 May 2011


  1. Bui, A. L. Horwich, T. B. Fonarow, G. C. Epidemiology and risk profile of heart failure. Nature reviews. Cardiology. 2011 Jan; 8 (1): 30-41.
  2. Abou-Raya, S. Abou-Raya, A. Osteoporosis and congestive heart failure (CHF) in the elderly patient: double disease burden. Archives of gerontology and geriatrics. 2009 Sep-Oct; 49 (2): 250-4.
  3. Alsafwah, S. Laguardia, S. P. Arroyo, M. Dockery, B. K. Bhattacharya, S. K. Ahokas, R. A. Newman, K. P. Congestive heart failure is a systemic illness: a role for minerals and micronutrients. Clin Med Res. 2007 Dec; 5 (4): 238-43.