Causes and Symptoms of Exacerbating Congestive Heart Failure

A congestive heart failure (CHF) patient may have worsening condition if he experiences weight gain, fatigue, leg swelling, mental confusion and shortness of breath. In more severe cases, exacerbated CHF is indicated by serious shortness of breath, some patients also report a sensation of drowning. He may be unconscious occasionally and cough up frothy sputum with pinkish color. Exacerbated CHF is an emergency condition and should receive immediate treatment from health professionals.

This condition commonly happens when the weakened heart is subjected to increased demands. These demands may happen due to non-cardiac and cardiac changes. Exacerbated CHF is often life-threatening and require hospitalization to stabilize patient’s condition. In many patients, CHF exacerbations happen more often and the severity increases over time, the heart becomes weaker and less able to deal with higher loads.

In the U.S. and Canada, CHF exacerbations are likely reason for hospitalization. If the patient experiences a severe case, he may need a ventilator until his condition stabilizes. According to a study, it is discovered that a third of CHF exacerbations are caused by the failure to fully comply with the medical regimen. For example, after a high sodium intake, salt can cause water retention in the bloodstream, which makes the already weakened heart works harder. Finally, water may accumulate in the lung. Some people also wouldn’t comply with the medication instructions.

These are common cause of CHF exacerbations:

Excessive alcohol intake.

Coronary artery disease.

Increased exercise.

Irregular heartbeats.


Endocarditis (heart valve infections).

Lung infections.

Medications side effects, (It may happen if the patient uses negative inotropic medications, such as diltiazem, nifedipine, verapamil, disopyramide and beta blockers).

Higher blood pressure.

Although this situation can be depressing or frightening, there is still a hope. It is highly possible to control common causes of CHF exacerbation. You can significantly reduce the risk by taking into account those common causes. Proper handling of the causes can also improve the future prognosis. It is also highly important for patients to detect likely symptoms of CHF, immediate treatment can prevent hospitalization, significantly reduce medical costs and avoid worsening overall health condition. Unfortunately, CHF symptoms in each patient can vary widely. The patient, spouse, children and other family members must be vigilant and watch for these signs regularly.

Weight gain: Body weight should be monitored twice a day, at morning and before bedtime. Exacerbating CHF is possible if the patient gains 3 lbs in one day or 5 lbs in one week.

Shortness of breath: It is often called dyspnea by the medical community. It can happen anytime, during sleeping, at rest; and after light or heavy activities. This symptom can appear progressively or abruptly, it often can wake patient from sleep. They may find it difficult to breathe and lie flat at the same time. They can be restless or tired. Shortness of breath happens when the blood accumulates in the pulmonary veins. It causes fluid leakage into the lungs and makes it harder for oxygen to get into your body. Usually the skin is pale and clammy, in more severe cases it may appear bluish, it is a life-threatening situation and requires immediate ER assistance.

Persistent wheezing and coughing: Although it is sometimes misinterpreted by doctors and patients as bronchitis or chest cold; wheezing and coughing may indicate CHF exacerbation. These conditions are caused by fluid buildup in the lungs. In more severe cases, coughing will produce pinkish blood tinged mucus. It is a serious symptom and warrants a quick doctor treatment.

Hands or feet swelling: Swelling on body tissues caused by fluid buildup is known as edema. This condition may occur on your abdomen, legs, ankles and feet. The patient may first notice that it is more difficult to put on shoes or get a ring on finger. It is usually caused by slower blood flow and some fluid may accumulate on the tissue. If kidneys lose their efficiency in disposing water and sodium, fluid retention may also happen.

Excess fatigue: People with exacerbated CHF may become easily tired after performing normal activities such as walking at a normal pace for a few hundred yards, carrying groceries, climbing stairs and shopping. Fatigue happens due to slower blood flow to body tissues. Muscles on limbs are considered as less important organs, as the result, our body diverts some blood to brain and heart. Without proper treatment, muscles mass on the limbs may decrease due to the lack of oxygen.

Appetite loss: If you fell “stuffed” or nauseated after eating a snack, it could be a sign of CHF. It happens because the gastrointestinal system receives less blood, as the result causes digestion problems. Some of the blood is shunted to the heart and brain. Although, patients eat very little, they still gain weight due to water and salt retention.

Confusion: In severe cases of CHF, patient’s heart is working harder to ensure the brain gets enough oxygen. It may result in disorientation, memory loss and confusion. Patients may find it difficult to read newspaper or carry a conversation. Lack of oxygen in blood may cause other symptoms like, excessive sleepiness, slurred speech, confusion, forgetfulness and prolonged headaches. The patient may be less aware of the condition, in this case a family member’s role as a caregiver is important. This condition warrants an immediate treatment by doctor.

Palpitations: It is a condition of increased heart rate and happens when heart works hard to deliver oxygen-rich blood on tissues and organs around the body. The failure to maintain pumping capacity is compensated by higher heart rate. This symptoms is often described as throbbing chest or racing heartbeat.

Sleeping difficulty: Fluid build up in the lungs can use sleeping problems. Patients may have breathing problems, wake up at night frequently, sleep in a chair or use pillows to prop themselves up.

Prolonged symptoms: Patients may feel the lack of energy, increased fatigue and ill health for more than one day.

Cyanosis: Bluish discoloration on the fingernails and lips.

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