Congestive Heart Failure: What Happens?

Medically Reviewed by James Beckerman, MD, FACC on May 15, 2023
2 min read

Congestive heart failure doesn't mean your heart has stopped. It means it's not pumping blood the way it should. When that happens, blood and fluid can back up in your body and make it harder for your kidneys to flush out sodium and water. That can make you hold on to too much fluid, which causes swelling.

There's no cure. But your doctor may give you medication to do things like lower your blood pressure, relax your blood vessels, make your heart beat stronger, or ease swelling. And diet and lifestyle changes -- like not smoking -- can help, too.

Congestive heart failure can cause:

  • Shortness of breath: This happens when fluid collects in your lungs. It's also called pulmonary edema. It may be worse when you're lying down or when you're active. If you're having a hard time breathing, call your doctor or 911 right away.
  • Coughing: Like shortness of breath, this is usually caused by extra fluid in your lungs.
  • Tiredness: With heart failure, your body doesn't pump out enough blood to keep your cells healthy. That can make you tired. You might find it hard to do everyday things like climb stairs.
  • Swelling (also called edema): This happens when there's too much fluid in your tissues. Your legs and ankles are the most likely places to swell. But other areas of your body, like your arms or belly, can also swell.
  • Weight gain: This is caused by extra fluid that doesn't get flushed from your body the way it should.
  • A need to pee more often.

Anything that damages your heart muscle or makes it work too hard can lead to congestive heart failure. Some examples include:

  • Diabetes: This causes high blood sugar. That can damage your heart muscle over time.
  • High blood pressure: Blood pressure is the force of your blood as it pushes against the walls of your arteries. Too much pressure eventually will weaken your heart muscle.
  • Other forms of heart disease, including heart valve disease, congenital heart defects, and coronary heart disease.
  • Certain medical treatments, including cancer treatments such as chemotherapy and radiation.
  • Thyroid disease.
  • HIV and AIDS.
  • Alcohol or drug abuse.