Understanding Congestive Heart Failure (CHF) - Risks Factors, Symptoms and Treatment


By:  Dr. Dipanjan Banerjee

Nationally heart disease, which is also known as cardiovascular disease, affects as many as 6 million Americans. It is the leading cause of death in Hawai’i and is responsible for more than 18,000 hospitalizations across our state every year, making it the leading cause of hospitalization for our kupuna.

What is Congestive Heart Failure (CHF)?

Despite its name, heart failure does not mean a heart has stopped functioning. Instead, it means the heart is not functioning as effectively as it should. When a person has heart failure, their heart works less efficiently at supplying the body with required oxygen. As the body struggles without enough oxygen, it may begin to retain fluid. This fluid can build up around the ankles, legs, arms, feet, or even other organs - resulting in the body becoming congested, which is how the heart condition gets its name.

Congestive heart failure can be caused by many conditions, including a heart attack due to coronary artery disease (CAD - the buildup of plaque in the heart’s arteries), damage to the heart resulting from infections, alcohol or drug abuse, abnormal deposits of material in the heart, and/or medical conditions that result in overwork of the heart muscle. 

Unfortunately, not all conditions that lead to congestive heart failure can be reversed. However, treatments can improve the symptoms of heart failure and allow people to live longer, fuller lives. Changes in lifestyle, including exercise, diet, weight loss and stress management are essential, and can also help people with heart failure improve the quality of their life.

What are the Symptoms of Congestive Heart Failure (CHF)?

Symptoms of congestive heart failure (CHF) may be mistaken for other medical conditions.  Displaying more than one of the below symptoms, even without being previously diagnosed with a heart condition should result in seeking timely medical attention. 

Symptoms of CHF or congestive heart failure can, but may not always, include:

  • Trouble breathing or shortness of breath
  • Fluid retention leading to swelling in the ankles, feet, legs, and abdomen 
  • Dizziness or fatigue

When congestive heart failure symptoms first present, people may feel tired or find themselves short of breath with physical exertion after completing brisk walks or climbing stairs. When symptoms worsen, people who have heart failure may experience these symptoms during simple everyday activities.

Can Heart Failure be Treated?

Now, more than ever, there are more treatment options for congestive heart failure, including both medications and lifestyle changes.  These require monitoring by a cardiologist such as those at the Queen’s Heart Institute.  A team of cardiologists like those at The Queen’s Heart Center for Advanced Heart Failure can offer the most experience in treating heart failure in Hawai’i, and the most advanced treatment options available. 

Your Queen’s Heart specialist will work together with you to determine the best course of treatment for heart failure, with the goals of stopping the disease’s progression and treating your symptoms to help you live a better, more quality life.

Working together, you and your provider can consider the best treatment options, including:

  • Lifestyle changes that include limiting salt intake, increasing physical activity, monitoring your own symptoms, and losing weight if needed. 
  • Prescribing medications to reduce stress on the heart and keep the blood pressure low in order to promote heart recovery 
  • Adjusting your heart medications for maximum benefit and minimal side effects 
  • Cardiac Rehabilitation: a supervised exercise program proven to improve wellbeing for those with weak hearts 
  • Catheter based procedures to improve the heart’s rhythm, open up the heart’s blood vessels, and fix leaky or narrow heart valves 
  • Advanced therapies such as wireless heart monitoring, a heart pump, or even a heart transplant 

Living with Congestive Heart Failure 

Congestive heart failure is a serious disorder and a chronic illness.  With the right treatment, such as lifestyle changes and medications, heart failure can be effectively managed. While your heart care specialist can work with you on a treatment plan, your active involvement and participation will be required to ensure you live a longer, fuller life.

Often, lifestyle changes such as improving your diet, self-tracking and managing symptoms and exercising can lead to the biggest gains in the health and wellbeing of individuals living with heart failure.

How to Improve Your Cardiovascular Health 

Today, heart disease is the leading cause of death for both men and women in Hawai’i, but with smart lifestyle changes, you can take steps to lower your risk of cardiovascular or heart disease.

When it comes to heart disease like heart failure, there are two types of risk factors - those risk factors you can control and those you cannot control. Risk factors for cardiovascular or heart disease you cannot control include your gender, your ohana’s medical history and your age.

There are several risk factors for heart disease you can take active steps to control, including:

  • Obesity or being overweight 
  • Physical inactivity 
  • Unhealthy cholesterol levels  
  • High blood pressure 
  • Smoking 

Nearly half of all Americans have at least one of three key risk factors for heart disease. These three key risk factors include high blood pressure, smoking and high cholesterol. One way to prevent heart disease is to control the risk factors that cause cardiovascular disease - this is like a medicine for your heart.

The Most Advanced Heart Failure Care Available

The Queen’s Heart Center for Advanced Heart Failure is home to Hawai'i’s only heart failure disease management program. Our team-based approach to care brings together a wide range of world-class heart care specialists to provide comprehensive, personalized care in both hospital and outpatient settings.

Our team of cardiologists at the Center for Advanced Heart Failure will ensure you receive easy-to-understand care instructions for you and your loved ones, allowing you to manage your symptoms, a critical step in the treatment of congestive heart failure. Our mission is to help our patients live a better, fuller life.

The Queen’s Heart Center for Advanced Heart Failure includes:

  • Patient and family education for how to care for a patient with heart failure
  • Lifestyle and dietary recommendations personalized to the patient’s condition
  • Prescribed medications to manage the heart, blood pressure and associated fluid buildup 
  • Simple guidelines for self-assessment of symptoms
  • Easy access to our world-class care team
  • A vast array of procedures designed to improve heart health


About the Author 

Click here to learn more about Dr. Dipanjan Banerjee

Dr. Dipanjan Banerjee is the Director of the Advanced Heart Failure program at The Queen’s

Medical Center and Associate Professor at the University of Hawai‘i, John A. Burns School of Medicine.  He also serves as Program Director for the University of Hawai’i Cardiovascular Medicine Fellowship. He was formerly the Medical Director of the Mechanical Circulatory Support Program at Stanford. As a Heart Failure Cardiologist, he cares for patients with a wide range of heart failure including: amyloidosis, hypertrophic cardiomyopathy, sarcoidosis, idiopathic and dilated heart failure.

Dr. Banerjee also evaluates patients for specialized valve procedures, pacemakers, heart assist device (left ventricular assist device), and heart transplant. He is a member of the American College of Cardiologyand the International Society of Heart and Lung Transplantation.

• Board Certified in Cardiovascular Medicine, Advanced Heart Failure and Transplant Cardiology, and Adult Echocardiography

• Advanced Heart Failure and Transplant Cardiology Fellowship – Stanford University

• Cardiovascular Disease Fellowship (Chief Fellow) – Stanford University

• Internal Medicine Residency – Stanford University

• Medical School – University of Missouri-Columbia, summa cum laude

• Undergraduate – Harvard University, A.B. in English, magna cum laude

Caring for the Hearts of Hawai’i 

Queen's Heart Institute at The Queen's Medical Center offers comprehensive patient-centered cardiovascular medicine, surgical care and diagnostic testing all in one convenient setting. For both routine and more complex heart and vascular conditions, our world-class team provides comprehensive services utilizing the most advanced technology, treatment and care options to ensure the highest quality of cardiac care for our patients.

From your general cardiology needs to the most complex surgical or non-invasive procedures, the Queen’s Heart Institute provides compassionate cardiac care to you and your ohana (family). Our multidisciplinary team of board-certified, professionally trained physicians and advanced practice nurse practitioners are committed to providing expert diagnosis, treatments and care for the full range of cardiac and vascular conditions to improve the quality of our patients’ lives.

With the help of the team here at the Queen’s Heart Institute, you can keep your heart healthy. Explore other heart health tips and information at queens.org.

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