Congestive heart failure (CHF) occurs when the heart can no longer pump blood efficiently, so the blood backs up in the body – particularly in the liver, lungs, hands, and feet. This typically presents as swelling. For example, the legs may have swelling that gets worse when the person stands and improves when they lie down. If the lungs are involved, it can cause shortness of breath and coughing, especially during exercise such as walking up stairs or when lying down flat in bed. CHF may occur in those who have had a previous heart attack or who have high blood pressure, narrowed arteries to the heart, infections, or congenital heart disease.

A combination of tests may be used to diagnose the condition, including physical exam, echocardiogram, chest x-ray, and any of several nuclear or CT scans. Laboratory tests are used to a lesser extent. Those tests may include a urinalysis to determine if there is kidney failure and a metabolic panel to check for electrolyte balance or kidney failure, since symptoms of kidney disease are similar to those of CHF. A new test that measures the amount of brain natriuretic peptide (BNP), a hormone found in the left ventricle (the main pumping chamber of the heart), in the blood may also be used to help diagnose and grade the severity of heart failure.

CHF is usually a progressive disease. Treatment is aimed at stabilizing the condition and treating the symptoms. This usually includes controlling salt intake, water retention, and eliminating smoking and alcohol. Regulating these external problems will also help control blood pressure – a primary concern in heart diseases.