What are the stages of congestive heart failure?

Hi Rob, you're pretty young to have so many medical issues. All of your conditions can be treated. If you're a smoker, QUIT! If you're overweight, lose weight. My mom is 94 and has COPD and atrial fib. She's on medications and does pretty well. Be sure to get your blood pressure and diabetes treated and stick with what the docs tell you about that.

My mom gets winded with her COPD, as she has aortic stenosis too, so her aorta is narrowed and she can't get enough blood to keep her from being winded with any exertion. If the cardiologist didn't give you the kind of information you need, do some research on Google about your conditions and make sure you're following doctor's orders. My mom's cardiologist told her to keep walking and to stay as active as she could tolerate, even though it wears her out. Ask your cardiologist about exercise, since it would help both your diabetes and blood pressure, particularly if you're overweight.

I don't think any of the things you have are an immediate death sentence and if you take good care of yourself, you should be able to manage all of them well into the future. But it's important to make lifestyle changes if your lifestyle has lead to any of your conditions.

It depends a lot on the causes and type of his heart failure; but left ventricular cardiomyopathy is the common or garden variety: this describes the condition where the diseased muscle of the heart wall becomes flabby and distended, so that the heart's pumping action becomes increasingly inefficient.

You can gauge how badly affected the heart is by its "Ejection Fraction" which is measured when a cardioechogram is done. A normal EF would be around 65%, I believe - this means that the heart is squeezing more than half of its contents out with each contraction. The EF can be difficult to measure accurately, though, so don't panic if you're told that it's 10% - my family doctor explained kindly that this was the cardiac physiologist's polite way of saying that she couldn't measure it at all, and it did not mean that my poor mother was about to drop dead on the spot.

I find that it helps to visualise the heart as a mechanical pump with its rubber wall beginning to perish and slacken. The other major mechanical problem is that because the left ventricle is slack and distended, it pulls on the valves between the heart chambers and prevents them from snapping shut cleanly, as they should. Valves can be replaced, but this is futile if the dilatation is severe: the new valve will fail in the same way.

The medications given can be aimed at improving heart function, relieving symptoms of heart failure such as breathlessness and swollen lower limbs, and protecting the heart itself and other organs such as the kidneys. Different medications suit different patients; if side effects are ever a problem, don't hesitate to report them because there may well be better options for him that your father's doctor will be happy to try.

Pacemakers can be implanted either to regulate heart rhythm (2 leads), or to synchronise the left and right chambers of the heart so that more blood is pumped with each beat (Cardiac Resynchronization Therapy, which requires a device with 3 leads).

The big problem, of course, is that a poorly operating pump means a decrease in the supply of oxygen to the whole body: so all of the major organs, including the heart itself, and the brain are inevitably affected as the disease progresses. Lack of oxygen supplied to the heart muscle leads to angina and (ultimately) heart attack; to the brain - TIA's, stroke and vascular dementia; to the kidneys - deteriorating kidney function, leading to fatigue and poor excretion of various toxins and sometimes poor drug metabolism (so you can get accidental overdoses, for example, or unusually high levels of blood electrolytes such as sodium and potassium - but your father's doctors will already be keeping a close eye on these things so don't worry).

Dementia is proving particularly tricky to diagnose. Vascular dementia is a common result of longstanding CHF, but of course having CHF is no guarantee against Alzheimer's or any of the other dementias either: so you could be looking at a very complex picture. When my mother's being especially loopy, I don't know whether it's because she's fatigued, deaf, fed up, bored, feeling ill, not in the mood to concentrate, actually demented or having a stroke. I hope your father's still a long way off this stage, though.

If your father does have this type of CHF, with no other presenting heart disease, and his doctors have succeeded in finding a good balance of medications for him, he should continue to have a good quality of life for some years to come. My mother was diagnosed in about 1986 and remained reasonably fit and well until about two years ago. The normal rules for healthy living apply - eat well, exercise as much as he's comfortable with, watch his weight, don't smoke… nothing you wouldn't include in your New Year's resolutions anyway!

I agree, it would be wonderful if there were some sort of timetable or clear prognostic chart; but because there's no knowing what will fail first or how individual patients will respond to drugs or lifestyle changes… it all seems to remain anybody's guess. My mother's had 15 decent extra years from the medical profession so I'm not really complaining; but all that my medically qualified daughter, even, can tell me is that my mother will be on her family doctor's "Don't Be Surprised If They Die" list. With the when and how, exactly, nobody's taking bets.

Wikipedia is always good for diagrams. Most of the medical schools will have some helpful online material, but make sure you're looking at the right species of CHF or it all becomes impossibly confusing. And if do you find any kind of crystal ball toolkit out there, please let me know!

I mean 1996. It's that contagious dementia getting to me again… Apologies.

Currently I am the primary care giver for my father in law with CODP and CHF. Last week we were not sure he would make it to Christmas. I did bring him home from the hospital on the 22nd of Dec and he was ok. Christmas eve he was clearly worse the ankles swollen and could hear the rattle in his chest. He has home O2 for the first time but barely uses it. And is not taking his "water pills".

On Christmas morning however he woke up fine. Better then I've seen him in months to be honest. Only change was a beer he drank with our son Christmas eve. Christmas dinner he had another one and again he looked amazing on the 26th. We were totally prepared for this to be end of his journey with us but now I just dont know. He still wont take the water pills and hardly uses the "dreaded" O2.

Is it normal to suddenly get better like that? Is it ok to think we got lucky and he will be around for awhile? I'm so confused over what to expect here. We had planned he would not go back to the hospital but now I just dont know what to expect?

What's he got against taking his diuretics? If he wants to keep breathing, he'd better.

If he's against taking meds, oxygen and wants to live on his own terms, I'd bring in hospice. And beer!

we are getting hospice ordered this week and there are nurses coming in and out almost daily.

My 63 year old father just had a second stroke. So during a visit a nurse mentioned that my father has CHF, but none of the doctors including his regular doctor have never mentioned anything about. Not sure what to think about this. Please advise.

Espinoza, how involved have you been in your father's care? I don't mean to sound critical, I'm not being, but if your father's strokes have been caused by blood clots arising from poor heart function it seems unlikely that his regular doctor would have known nothing about the CHF up 'til now. What conditions has anyone discussed with you previously? I'm sorry to hear about your father's stroke - is he recovering well? What were the effects?

There is a procedure I have heard about called ablation or catheter ablation that can be done if cardioversion can't be done or doesn't work. It cauterizes the heart tissue that is causing the a-fib. For some people this might be a thing to look into as I know someone who had this done and it really helped them.

My ex husband died 2 nights ago with chf and a severe diabetic since January of this year he has been on life support twice we have a 14 yr old daughter who is devastated and I was at work when she found out he was gone which was heartbreaking for me I wasn't here for her when she needed me and it is a horrible disease he could never catch his breath his stepdaughter was in denial of him being really wick

Hello- my father is 90 years old with demensia and COPD. He refuses to sleep...at all. I will get him to bed then when he lays down fights to get back up to say he had to go to the bathroom when he doesn't. This is so frustrating. I have been taking care of him for 3years now. He insists on wondering all night around the house. Also he talks in very scary voices late at night. Why and what can I do???

Barby56007, you are posting on a 4 year old old thread about CHF, you would do better if you asked a new question, just click on the blue box "ask a question" at the top of the list of threads. Have you talked to his doctor about your dad's behavior? There are meds that can help.

My Mom is 88 years old and has chf, she is on oxygen 24/7. her lower legs were swelled. My sister that had been doing the cooking for her held the salt and sugar ( she is also diabetic) Mom stayed with me for a week and I didnt require her to do anything. She only went to the bathroom and took care of her personal self (she has to use a walker and carry her oxygen cord) she kept her feet and legs elevated. Now my sister thinks that Mom needs to be up and doing her house work and Laundry which she was doing before she came to my house, my question is should she be up and working or setting and elevating her feet and legs, what should her activities be?

Momlizzy that's a good question for her doctor. I know my mom's cardiologist has told my mom it's good for her to be up and around. But my mom's not on oxygen. She gets very short of breath, but her doc said keep up and moving as much as you can. Sitting too much isn't good for your heart.

MomLizzy, probably up a little for some walking and very light activities is good, but just don't push that heart too hard. Getting up and walking over to a table where she can fold laundry should be fine, but doing a big load with all the lifting and pulling by herself may be too much. Ask her doctor for advice on it too.

My father is 90. 22 yrs ago he had a quadruple bypass,and was told it would last him about 10 years. 3 years ago he was told that one of the valves had stopped working, and at his age he was too old to undergo another valve replacement. About six months ago his legs started leaking really badly,he has his dressings changed everyday but as soon as he has changed his socks they are sodden again within 10 minutes.Two weeks ago,on top of his leaking ulcerated legs,he developed a painful red eczema like rash as well.He is often out of breath & has become very tired all of a sudden. My Dad is my world,I cannot imagine life without him.He is a very private man and doesn't tell us much as he knows we'd be worried. My question is, how do doctors know when patients like my Dad are coming to the end of their journey, I'm trying to prepare myself but it's very hard.

My wife had an ICD implant fitted which she was coherced into having it turned off, which I her husband did not want. And at no time at all had we been told what stage my wife's heart condition was, by that I mean they had not informed us if she was at end stage with her heart condition. My wife was 45yrs she died within less than 24hrs of being discharged,I do believe that if her ICD implant had remained active then she would be alive today. Can you let me know your thoughts on this course of action taken in my wife's care.

Nodrog, you need much more technical information than any of us can offer without knowing more about your wife's conditions and medical history.

If you or your wife were "coerced", that's when you should have been asking what stage her cardiac condition was, what the prospects for survival were, what other options there were.

If you really want to pursue this, you'll need to get your wife's medical records from her cardiologist, the cardio or electrophysiologist who performed the implantation and d/c of it, probably some pacer readouts and of course the hospital records of the surgery.

You should also investigate whether or not the defibrillator had a defective lead. Some leads were defective and could activate w/o cause, resulting in the person in whom the device was implanted to suffer shocks and bodily trauma. In my father's situation, the Medtronic defib lead was defective, and I did agree to have it turned off. But (much to my surprise) his cardiac condition had improved and the defib lead wasn't as necessary as it was when it was inserted when the pacer was changed out.

Unfortunately, the option to remove it was much more complicated, so it was left in but wasn't active. It couldn't accidentally shock him, which could happen with the defective lead left active.

There are a lot of issues with these kinds of pacers with defibs.

If you feel there's grounds for malpractice, you'll need to find a med/mal attorney who will consider the case, order the records for you (expect the cost to be several hundred dollars just to get the records), have them reviewed by a cardiologist or electrophysiologist or other similar expert who will advise whether or not grounds exist for a suit.

Years ago tort reform pushed attorneys in Michigan into the position of having to find a physician who would testify that malpractice had existed. It was a good move, b/c prior to that some aggressive attorneys would "make" a case into a med/mal case, even if it was one.

I am sorry for your loss, especially since your wife was so young. I think it might bring some peace to you to explore whether or not there was malpractice, as the process of an attorney's and medical practitioner's review might provide some insight into what the real situation was, assuming that cardiac arrest was in fact the cause of her death.

Thank you for your answer to my question, They did not have any discussions with regards to different options it was all rushed. We had not had a chance to ask the questions that you have suggested. One thing I have found out though is they did not get a consent form signed allowing them the authority to turn the ICD unit off, also we were not informed that we had the option to reactivate the ICD if my wife's condition did not worsen. I am quite adamant that there are things that were done and should not have been. My wife was on her second unit after the first was due to be changed because of the time it had been in. Which was 7 yrs, the latest one had been in 3yrs, and all the time that she had, had these units in neither had ever had to shock. The consultant had arranged a palliative care package that had been put in place. They had also arranged for certain items to be put in place at home before her discharge. Why go to all this trouble if my wife's condition was at the stage the call end of life. She was so upbeat and looking forward to coming home and was planning what she wanted to do, before she was tragically taken. What else is so upsetting for me is that this year was to be our Silver wedding anniversary. I'm am very angry at the hospital treatment and the consultant's actions. There are a load of questions that need answers to before I can move on, and I am determined to fight on her behalf to get the answers that I need. I thank you for the support you have given.

I really believe that once a person gets to 85, anything after that is a bonus, especially if there are already health conditions present. My own mother died at 92 and made me promise I would not use heroics to keep her alive. She emphatically did not want to be hooked up to a machine and did not want to be warehoused in a nursing home, no longer resembling who she used to be. As hard as it is to lose a parent that is beloved, I believe, as my mother taught me, that we are all only loaned here and we all have an expiration date. Sometimes medical ability extends life when it really should not and does not serve the person well. There is much to be said for having a good quality of live and not merely to extend elderly years into infinity. My mother did not want this and I know I sure as hell would never want to live like that either.

My Dad had a quadruple by pass 22 years ago,as he says it has served him well. He is now aged 90,and 3 years ago he was told a valve wasn't working anymore.I didn't know this until 6 months ago.His legs are leaking terribly,and he now has a red raw rash on one of them.He sometimes gets out of breath. He was told my

Sorry it posted before I was able to finish what I was saying!

He was told by his cardiologist that he is too old for a valve replacement as he wouldn't survive it. I know that 90 is a good age but I'm just not ready to lose him,mi d you I never will be.i have a vacation oozed for June and I don't know whether I should cancel it,my brother has told us to go as if. It's going to happen it will and I could not stop it so I am to go away.

It's hard not knowing how to plan our lives,I'd out everything on hold for him.

A great many people on these pages are a good age and still coping with H.F.I am 73 and was diagnosed a year ago after suffering a TIA two years previously,the cause I was told was Atrial Fibrilation,which I had been trying to get diagnosed for many many years before at a quite young age.not much confidence in the doctors I have seen,I now have a Heart nurse I see and am taking Digoxin Candesartin Bisoprolol,I also get Asthma,I get very breathless several times a day, and cannot do too much excertion of any kind.I find it difficult to live with and can get very depressed,also am most unhappy in the place I live,and get no help or advice from anyone.😪

No diuretic, Jenpen? Is there some reason your doctor wouldn't want you to take one? They are prescribed to help with breathlessness by removing excess fluid from body tissue, but they do (like all drugs) have undesirable side effects, and perhaps in your case it wouldn't be a good idea for you to take them.

Also, I don't see an anti-clotting medication in that list, is that right? But again, there could be good reasons if you're not taking one.

All the same. If you are experiencing symptoms that interfere with your life, speak up to your nurse, don't suffer in silence. Some things can't be avoided, but that's no reason to assume that nothing can be done to help you. Hugs to you.

Jensen time to take matters into your own hands and change the drs you are seeing. Heart nurses can be very good but you need a cardiologist and an advocate to go with you to appointments.
You may not want to be saddled with oxygen but it will improve your breathing and allow more activity. Yes you can drive with oxygen there a small portable tanks or a battery operated concentrated. Ask to have your oxygen level checked. If the level is below 88 without oxygen medicare will pay for it.
Warfarin is only one of the anti coagulants available and the downside is that there are diet restrictions and you need regular blood testing. once a month once you are stabilized. The effects are fully reversible. There are several newer more expensive anticoagulants on the market with no restrictions but they are more expensive and they are more difficult to reverse.
There is procedure called an ablation that may be able to control Afib. It is done by threading a catheter through a blood vessel in the groin and advanced to the heart and offending nerve connection are destroyed. it is usually done with sedation but you can insist on general anesthetic as it can take several hours to complete.If you don't already have supplementary insurance with your Medicare it is advisable because the costs can be astronomical unless you can qualify for medicaid. There is a lot of help out there but it takes the effect to find it.

Jenpen, that sounds very difficult and I hate to hear how unhappy you are! Can anything change in your environment, if the medications are tuned up as well as possible?

I'm 66 and I have chf for the last 15 years. what foods or meds would help me dealing with chf

What does your doctor say? Are you not happy with the advice you are being given?

Heart, your doctor probably could either provide a list of heart healthy foods or refer you to a nutritionist who could counsel you individually. However, heart healthy foods have been a "category" of foods for some time. You can Google that - "heart healthy foods" for general overall guidelines.

With CHF, there's retention of fluid, so you would want to avoid foods that contribute to that - specifically salty foods. Junk foods like potato chips fall into this category, but many frozen dinners are also high in sodium, as are condiments and sauces.

Research the ranges of tolerable sodium levels, check labels on all the foods you buy to determine the sodium levels, and plan accordingly.

You can find heart healthy menus and recipes online as well. I just did a quick Google search and got hits on both heart healthy diets, recipes, and more.

I also got several hits for "CHF Diet."

I'm wondering though if you have chronic CHF b/c of underlying conditions; if so, those would be a factor in the effectiveness of your diet, so this is something I would really raise with your cardiologist. E.g., some of the foods which can contribute to hypertension can affect CHF as well.

One thing you can do is substitute herbs for flavoring in lieu of salt and all those high sodium sauces.

Make it a challenge and it'll be easier if you have to give up high fat and high salty foods you enjoy.