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Congestive Heart Failure

Your heart is an essential organ, responsible for keeping your blood pumping throughout your body. This critical function not only pumps blood to different parts of your body, but that blood carries the oxygen vital to keeping your tissues healthy and functioning properly. So what happens when the heart stops working the way it should?

Digital Heart Image

What is Congestive Heart Failure?

Congestive heart failure (CHF) is what happens when your heart fails to pump blood the way that it should. When the heart’s pumping becomes ineffective, the blood can back up and create “congestion” in your body. This can work in different ways.[1] 

  • Left-sided heart failure: If the left side of the heart is not working as well, fluid may back up into the lungs, creating something called pulmonary edema. This can cause difficulty breathing, especially when lying down to sleep. 
  • Right-sided heart failure: If the right side of the heart is not working correctly, the blood trying to enter the heart backs up into the abdomen and the lower body, so you will see swelling in the legs and feet. 

Regardless of the type of CHF, congestive heart failure means your body is unable to pump blood properly and meet your body’s needs. While CHF can affect one or both sides of your heart, it does not mean your heart is about to stop working. However, CHF can have a variety of consequences for the rest of your body.[2]

Symptoms of Congestive Heart Failure

Congestive heart failure can impact your body in several ways. Depending on the type of CHF you have, you can experience any of the following symptoms:[2]

  • Edema: A buildup of fluid in the feet, ankles and legs
  • Fatigue 
  • Limited endurance
  • Shortness of breath
  • Weight gain

Shortness of breath, weight gain and edema all occur because fluid can build up throughout your body as a result of the insufficient pumping of blood. Along with shortness of breath, some people may experience a cough or additional difficulty breathing while lying down flat. This is typically due to the chest congestion from pulmonary edema. Pulmonary edema is caused by blood backing up into the veins that take blood through the lungs, which causes fluid to be pushed into the alveoli, or air sacs, in the lungs.[3] 

Fluid may also accumulate in the liver and affect the kidney’s ability to properly dispose of sodium and water, which is what causes edema.[4][5] Both of these can cause you to feel nauseated and bloated. You may or may not feel chest pain. CHF cannot be cured, but it can often be controlled and the symptoms can be treated

Causes of Congestive Heart Failure

Congestive Heart Failure (CHF) can have a number of different causes. You can be born with a condition that leads to CHF, or you may develop a condition as a result of illness, substances or heart damage. Some causes of CHF are:

  • Arrhythmia: Abnormalities in heart rhythm
  • Cardiomyopathy: Damage to the heart muscle
  • Congenital heart defects
  • Coronary artery disease
  • Heart valve disorders
  • High blood pressure: Also called hypertension
  • Long-term alcohol abuse
  • Thyroid disorders
  • Viral infections causing myocarditis: Myocarditis is inflammation of the heart muscle

One of the causes listed above is damage to the heart. So, how does the heart become damaged? Longstanding coronary artery disease, or CAD, is one of the key factors. CAD occurs when the blood vessels supplying the heart with blood and oxygen are narrowed, often from a buildup of cholesterol. Additionally, the heart’s valves can be damaged either from infection or a birth defect, which can result in the valves not fully opening or closing. 

Another common cause of CHF is long-standing high blood pressure, or hypertension, which causes the heart to strain and work harder. Someone who is diabetic, or who has kidney or thyroid disease is at a higher risk of experiencing this stress on the heart. Any combination of these conditions can result in CHF, but what can you do to treat this condition?

Treatment of Congestive Heart Failure

When it comes to treating CHF, the first step is to ascertain the cause of your congestive heart failure. Because of this, your physician will be one of your primary guides here, as there may need to be specific testing done to determine what type of heart failure you have, and to what degree. 

Often, your doctor will recommend a combination of treatments, which will most likely include a combination of lifestyle changes and medications. These lifestyle changes can include:

  • Doing aerobic exercise 
  • Lowering salt intake
  • Limiting fluid intake
  • Monitoring your weight every day

Because the sodium from salt increases fluid retention in your tissues, your doctor may ask you to watch your intake of sodium. This requires careful monitoring of anything you eat or drink, and paying close attention to the labels on food and beverages. You may also be asked to limit fluid intake to help ease the shortness of breath caused by fluid retention. Alcohol consumption will likely be severely restricted or not allowed at all.[4] 

In addition to these lifestyle changes, your doctor may prescribe a combination of medications, including:

  • ACE inhibitors (angiotensin converting enzyme): These dilate your blood vessels to improve blood flow, which helps keep your heart from having to work too hard[5] 
  • ARBs (angiotensin receptor blockers): These help expand blood vessels to lower your blood pressure to help keep your heart from having to work too hard and can be used for patients unable to tolerate ACE inhibitors[6] 
  • Beta blockers: These can control the heart rate, increase cardiac output and ejection fraction (which is how well your ventricles pump blood with each heartbeat)4 
  • Diuretic medication: These decrease fluid retention in the body
  • Medical oxygen

The primary purpose of these medications are to lower blood pressure, improve cardiac output and reduce fluid retention. Your doctor may also recommend medication for cholesterol or any other cause of your CHF, as well as oxygen therapy for heart failure

All treatments and medications should be closely monitored by your doctor. With the right treatment, you can reduce the discomfort and negative effects of CHF on your body.

Risk Factors for Congestive Heart Failure

If there is a history of congestive heart failure in your family, or if any of the following risk factors apply to you, discuss ways of reducing your risk with your doctor. Making some lifestyle changes now could make all the difference. The risk factors for CHF are:[4] 

  • Diabetes 
  • Family history of CHF
  • High blood pressure
  • High cholesterol
  • Smoking
  • Thyroid problems

You can reduce your risks by quitting smoking right away, and incorporating a healthy, balanced diet and regular moderate exercise. These can improve blood pressure and cholesterol, and can even improve diabetes. You may also need medication to help control any of these conditions, or any thyroid problems. It may take a little extra work, but the payback may be huge – a happy, healthy heart! 

Home Oxygen for Heart Failure: Do You Need Oxygen Therapy?

So, do you need oxygen therapy for heart failure? Not always, but depending on the severity of your congestive heart failure, you may require oxygen therapy for heart failure. If your heart is struggling to pump enough blood to meet your body’s oxygen needs, you may end up with low oxygen levels. If that is the case, your doctor may recommend home oxygen for heart failure to improve your oxygen levels. 

Mostly commonly, CHF patients will need oxygen therapy at night. Much of the time, CHF patients have good oxygen levels during exercise, but many patients experience low oxygen levels at night, also called nocturnal hypoxemia.[7][8] Because resting and ambulatory oxygen levels may not indicate that you are experiencing nocturnal hypoxemia, a pulse oximetry study may be required while you sleep to diagnose this condition. If you are diagnosed with nocturnal hypoxemia, your doctor may recommend low flow nasal oxygen therapy for heart failure to help treat your low oxygen levels.8 

If your doctor prescribes home oxygen for heart failure, an oxygen concentrator is likely an excellent choice for you. Since many CHF patients use oxygen therapy for heart failure at night, an oxygen concentrator can work especially well. An oxygen concentrator uses the surrounding air to purify and compress medical oxygen for you, so it can provide an endless supply of oxygen to you as long as it has power. Additionally, many modern oxygen concentrators, like those made by Inogen, incorporate technology that makes using an oxygen concentrator a safer choice at night. 

Inogen Portable Oxygen Concentrators are ideal for home oxygen for heart failure at night because they feature Intelligent Delivery Technology®. This technology ensures that oxygen therapy is delivered efficiently and effectively in all modes of use, including sleep. Your respiratory rate changes when you sleep, and Inogen One units are able to detect and respond to changes in your respiration. This allows the Inogen One to deliver your oxygen at the very start of your inhalation, and increase the bolus size delivered, so that you get the right amount of oxygen. 

Our Inogen One units have been clinically tested and validated to be used 24/7, but because they are able to compensate for the amount of inhaled oxygen while you sleep, they can be especially effective for treating nocturnal hypoxemia. They are small, quiet and easy to use, making them ideal for use no matter when you require home oxygen for heart failure

If you have congestive heart failure and require oxygen therapy for heart failure, find out how an Inogen One Portable Oxygen Concentrator can help you improve your oxygen levels. As part of a comprehensive treatment plan, home oxygen for heart failure can help improve the way you feel. 

Inogen was founded on the belief that oxygen therapy should improve your life. With the Inogen One by your side, you can enjoy improved quality of life, even with CHF. Contact one of our oxygen specialists to find out more today.

Oxygen. Anytime. Anywhere. 

Sources:

[1] “Heart Failure.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 May 2020, www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142. 

[2] “Congestive Heart Failure | Heart Failure | CHF.” MedlinePlus, U.S. National Library of Medicine, 18 Feb. 2021, medlineplus.gov/heartfailure.html. 

[3] “Pulmonary Edema: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 26 Feb. 2021, medlineplus.gov/ency/article/000140.htm. 

[4] Kulick, Daniel Lee, and Benjamin Wedro. “12 Congestive Heart Failure Symptoms, Treatment, Causes & Stages.” MedicineNet, MedicineNet, 19 Feb. 2021, www.medicinenet.com/congestive_heart_failure_chf_overview/article.htm. 

[5] Beckerman, James. “Treating Heart Failure with ACE Inhibitors.” WebMD, WebMD, 16 Oct. 2019, www.webmd.com/heart-disease/heart-failure/heart-failure-ace-inhibitors#1. 

[6] Beckerman, James. “Heart Failure: Treatment with Angiotensin II Receptor Blockers.” WebMD, WebMD, 24 Aug. 2020, www.webmd.com/heart-disease/heart-failure/heart-failure-angiotensin-ii. 

[7] Clark, Andrew L. “Does Home Oxygen Therapy (HOT) in Addition to Standard Care Reduce Disease Severity and Improve Symptoms in People with Chronic Heart Failure? A Randomised Trial of Home Oxygen Therapy for Patients with Chronic Heart Failure.” NCBI, U.S. National Library of Medicine, Accessed 30 Mar. 2021, www.ncbi.nlm.nih.gov/books/NBK316461/. 

[8]  “Oxygen Therapy in Stable CHF Patients with Nocturnal Hypoxemia.” RT, Medqor, 28 Jan. 2014, rtmagazine.com/department-management/clinical/oxygen-therapy-in-stable-chf-patients-with-nocturnal-hypoxemia/. 

Additional Sources: 

Beckerman, James. “Oxygen Therapy Treatment for Heart Failure: Purpose, Procedure, Side-Effects.” WebMD, WebMD, 6 May 2019, www.webmd.com/heart-disease/heart-failure/what-is-oxygen-therapy-for-heart-failure. 

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