Left-Sided Congestive Heart Failure (CHF)

View of heart showing right and left atrium and right and left ventricle. The left ventricle is enlarged.

The heart is a large muscle that pumps blood throughout the body. Blood carries oxygen to all the organs including the brain, plus the muscles and skin. After the body takes the oxygen out of the blood, the blood returns to the heart. The right side of the heart collects that blood. It pumps the blood to the lungs to get fresh oxygen. This oxygen-rich blood from the lungs then returns to the left side of the heart. There it is pumped back out to the brain and rest of the body, starting the process all over. 

Heart failure occurs when the heart muscle does not function normally, leading to fluid retention and reduced blood flow. This can be caused by heart muscle weakness or stiffness, or a heart valve problem.

When the left side of the heart is failing, it can’t handle the blood it is getting from the lungs. Pressure then builds up in the veins of the lungs, causing fluid to leak into the lung tissues. This may be referred to as congestive heart failure. This causes you to feel short of breath, weak, or dizzy. These symptoms are often worse with exertion, such as climbing stairs or walking up hills. Lying flat is uncomfortable and can make your breathing worse. This may make sleeping difficult and force you to use extra pillows to elevate your upper body to help you sleep well. You may also feel weak or tired and have less energy during exertion.

Causes of heart failure include:

  • Coronary artery disease

  • Heart attack in the past (also known as acute myocardial infarction, or AMI)

  • High blood pressure

  • Damaged heart valve

  • Diabetes

  • Obesity

  • Cigarette smoking

  • Alcohol abuse

Treatment

Heart failure is usually a chronic condition. The purpose of medical treatment is to improve the pumping action of the heart, and remove excess water and fluids from the body. A number of medicines can help reach this goal, improve symptoms and keep the heart from becoming weaker. In some cases of severe heart failure, a mechanical device will be placed in the heart to help the heart pump. Another major goal is to better treat the causes of heart failure, such as diabetes, high blood pressure, and your lifestyle.

Home care

  • Check your weight every day. A sudden increase in weight gain could mean worsening heart failure.

    • Use the same scale every day.

    • Weigh yourself at the same time every day.

    • Make sure the scale is on the floor, not on a rug.

    • Keep a record of your weight every day, so your healthcare provider can see it. If you are not given a log sheet for this, keep a separate journal for this purpose. 

  • Cut back on how much salt (sodium) you eat:

    • Your provider will tell you how much salt to have daily, usually 2,000 mg or less.

    • Limit high-salt foods. These include olives, pickles, smoked meats, processed foods, and salted potato chips.

    • Don't add salt to your food at the table. Use only small amounts of salt when cooking.

    • Don't binge on salt-heavy meals.

  • Follow your healthcare provider's recommendations about how much fluid you should have.

  • Stop smoking.

  • Cut back on the amount of alcohol you drink.

  • Lose weight if you are overweight. The excess weight adds a lot of stress on the workload of the heart.

  • Stay active. Talk to your provider about an exercise program that is safe for your heart.

  • Keep your feet elevated to reduce swelling. Ask your provider about support hose as a preventive treatment for daytime leg swelling.

  • Follow your healthcare provider's instructions closely.

Besides taking your medicine as instructed, an important part of treatment includes lifestyle changes. These include diet, physical activity, stopping smoking, and weight control.

Improve your diet. Often in the hospital, people are given a heart healthy diet. This includes more fresh foods, lower saturated fat, less processed foods, and lower salt.

Follow-up care

Follow up with your healthcare provider, or as advised. Make sure to keep any appointments that were made for you. This can help better control heart failure.

If an X-ray was done, you will be told of any new findings that may affect your care.

Call 911

Call 911 if you:

  • Become severely short of breath

  • Feel lightheaded, or feel like you might pass out or faint

  • Have chest pain or discomfort that is different than usual, the medicines your provider told you to use for this don't help, or the pain lasts longer than 10 to 15 minutes

  • Develop a rapid heart rate suddenly

When to seek medical advice

Call your healthcare provider right away if you have any of these signs of worsening heart failure:

  • Sudden weight gain. This means more than 2 pounds in 1 day, or 5 pounds in 1 week, or whatever weight gain you were told to report by your provider

  • Trouble breathing not related to being active

  • New or increased swelling of your legs or ankles

  • Swelling or pain in your abdomen

  • Breathing trouble at night, waking up short of breath or needing more pillows to elevate your upper body to help you breathe

  • Frequent coughing that doesn’t go away

  • Feeling much more tired than usual

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