What Is Congestive Heart Failure?

January 13, 2026

Congestive heart failure, or CHF, happens when your heart isn’t able to keep up with your body’s needs. This doesn’t mean your heart has stopped working - it just needs some extra support. When the heart is unable to move blood forward, blood and fluid (congestion) can build up in the lungs, legs, or belly, making it harder to breathe or stay active.

Why Does Congestive Heart Failure Happen?

When the heart isn't pumping efficiently, the body senses "low flow" and thinks you are dehydrated, even if you are not. This causes hormones to be released that tell the body to hold onto even more water and salt. This can lead to quick fluid retention and weight gain. These hormones can also cause long-term damage to the heart muscle. Certain heart failure medications help block these hormones, which is why medications are used to help manage heart failure.

Common Signs and Symptoms of Congestive Heart Disease

Heart failure can start slowly, so it’s easy to miss the signs. You may notice:

• Feeling short of breath when moving or lying down

• Swelling in your feet, ankles, or stomach

• Tiredness or weakness

• Coughing or wheezing

• Sudden weight gain from fluid buildup

If you notice these symptoms, call your doctor. The sooner heart failure is treated, the better you’ll feel.

What Causes Heart Failure?

There a lot of things can weaken the heart over time, such as:

• High blood pressure

• History of heart attack or heart disease

• Diabetes

• Smoking

• Too much salt in your diet

• Lack of exercise

• Drinking alcohol excessively or using illicit substances

• Uncontrolled high heart rate

• Obesity

• Abnormal heart rhythms, such as atrial fibrillation

• Connective tissue disorders

• Thyroid disorders

• Kidney disease

• Chronic stress

• Pregnancy

• Anemia

• Valvular heart disease

• Iron imbalance

• Certain autoimmune disorders

• Some chemotherapy medications

• Certain viral conditions, leading to an inflamed heart muscle (myocarditis)

• Sarcoidosis

• Amyloidosis

• Excessive pacing from a pacemaker

Your doctor can run tests to find the cause and create a plan that’s right for you.

Living Well with Heart Failure

Many people live long, active lives with heart failure. Taking your medicines, eating less salt, staying active, and tracking your weight daily can make a big difference. Presbyterian Heart and Vascular Care’s cardiology and heart failure care teams are here to help you take control of your heart health.