All you need to know about the different stages of heart failure to live longer with the condition.
A congestive heart failure diagnosis does not mean your heart is no longer working, what this means is that your heart is unable to pump enough blood throughout your body.
“Heart failure is a scary phrase,” says Maria Mountis, DO, a cardiologist at the Cleveland Clinic in Ohio. The condition can get worse if the proper steps aren’t taken to slow or stop the problem, but it does not mean your life has ended.
Congestive heart failure, primarily known as “heart failure,” happens when there’s a reduction in blood flow throughout the body because blood flow from the heart slows down. That means blood going back to the heart through the veins backs up, causing congestion in the body’s tissues. That congestion may cause swelling in the ankles, legs, or stomach, as well as fluid in the lungs that causes trouble breathing.
Life expectancy with congestive heart failure differs depending on the severity of the condition, genetics, age, and other factors. According to the Centers for Disease Control and Prevention (CDC), around one-half of all people diagnosed with congestive heart failure will survive beyond five years. Only around 10 percent of people diagnosed with the condition survive at least 10 years, according to a study published in August 2013 in the journal Circulation Research.
Interestingly, a study published in January 2017 by the University of Oxford in the journal Family Practice saw that survival rates for people in the United Kingdom suffering from heart failure have not improved since 1988, in contrast to cancer survival rates in the country, which have doubled in the last 40 years.
Although there is no cure for heart failure, it’s important to curb the condition with meds and lifestyle changes to prevent it from worsening.
To improve life expectancy while living with congestive heart failure, you should know the different stages of the disease and what to do after diagnosis.
Stages of Congestive Heart Failure
Regardless of the “stage” of heart failure, it is a chronic, long-term heart health condition that can worsen over time. The sooner you begin making lifestyle changes to treat the condition, the better chance you have at improving your outcome.
This is “pre–heart failure.” It means you’re at risk of developing heart failure because you or someone in your family has diabetes, high blood pressure, early coronary artery disease, or there’s a family history of cardiomyopathy, a disease of the heart muscle.
“These are the people we want to prevent from getting heart failure,” Dr. Mountis says. Treatment may include changing your diet, watching salt intake, reducing alcohol, increasing exercise, and possibly taking blood pressure medicines or other medication.
This diagnosis is also early in the progression of heart failure. It means you already have some changes to the heart that could possibly lead to heart failure. For example, your heart health might also be compromised because of blood pressure, but you don’t have classic symptoms of heart failure — yet. Patients in this stage typically may have had a prior heart attack or have some form of heart valve disease, Mountis says. Treatments could include those from stage A, as well as possible surgery or intervention as treatment for coronary artery blockage, heart attack, or valve disease.
Persons at this stage have been diagnosed with heart failure, and currently have or have previously had signs and symptoms of the condition, including shortness of breath, inability to exercise, swelling of their legs, or waking up short of breath after lying down.
“These are the people who, if you can get them on good regimens of medication, they can have a good, long quality of life. We know medication works on this group of people,” Mountis says. Cardiac rehabilitation can also help people with stage C heart failure recover everyday functions and help them live longer lives and reduce symptoms.
This is an advanced stage of heart failure, and these patients are the sickest, Mountis says. “These are the people who, when I see them, we need to talk about a heart transplant, mechanical heart pump, or end-of-life care if we have nothing else to offer,” she says. Patients with this stage of heart failure should see a specialist to help determine the best course of treatment and which options are still on the table. “It’s critical that they see a specialist within a few days of someone telling them they have stage D heart failure,” Mountis says.
Seeking out a specialist may present more treatment options for individuals diagnosed with any stage of heart failure, Mountis adds. She recommends bringing a list of your questions to the appointment, as well as a list of your medication, and a supportive family member. Oftentimes a family member may have noticed symptoms of fatigue or shortness of breath that the patient forgot about, Mountis says.
Can You Get Well After a Diagnosis of Heart Failure?
Heart failure is a chronic, progressive condition, which means it gets worse with time. But even though it doesn’t necessarily get better, managing heart failure the right way can help reduce symptoms and slow down the progression of the condition.
“I try to get patients to understand that this is not a death sentence,” Mountis says.
- Coronary heart disease or heart attack
- High blood pressure
- Faulty heart valves
- Damage to the heart muscle (cardiomyopathy)
- Inflammation of the heart muscle (myocarditis)
- Congenital heart defects
- Abnormal heart rhythms (heart arrhythmias)
- Other chronic disease, like diabetes, HIV, or thyroid disease
Depending on the stage and severity of condition, some individuals may need more aggressive treatment, Mountis adds. “But it is very possible to live a very good life with a diagnosis of heart failure.”
Living With Congestive Heart Failure: What to Expect
Yes, there are several lifestyle changes you should take into account if you’ve been diagnosed with congestive heart failure. But remember your diagnosis doesn’t mean you should necessarily stop doing things you love.
“You are supposed to be exercising — walking, biking, swimming, or doing light weight exercises,” says Mountis. The American Heart Association recommends at least 30 minutes of moderate intensity aerobic activity at least five days a week for optimal heart health. Avoid exercises that make you feel breathless, and make sure to talk to your doctor before starting a new exercise routine.
Your healthcare provider will also likely suggest dietary changes that can help reduce the swelling associated with congestive heart failure and slow the progression of the condition. Those changes may include following a low- or reduced-salt diet, or reducing how much fluid you drink to lessen the body’s water content.
Other lifestyle changes that can slow the progression of heart failure include:
- Quitting smoking
- Avoiding alcohol
- Maintaining a healthy weight
- Getting adequate sleep and rest
- Controlling high blood pressure
- Reducing stress
For some persons, doctors may prescribe medication, like angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers, beta blockers, and aldosterone blockers. Other drugs that may be prescribed to reduce symptoms include diuretics, and vasodilator, digitalis, and anti-arrhythmia drugs.
If being on medication leads to an improvement of symptoms and your health, your doctor might advise you to stay on them for good, Mountis says, as they may help prolong your life.