CHF Study Guide

CHF- Congestive Heart Failure

Thinking About CHF

People with advanced and end stage congestive heart failure are tired.  They’re discouraged.  They’re unmotivated.  Even though they could very well be dying.

“Why the heck is that?” you’re probably wondering if you’re a caregiver.  Why won’t they take their pills?  Why do they keep eating salty foods?  Why don’t they ever want to change their clothes or take a bath?

Well, for one reason — They’re not you! If it was you, you’d do all those things.  You’d take care of yourself!  If you couldn’t beat this thing, you’d die trying (So to speak).


But here’s the thing. It isn’t you who has congestive heart failure. It isn’t you who had a heart attack that changed everything in your life for the worse.

Or, just as likely, it isn’t you who has been eating unhealthy food (and lots of it) for the past 30 years), smoking cigarettes for just as long, drinking too much (and maybe doing some other things we don’t need to mention here).

Who can sit in front of a TV set for 18 hours a day? Who knows? But one thing you do know is that person is frustrating. They might even make you mad.  They can be hard to love. They can be hard to care about.  But even if they are, you still do care about them.  You still take care of them.  Thank you.

If the heart is the at the center of a human life, congestive heart failure is a disease that can take the life out of you.
CHF wrecks your heart.
The heart is pretty much designed to do one thing: Beat. With each beat, the heart pumps blood into your blood vessels, and around your body, carrying important nutrients, infection-fighting white blood cells and, most importantly, the oxygen every single cell and organ in your body needs to keep it working at all. (Without that oxygen, you can feel things go downhill immediately and, in just a few minutes, you’ll be dead.)
But CHF makes your heart weak: Those heartbeats are weak. The pumping is weak. And all that stuff that used to make it around your body gets to where it’s supposed to be late and with less energy.
And that pretty much sums up a person with advanced or end stage heart failure—Tired. Without energy. And out of breath a lot of the time, because their bodies are out of oxygen too.

Caregiving for someone with CHF can be frustrating and discouraging.  Many people with congestive heart failure don’t seem to care about themselves.  Not taking care of yourself is one of the main ways you get congestive heart failure in the first place.

How many family caregivers and home health workers have wondered, “If he doesn’t care about himself, why should I?” How many people have wondered, ‘Why am I spending so much time and energy on someone who doesn’t even seem to care whether they live or die?’

Here’s why -- They may not show it but, if you’re a caregiver, there is one thing heart failure patients do care about-- how much you care about them. If you’re a caregiver, you’ll probably understand this statement. You don’t get credit for all you do. But here’s the thing. It doesn’t mean you didn’t do it.

But that extra “blood volume” causes problems—it means that there’s extra blood fitting into an amount of blood vessel space that was meant for a regular amount of blood volume—and that means high blood pressure (AKA hypertension).
It also means that your heart has to strain like crazy to pump blood into those high pressure blood vessels. The blood is moving, but it’s wedged in there. Because it’s crammed in there, it’s hard for the heart to pump blood into. That means heart strain and damage.

Kind of like lifting weights… pumping iron… isn’t it.

Just like weight lifters these hearts get over-muscled. And here’s the problem—they not only build muscles on their outside, but also on the inside—and that means that these hearts can’t fit as much blood as a normal heart.

So they only hold about 1/8 of a cup (.75 shots) (or

Here’s the part that takes some thinking to understand. There are two kinds of heart failure:
Heart failure with preserved ejection fraction, and
Heart failure without preserved ejection fraction

Here we’re going to discuss heart failure with preserved ejection fraction.
So we’re not even going to think about ejection fraction—Because these hearts don’t have a problem with ejection fraction. (If you want to learn about ejection fraction look here: CHF without preserved ejection fraction)

Our blood basically travels around our bodies in a circle—They call it circulation, right? That means the heart pumps the blood out, the blood travels around the body, and then it comes back to the heart to be pumped again.

The blood travels through our blood vessels, all around the body, delivering important stuff, like infection-fighting white blood cells, vitamins we get from food and, most importantly, oxygen that we get from the air we breathe. That oxygen is used to make everything . CHF hearts pump blood weakly. Each pump of blood has less blood in it than it should, and has less force behind it than it should.

There are actually two kinds of congestive health failure. CHF without preserved ejection fraction and CHF with preserved ejection fraction.

The heart is a muscle that pumps blood. CHF without preserved ejection fraction hearts are flabby and swollen. And, no surprise, like any flabby, swollen muscle, the CHF without preserved ejection fraction heart is like any flabby, swollen heart—weak.

These flabby, swollen hearts got that way either because of a heart attack, or because high blood pressure, that jammed more blood into blood vessels that was supposed to fit in them, over-worked, strained and stretched the heart until it xx