Congestive heart failure (CHF) means the heart is failing to pump blood properly and can’t meet the requirements of the body. Different heart diseases or disorders can cause this condition.

The degree of heart failure is often described using a system developed by the New York Heart Association. It has four classes, which define the degree of failure according to its effect on a person’s life. The higher the class number the worse the CHF, and the underlying heart disease. As someone’s disease worsens he or she will progress through these classes:

• Class 1 – No limitation in physical activity. Ordinary physical activity produces no symptoms.
• Class 2 – Slight limitation in physical activity. No symptoms at rest. Symptoms possible with ordinary physical activity.
• Class 3 – More severe limitations in physical activity. Usually comfortable at rest. Symptoms with unusual physical activity.
• Class 4 – Inability to carry on any physical activity without producing symptoms. Symptoms possible at rest.

It’s hard to predict how CHF will progress. It depends on the underlying disease. Some cardiac diseases produce more symptoms and more rapid decline than others. The following symptoms, however, are a good indicator of severity of the condition and often become worse as the disease progresses:

• fatigue;
• dyspnea – shortness of breath;
• edema – swelling in the limbs and other places in the body;
• increased heart rate;
• nighttime urination;
• chest pain;
• skin changes – cool and sometimes greyish skin.

Several tests are available to determine the degree of heart damage, and assess a person’s physical condition and capacities. Medications and other therapies can control symptoms. When the symptoms become severe, they can be treated in hospital. As someone’s CHF becomes worse, the person usually is admitted to hospital more often and for longer periods at a time.