Congestive Heart Failure

Heart failure is a very common condition, affecting more than 5 million Americans. Your cardiologists can help you manage the condition with lifestyle changes and medications, leading to a longer, fuller life.

Our Advanced Heart Failure Program can also help with more serious cases of heart failure, with renowned doctors who specialize in the condition and use the latest surgeries, devices and other treatments. Learn more about our Advanced Heart Failure Program.

What is Congestive Heart Failure?

The heart squeezes blood through the circulatory system and also relaxes to accept blood returning from the body and lungs. 

Any disruption in this squeezing (systolic dysfunction) or relaxing (diastolic dysfunction) can lead to a failure of the heart to pump enough blood for your body or fill with enough blood. This condition is called heart failure, or congestive heart failure (CHF).

Heart failure is different than cardiac arrest, during which the heart actually stops beating. Still, heart failure requires medical attention. Two kinds exist:      

  • Heart failure with preserved ejection fraction (HFpEF): The heart cannot provide sufficient blood even though it squeezes normally.
  • Heart failure with reduced ejection fraction (HFrEF): The heart muscle is weak, so it has difficulty pumping blood to the rest of the body. 

Heart Failure Risk Factors

Certain factors make it more likely than you will develop heart failure:

  • Age: You have a greater risk if you are 65 or older. The heart weakens with age, and many patients have also endured diseases that lead to heart failure.
  • African-Americans: Heart failure is more common in African-Americans, as is the early onset of symptoms.
  • Weight: Too much weight strains the heart and also contributes to heart disease and diabetes, two heart failure causes.
  • Heart attack: A previous heart attack increases your risk.
  • Gender: Men are more likely to experience heart failure than women.

Heart Failure Causes

Most heart failure cases are caused by an underlying medical condition, such as:

Heart Failure Symptoms

Heart failure can produce a range of symptoms, including:

  • Fatigue
  • Shortness of breath
  • Swelling of the legs and feet
  • Swelling of the abdomen
  • Irregular heartbeat
  • Chest pain

Other conditions can cause similar symptoms. Please see one of our cardiologists for a proper diagnosis. Patients with more severe heart failure often feel symptoms even when resting. Learn more about our Advanced Heart Failure Program.

Heart Failure Classification

Functional capacity refers to the way heart failure patients feel when they engage in physical activity. This measure is used to classify heart failure into different stages:

  • Class I: No limits on activity; no shortness of breath, fatigue or chest pain with ordinary physical exertion
  • Class II: Slight limits on activity; mild symptoms when walking or performing other normal physical activity
  • Class III: Substantial limits on activity; shortness of breath and other symptoms occur with less-than-ordinary physical exertion
  • Class IV: Major limits on activity; unable to perform any ordinary physical activity without experiencing symptoms, or symptoms may occur at rest

Heart Failure Diagnosis

Early diagnosis of heart failure is the key to helping patients live longer, more active lives. We offer the latest tools and tests to provide for a prompt and accurate diagnosis. Learn more about our:

Heart Failure Treatment

The goals of heart failure treatment are to relieve symptoms and improve both the quality and length of life. In the earlier stages of the condition, treatment involves:

  • Lifestyle changes: Taking certain steps can help you feel better:
    • Eating a heart-healthy, low-salt diet (our dieticians can help)
    • Limiting the amount of daily fluid intake
    • Losing weight
    • Giving up smoking
    • Exercising
  • Medications: Medications can improve the heart’s function and your ability to live a normal life. Possible medications include:
    • Diuretics (water pills) to reduce fluid buildup
    • ACE inhibitors and ARBs to lower blood pressure
    • Beta blockers to slow your heart rate and lower your blood pressure
    • Aldosterone blockers to help prevent your body from holding onto fluids
    • Hydralazine/isosorbide to relax your blood vessels
  • Implantable cardioverter defibrillator (ICD): ICDs correct irregular heart rhythms, called arrhythmias.
  • Heart surgery: Possible surgeries for related heart problems can include coronary artery bypass graft (CABG) surgery or heart valve surgery.

More severe heart failure may require intervention from our cardiologists or surgeons specializing in advanced heart failure. Learn more about our Advanced Heart Failure Program.

For information or appointments, please call 888-354-3422.

Heart Transplants

In some cases, heart failure progresses to the point where the heart is no longer able to pump an adequate amount of blood, and heart transplantation may prove the best treatment option.

At MedStar’s Advanced Heart Failure Program, our expert heart transplant team offers you comprehensive care and support throughout the entire heart transplant journey. Our program features:

  • Experience: Our center performed the first heart transplant in the region in 1987. We have since performed more than 250 heart transplants.
  • Expert doctors: Our cardiologists are board-certified in heart transplantation. Our surgeons have years of experience performing heart transplants.
  • Multidisciplinary team: Our large team includes many dedicated clinicians and health care workers who have particular expertise in the specialized needs of transplant patients, such as coordinators, infectious disease specialists, pharmacists, social workers, physical therapists, occupational therapists, etc.
  • Quality of life: Our experienced transplant coordinators work with you and your family ever step of the way to help prepare you for a heart transplant. Our goal is to allow you to get back to the kid of life that you want to live, where you can return to work, spend quality time with your family and friends, resume the activities that you enjoy, etc.

Heart Transplant: Steps

Receiving a donor heart to replace your own requires many steps. Your heart transplant journey begins with expert doctors and a multidisciplinary team to support you through each stage of the process. In general, you can expect the process to unfold like this:

Step 1: Pre-Surgery

  • Initial evaluation: To help make sure you will benefit from a heart transplant, we perform a thorough medical and psychosocial evaluation, including blood tests and imaging studies, and we arrange for you to meet with several members of the transplant team.
  • Pre-surgical consultations: Before receiving a heart, you will meet with a transplant coordinator who will educate you about a heart transplant. You also will meet with a social worker to help you identify your social support systems and discuss what it is like to live with a transplanted heart. A financial counselor will meet with you to coordinate your insurance benefits and ensure you have adequate coverage for the special medications needed to live with a transplanted heart.
  • Transplant list: If the evaluation suggests that heart transplantation is a good option for you, your name will be placed on the national waiting list for a suitable donor heart. The wait time to receive a heart can be lengthy. When a suitable heart becomes available, a heart transplant coordinator will notify you and you will be asked to come to the hospital right away.
  • Clinical management: Patients may require a combination of therapies to support them while waiting for a new heart. These may include inotrope medications or LVADs. Some patients wait at home for their transplant, while others may require admission to the hospital. Learn more about left ventricular assist devices (LVADs).


  • Surgery day: The heart transplant surgery requires 4-8 hours. The transplant team will keep your family members informed of your progress.
  • Post-surgery: After surgery, you will wake up in a special cardiac intensive care unit. Our nurses have special training and expertise in caring for heart transplant patients. Our expert cardiac intensivist physicians and their team will closely monitor you and oversee your care in close collaboration with the transplant surgeons and cardiologists.
  • Progressive Care Unit: When you no longer need intensive care, you will be transferred to a specialized unit. During the course of your recovery, you will receive information about your transplant medications from a transplant pharmacist, physical therapy services, nutrition consultation and specialized education from one of the transplant coordinators. Your entire team will help prepare you and your loved ones for life after discharge.

After discharge:

  • Follow-up: We follow all of our heart transplant patients very closely. We will ask you to come in for follow-up visits after you receive your new heart, initially at least once a week. These checkups will be gradually spread out so that by year three you will only need to make annual visits. Testing to accompany these visits may include heart biopsies, echocardiograms and lab tests. Your Transplant Coordinator will help you arrange all of these visits.
  • Living with a donor heart: Life after a heart transplant can be an adjustment. For some it is a very emotional experience. That is why we offer a unique Patient Support Program that can assist you and your family in a number of ways, including an on-call nurse coordinator, patient support groups and referral to therapists if necessary. There is also a pharmacist and registered dietician to help answer any questions you may have at any time about medications and diet.


For information or appointments,
please call 888-354-3422.