Here’s what you should know about the different heart failure stages and the right lifestyle changes to live longer with the condition.
A congestive heart failure diagnosis doesn’t mean that your heart doesn’t work anymore. It means that your heart isn’t pumping blood as well as it should, and could get worse if you don’t take steps to slow or halt the problem.
“Heart failure is a scary term,” says Maria Mountis, DO, a staff cardiologist in the Department of Cardiovascular Medicine at Cleveland Clinic in Ohio. That’s because it’s urgent that you address the problem, but it doesn’t mean your life is over.
Congestive heart failure, sometimes just known as “heart failure,” happens when there’s a reduction in blood flow throughout the body because blood flow out of the heart has slowed down. That means blood returning to the heart through the veins backs up, causing congestion in the body’s tissues. That congestion may cause swelling in their ankles, legs, or stomach, as well as fluid in the lungs that causes trouble breathing.
Congestive heart failure life expectancy varies depending on the severity of heart failure, age, and other factors. Estimates suggest 50 percent of individuals diagnosed with heart failure survive at least five years, and 10 percent survive at least 10 years, according to research published in an August 2013 issue of the journal Circulation Research. It’s also important to note that over time survival rates have improved thanks to better heart failure treatments.
And that’s why even though heart failure has no cure, managing the condition with medication and lifestyle changes can greatly impact someone’s prognosis. Here’s what you should know about the different stages of heart failure, what to expect after a diagnosis, and what you can do to live a long, active life if you have the condition:
The Stages of Congestive Heart Failure
Regardless of the “stage” of heart failure, it is a chronic, long-term heart health condition that can get worse over time. But the sooner you begin making lifestyle changes to treat the condition, the better outcomes you can expect.
Stage A This is “pre–heart failure.” It means you’re at risk of more severe heart failure because you or someone in your family has diabetes, high blood pressure, early coronary artery disease, or 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.
Stage B This diagnosis is also early in the progression of heart failure. It means you already have some changes to the heart that could lead to heart failure. Your heart health also might be compromised because of blood pressure, but you don’t have classic symptoms of heart failure, yet. These people typically may have had a prior heart attack or they have some 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.
Stage C Individuals 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 where 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 help people with stage C heart failure recover everyday functions and help them live longer lives and reduce symptoms.
Stage D This is an advanced stage of heart failure and these patients are the sickest, Mountis says. “These are the people that 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 heart failure 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 medications 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 Better After a Diagnosis of Heart Failure?
Heart failure is a chronic, progressive condition, which means it gets worse with time and you cannot move back to a less advanced stage. But even though the condition doesn’t necessarily get better, managing heart failure the right way can help reduce symptoms and slow down the condition.
“I try to get patients to understand that this is not a death sentence,” Mountis says.
More than five million people in the country have a diagnosis of heart failure. Several conditions can weaken the heart enough to lead to heart failure, including:
- 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 heart failure, 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. There are certain activities you should avoid, like shoveling snow out in the cold, running out in very hot, humid weather, or doing heavy weight lifting. But for most people, some type of regular physical activity is still good for your heart and will help slow the progression of the condition. Check with your doctor about what’s best for you.
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 individuals, 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.