Congestive Heart Failure and Life Expectancy

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Congestive heart failure (CHF) is a particular type of heart failure that occurs when blood flow from the heart slows and freshly oxygenated blood returning to the heart continues to flow at the same rate, resulting in swelling (oedema) in the legs and ankles, fluid collection in the lungs (pulmonary oedema), and shortness of breath. Life expectancy for patients with CHF depends on several factors, including medical history, lifestyle and stage of CHF diagnosis.

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Stage A

In 2001, the American Heart Association and the American College of Cardiology established four stages to delineate the range of CHF: the first stage, Stage A, applies to those with medical histories of other conditions, such as heart attack, high blood pressure and heart disease, which automatically place them at higher risk of congestive heart failure. Stage A patients may not exhibit symptoms of CHF. They also stand the greatest chance of preventing the progression of CHF and prolonging their lives by not smoking, restricting or eliminating altogether alcohol consumption, eating a diet low in salt and fat, exercising, and following the treatment regimens as prescribed by their doctor for their other conditions.

Stages B & C

Patients who receive a diagnosis of Stage B or C will have both test results and symptoms that clearly indicate CHF. More specifically, Stage B patients will have an ejection fraction (a measure of the amount of blood pumped out of the left ventricle with each heartbeat) below 40 per cent (55 per cent or higher being normal). Stage C patients will have not only a low ejection fraction but also CHF symptoms, including difficulty breathing, fatigue and reduced physical activity. Because Stage B and C patients are symptomatic, they are more limited in what they can do to help manage the condition themselves; fatigue and shortness of breath will make exercise particularly difficult.

Stage D

Patients who receive a Stage D diagnosis will have severe and advanced symptoms of Stages B and C and will likely undergo hospitalisation. Life expectancy at this stage, as with other diseases and conditions, is bleak, though doctors will still remain wary of assigning an estimated survival time. With late-stage CHF, a doctor's focus will be on providing palliative care.

Treatment and Life Expectancy with CHF

For patients diagnosed with congestive heart failure in Stages B to D, life expectancy remains difficult to determine. In an attempt to treat symptoms and prolong life, doctors may prescribe medications, such as beta blockers, ACE inhibitors and diuretics to help improve heart function and treat symptoms, such as swelling and fluid retention. Surgery, including the insertion of a pacemaker or a transplant, may also be necessary. Patient age also is a factor in determining treatment and estimating life expectancy. Doctors are more likely to recommend standard medical care, over intensive treatment, for frailer, elderly patients.

Expert Insight

The American Heart Association's website provides basic information that can be useful to patients who want to better understand their CHF prognosis. However, for further expert insight into life expectancy with CHF, patients may wish to consult current articles in specialised journals, such as Clinical Research in Cardiology; Gerontology; Journal of the American Medical Association; and the Journal of Cardiopulmonary Rehabilitation and Prevention.

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