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Stages of Congestive Heart Failure

By Traci Joy ; Updated August 14, 2017

Congestive heart failure is a serious physical condition, but it can be managed and lived with for quite some time. The American Heart Association defines CHF as occurring when the heart no longer has the ability to pump an adequate amount of blood throughout the body. Several conditions can lead to CHF, such as disease of the heart muscle, high blood pressure, heart defects, infection of the heart muscle or heart disease. The congestion takes place when the blood backs up in the veins when it's trying to get back to the heart. This can cause swelling and inflammation in the body, although it's most common in the lower extremities, such as the ankles. Congestion that occurs within the lungs can make it difficult for the patient to breathe. In 2001, the American College of Cardiology and the American Heart Association developed a "stage" classification for CHF patients. Unlike the stages of cancer, which are numbered, CHF stages are lettered.

Stage A

Stage A patients do not yet have CHF, but they have risk factors for developing it. Although there is not yet any disorder with the heart's structure, the underlying factors of high blood pressure, diabetes, heart disease or drug and alcohol abuse are present.

Stage B

In stage B, there is physical evidence of a structural disorder of the heart. Examples of a structural disorder are diseases of the heart valve, enlargement of the heart or one of the chambers, or fibrous tissue. Even though the structural disorders may be present, the patient does not show symptoms of CHF--fatigue, inflammation or insomnia.

Stage C

In stage C, the patient has evidence of structural disorders in the heart and is experiencing one, or several, heart disease symptoms. Shortness of breath, difficulty sleeping, swelling and edema all accompany physical changes in the heart. According to the American College of Cardiology, most patients who have been diagnosed with CHF are in this stage.

Stage D

Stage D is the most serious stage of congestive heart failure. In this stage, patients have difficulty with everyday tasks. They may need and are considered for specialized treatments--such as the removal of fluid from the lungs or other parts of the body, a heart transplant, or even hospice care as the heart nears failure.

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