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For this project, I will be focusing on Congestive heart failure (CHF) and its relation to the course objective “Explain the structure and function of the heart” from unit eleven. It will focus on the symptoms, causes, treatment, and types of CHF.
Congestive heart failure is a major contributor to cardiovascular disease and mortality, with about 6.7 million U.S. adults aged 20 and older currently affected. CHF can be defined as a condition caused by structural or functional heart abnormalities that impairs its ability to effectively pump blood and function properly (Golla, Hajouli, & Ludhwani, 2024). Individuals with congestive heart failure experience symptoms such as shortness of breath, nausea, rapid weight gain due to fluid buildup, chest pain, fatigue, swelling in the legs, ankles and feet, wheezing, and a rapid/irregular heartbeat (Mayo Clinic, n.d.).
Patients with CHF are often classified based on their ejection fraction (EF), which is the amount of blood the left side of the heart pumps out with each contraction. The two key types are heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) (Shams, Malik, & Chhabra, 2025). HFrEF, also known as systolic dysfunction, occurs when the heart is pumping less than or equal to 40% EF. As a result, the left ventricle is unable to contract normally and and the heart can’t pump with enough force to push enough blood into circulation (American Heart Association, n.d.). Some conditions that lead to HFrEF are coronary artery disease, arterial hypertension, valvular heart disease, arrhythmias, inflammatory diseases, and idiopathic cardiomyopathy (Schwinger, 2021). These conditions cause significant structural damage to the heart, resulting in the death of heart muscle cells (cardiomyocytes). This reduces the number of healthy, functioning muscle cells, leading the remaining ones to stretch and elongate through a process called eccentric remodeling (Schwinger, 2021). As the condition progresses, the ventricles expand (dilate) and the heart walls become thinner (Schwinger, 2021). This causes the heart muscle to weaken and dilate, impairing its ability to contract properly, which reduces the heart’s efficiency in pumping blood and leads to decreased stroke volume and cardiac output. (Shams, Malik, & Chhabra, 2025).
In contrast, HFpEF, often referred to as diastolic dysfunction, occurs when the heart is pumping greater than 50%(Shams, Malik, & Chhabra, 2025). This results in the left ventricle losing its ability to relax properly, causing inadequate blood filling during the resting phase between heartbeats (American Heart Association, n.d.). Diastolic dysfunction can be triggered by pre-existing conditions like arterial hypertension, valvular heart disease (which increases pressure load), diabetes mellitus, hypertrophic cardiomyopathy, and restrictive cardiomyopathy (Schwinger, 2021). The pre-existing conditions cause structural changes, impairing the heart’s ability to relax and fill properly during diastole (Schwinger, 2021). As pressure and workload of the left ventricle increases over time, the heart muscle thickens (hypertrophy), which makes the ventricle stiff and loses its elasticity. This prevents the left ventricle from filling with an adequate amount of blood, resulting in a reduced stroke volume and cardiac output (Fletcher & Thomas, 2001). Under normal conditions, the heart is able to regulate the amount of blood it pumps to match the body’s needs, ensuring all functions are carried out effectively (Fletcher & Thomas, 2001).
Unfortunately, there is no cure for congestive heart failure, but there are medications and life modifications that can aid in improving symptoms. Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARBs) are often given to patients to help relax blood vessels and lower blood pressure. Angiotensin receptor plus neprilysin inhibitors (ARNIs) can also be taken to improve blood flow and are especially effective in HFrEF. Beta blockers help slow the heart rate and improve blood flow, while Diuretics (water pills) remove extra fluid and reduce swelling and breathing problems (Mayo Clinic, n.d.). In addition to taking medications, making lifestyle changes is also recommended. These may include eating healthy, exercising often, maintaining a healthy weight, and avoiding drinking and smoking (Shams, Malik, & Chhabra, 2025).
My artwork illustrates the comparison between a heart with systolic dysfunction (HFrEF), diastolic dysfunction (HFpEF), and a healthy heart. On the left, it depicts a heart with systolic dysfunction, showing how the walls have thinned due to the inability to contract effectively, weakening the muscle and reducing ejection fraction. On the right, it shows a heart with diastolic dysfunction, where the walls have thickened due to increased pressure, forcing the heart to work harder and impairing its ability to relax and fill properly. At the center, the healthy heart is displayed with no signs of wall thinning or thickening, symbolizing normal function.
References
American Heart Association. (n.d.). Types of heart failure. American Heart Association. Retrieved April 12, 2025, from https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/types-of-heart-failure
Fletcher, L., & Thomas, D. (2001). Congestive heart failure: Understanding the pathophysiology and management. Journal of the American Academy of Nurse Practitioners, 13(6), 249. https://doi.org/10.1111/j.1745-7599.2001.tb00030.x
Golla, M. S. G., Hajouli, S., & Ludhwani, D. (2024, May 5). Heart failure and ejection fraction. StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553115/
Mayo Clinic. (n.d.). Heart failure – Symptoms, causes, and treatment. Mayo Clinic. Retrieved April 12, 2025, from https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142
Schwinger, R. H. G. (2021). Pathophysiology of heart failure. Cardiovascular Diagnosis and Therapy, 11(1), 263–276. https://doi.org/10.21037/cdt-20-302
Shams, P., Malik, A., & Chhabra, L. (2025, February 26). Heart failure (congestive heart failure). StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430873/
Hailey’s STEAM project focuses on Congestive Heart Failure. This cardiac disorder impairs the ability of the ventricles to fill or eject properly. The heart muscle can’t pump enough blood to meet the body’s needs. Systolic heart failure means the heart can’t pump enough blood, causing disfunction due to damage to the myocardium or heart muscles that can’t contract as forcefully, and pump blood efficiently most common cause is ischemic heart disease (coronary atherosclerosis) the plaque buildup. Uncontrolled hypertension is one of the causes of heart failure as arterial pressure increases in the systemic circulation it gets harder for the left ventricles to pump blood out into that hypertensive systemic circulation, so it has to work harder which means the increase of muscle mass demands more oxygen, which makes it worse for the coronaries get squeezed by the extra muscle which means less blood delivered to the tissue which can lead to systolic failure. Diastolic heart failure means you can’t have enough blood, the heart muscle becomes stiff and doesn’t fill with enough blood which then leads to congestion of blood and fluids in the lungs, Heart failure can affect the right ventricle or left ventricle or both ventricles (biventricular heart failure).
Diagnostic testing can be performed like an X-ray that will show an enlargement of the heart and pulmonary infiltrate, echocardiogram, and cardiac stress test. Since fluid retention might be reported per patient cases of Edema are to be looked for. Monitoring the daily weight gain, diet modifications, and dietary adjustment less sodium intake, fatty foods that will impact cholesterol, in some cases lifestyle changes is needed.
For medication like antihypertensives, ace inhibitors, and beta blockers like Hailey mentioned, digoxin, diuretics (potassium-wasting diuretics) like furosemide, and hydrochlorothiazide and potassium-sparing diuretics like spironolactone.
Hailey’s illustration represents the significant impact and changes of the heart when it is systolic dysfunction (HFrEF), diastolic dysfunction (HFpEF), and a healthy heart. This just means that the heart is weaker than it should be and can significantly affect the normal processing of pumping blood that our body needs. Great work Hailey!