What are the stages of congestive heart failure?

Momlizzy that's a good question for her doctor. I know my mom's cardiologist has told my mom it's good for her to be up and around. But my mom's not on oxygen. She gets very short of breath, but her doc said keep up and moving as much as you can. Sitting too much isn't good for your heart.

My Mom is 88 years old and has chf, she is on oxygen 24/7. her lower legs were swelled. My sister that had been doing the cooking for her held the salt and sugar ( she is also diabetic) Mom stayed with me for a week and I didnt require her to do anything. She only went to the bathroom and took care of her personal self (she has to use a walker and carry her oxygen cord) she kept her feet and legs elevated. Now my sister thinks that Mom needs to be up and doing her house work and Laundry which she was doing before she came to my house, my question is should she be up and working or setting and elevating her feet and legs, what should her activities be?

Barby56007, you are posting on a 4 year old old thread about CHF, you would do better if you asked a new question, just click on the blue box "ask a question" at the top of the list of threads. Have you talked to his doctor about your dad's behavior? There are meds that can help.

Hello- my father is 90 years old with demensia and COPD. He refuses to sleep...at all. I will get him to bed then when he lays down fights to get back up to say he had to go to the bathroom when he doesn't. This is so frustrating. I have been taking care of him for 3years now. He insists on wondering all night around the house. Also he talks in very scary voices late at night. Why and what can I do???

My ex husband died 2 nights ago with chf and a severe diabetic since January of this year he has been on life support twice we have a 14 yr old daughter who is devastated and I was at work when she found out he was gone which was heartbreaking for me I wasn't here for her when she needed me and it is a horrible disease he could never catch his breath his stepdaughter was in denial of him being really wick

There is a procedure I have heard about called ablation or catheter ablation that can be done if cardioversion can't be done or doesn't work. It cauterizes the heart tissue that is causing the a-fib. For some people this might be a thing to look into as I know someone who had this done and it really helped them.

Espinoza, how involved have you been in your father's care? I don't mean to sound critical, I'm not being, but if your father's strokes have been caused by blood clots arising from poor heart function it seems unlikely that his regular doctor would have known nothing about the CHF up 'til now. What conditions has anyone discussed with you previously? I'm sorry to hear about your father's stroke - is he recovering well? What were the effects?

My 63 year old father just had a second stroke. So during a visit a nurse mentioned that my father has CHF, but none of the doctors including his regular doctor have never mentioned anything about. Not sure what to think about this. Please advise.

we are getting hospice ordered this week and there are nurses coming in and out almost daily.

If he's against taking meds, oxygen and wants to live on his own terms, I'd bring in hospice. And beer!

What's he got against taking his diuretics? If he wants to keep breathing, he'd better.

Currently I am the primary care giver for my father in law with CODP and CHF. Last week we were not sure he would make it to Christmas. I did bring him home from the hospital on the 22nd of Dec and he was ok. Christmas eve he was clearly worse the ankles swollen and could hear the rattle in his chest. He has home O2 for the first time but barely uses it. And is not taking his "water pills".

On Christmas morning however he woke up fine. Better then I've seen him in months to be honest. Only change was a beer he drank with our son Christmas eve. Christmas dinner he had another one and again he looked amazing on the 26th. We were totally prepared for this to be end of his journey with us but now I just dont know. He still wont take the water pills and hardly uses the "dreaded" O2.

Is it normal to suddenly get better like that? Is it ok to think we got lucky and he will be around for awhile? I'm so confused over what to expect here. We had planned he would not go back to the hospital but now I just dont know what to expect?

I mean 1996. It's that contagious dementia getting to me again… Apologies.

It depends a lot on the causes and type of his heart failure; but left ventricular cardiomyopathy is the common or garden variety: this describes the condition where the diseased muscle of the heart wall becomes flabby and distended, so that the heart's pumping action becomes increasingly inefficient.

You can gauge how badly affected the heart is by its "Ejection Fraction" which is measured when a cardioechogram is done. A normal EF would be around 65%, I believe - this means that the heart is squeezing more than half of its contents out with each contraction. The EF can be difficult to measure accurately, though, so don't panic if you're told that it's 10% - my family doctor explained kindly that this was the cardiac physiologist's polite way of saying that she couldn't measure it at all, and it did not mean that my poor mother was about to drop dead on the spot.

I find that it helps to visualise the heart as a mechanical pump with its rubber wall beginning to perish and slacken. The other major mechanical problem is that because the left ventricle is slack and distended, it pulls on the valves between the heart chambers and prevents them from snapping shut cleanly, as they should. Valves can be replaced, but this is futile if the dilatation is severe: the new valve will fail in the same way.

The medications given can be aimed at improving heart function, relieving symptoms of heart failure such as breathlessness and swollen lower limbs, and protecting the heart itself and other organs such as the kidneys. Different medications suit different patients; if side effects are ever a problem, don't hesitate to report them because there may well be better options for him that your father's doctor will be happy to try.

Pacemakers can be implanted either to regulate heart rhythm (2 leads), or to synchronise the left and right chambers of the heart so that more blood is pumped with each beat (Cardiac Resynchronization Therapy, which requires a device with 3 leads).

The big problem, of course, is that a poorly operating pump means a decrease in the supply of oxygen to the whole body: so all of the major organs, including the heart itself, and the brain are inevitably affected as the disease progresses. Lack of oxygen supplied to the heart muscle leads to angina and (ultimately) heart attack; to the brain - TIA's, stroke and vascular dementia; to the kidneys - deteriorating kidney function, leading to fatigue and poor excretion of various toxins and sometimes poor drug metabolism (so you can get accidental overdoses, for example, or unusually high levels of blood electrolytes such as sodium and potassium - but your father's doctors will already be keeping a close eye on these things so don't worry).

Dementia is proving particularly tricky to diagnose. Vascular dementia is a common result of longstanding CHF, but of course having CHF is no guarantee against Alzheimer's or any of the other dementias either: so you could be looking at a very complex picture. When my mother's being especially loopy, I don't know whether it's because she's fatigued, deaf, fed up, bored, feeling ill, not in the mood to concentrate, actually demented or having a stroke. I hope your father's still a long way off this stage, though.

If your father does have this type of CHF, with no other presenting heart disease, and his doctors have succeeded in finding a good balance of medications for him, he should continue to have a good quality of life for some years to come. My mother was diagnosed in about 1986 and remained reasonably fit and well until about two years ago. The normal rules for healthy living apply - eat well, exercise as much as he's comfortable with, watch his weight, don't smoke… nothing you wouldn't include in your New Year's resolutions anyway!

I agree, it would be wonderful if there were some sort of timetable or clear prognostic chart; but because there's no knowing what will fail first or how individual patients will respond to drugs or lifestyle changes… it all seems to remain anybody's guess. My mother's had 15 decent extra years from the medical profession so I'm not really complaining; but all that my medically qualified daughter, even, can tell me is that my mother will be on her family doctor's "Don't Be Surprised If They Die" list. With the when and how, exactly, nobody's taking bets.

Wikipedia is always good for diagrams. Most of the medical schools will have some helpful online material, but make sure you're looking at the right species of CHF or it all becomes impossibly confusing. And if do you find any kind of crystal ball toolkit out there, please let me know!

Hi Rob, you're pretty young to have so many medical issues. All of your conditions can be treated. If you're a smoker, QUIT! If you're overweight, lose weight. My mom is 94 and has COPD and atrial fib. She's on medications and does pretty well. Be sure to get your blood pressure and diabetes treated and stick with what the docs tell you about that.

My mom gets winded with her COPD, as she has aortic stenosis too, so her aorta is narrowed and she can't get enough blood to keep her from being winded with any exertion. If the cardiologist didn't give you the kind of information you need, do some research on Google about your conditions and make sure you're following doctor's orders. My mom's cardiologist told her to keep walking and to stay as active as she could tolerate, even though it wears her out. Ask your cardiologist about exercise, since it would help both your diabetes and blood pressure, particularly if you're overweight.

I don't think any of the things you have are an immediate death sentence and if you take good care of yourself, you should be able to manage all of them well into the future. But it's important to make lifestyle changes if your lifestyle has lead to any of your conditions.

hello all
have been diagnosed with congestive heart failure coronary artery disease chronic obstructive pulmonary disease type2 diabetes along with high blood pressure.had a consultation with the cardiologist a few weeks ago.i asked what happens now a bypass operation.her reply was for me it is to late,and I will remain on meds until they fail to work.then palliative care.fine.but what is my prognosis anser because I have so many problems she is unable to give me a prognosis.i said that is strange as heart failure goes hand in hand with my other problems so surely you must have an idea her reply was no.i am a 60 year old male.diagnosed approx. 1 year ago but now I have continuous fatigue muscle wastage and general pain to muscle areas in my arms and legs.chest pain and breathing difficulties .all this while I am at rest.i reall y need an approx. prognosis as we live abroad and I really need to put things in order for my family etc.but still falls on deaf ears with doc and cardiologist.can anyone help
rgds rob

My mom 88years old also has congestive heart failure and takes Lasix twice a day to control fluid build up or she will have difficulty breathing. the Lasix has been increased over the year. I Watch her diet, her fluid in take, and adjust the Lasix if I see she is getting into trouble. it is a constant balancing act.

Thank you so much for the information and words of encouragement I am his only child and I am very close to my father. Don't know what I would do without him! Thanks again~

Quasia, It must be very unsettling to see your father that way. I know for the past few years it was difficult for me to see my mother losing weight, she went into the hospital several times for treatments... feeling terrible for a week before she went in, and then when she got out of the hospital, she recovered quite well. This past April at age 92 she snuck out to the hospital and took an intelligence test and scored at the top of 92 yr olds! She was so proud of it she fessed up and told me that she was scheduled for a driving test and she passed! One hour of driving and they told her she was OK to drive.

So, in my experience there are ups and downs. For my mom it was most important for for her to be able to do as much as possible in between... and to enjoy life. It was also important for her to be able to see and be with family and friends.

Please try not to worry as much as I did. My mom told me not to worry. We had 3-5 good years together and the only thing I struggled with is worry and the unknown. If you can hug your dad and tell him you love him every day, that will work miracles. Be kind and try to be helpful, but also take good care of you. He will want to know that you are OK. No one could tell me what would happen with my mom. She passed away in her sleep a few weeks ago. We had a wonderful evening. She was warm and comfortable and surrounded with love.

I am wishing you comfort and hoping you can be actively involved, but not worried. Also, many people her suggested that hospice would be very helpful and informative to us.

My father has a defibrillator he also suffers from CHF last year I went to visit him he was very healthy and had a lot of weight. I just went to see him this year and he so skinny stomach is swollen and now hes is wearing a diaper and he said he was in the hospital but left to pick me up from the airport he was on oxygen he went in to get fluid drained off his feet. I am thinking that his conditions has worsen yet him nor his girlfriend will tell me. Please help!

If anyone suggests pradaxa instead of coumadine, be sure you understand the trade off. If you do have a blood clot, with coumadine, there are techniques to help bust the clot. If you are taking pradaxa, they can do nothing to stop the clot. I would not take pradaxa unless I was very young with no chance of a blood clot or hemmorage. I speak from experience unfortunately. It is a sad lesson.... Do not allow your loved ones to take pradaxa.

Ecranos, It is so nice to hear your story. It seems each person with CHF lives a slightly different life. I think it's great that your dad can get out and about and enjoys traveling. That most likely stimulates his mind and seems to me like he is living his life fully. As you say, if he's happy then you are... I feel the same with my mom. As long as she is happy, then my mind is at ease. The odd experience for me is that with her CHF, there have been multiple times when she didn't seem like she was going to make it, and yet she did and today is toodling around happily. As for her medications, I do go to the doc with her. I find that some docs are happy to prescribe new meds to her and for example with her recent cold, she got antibiotics, but once she was feeling better the doc allowed us to stop the extra meds early. We are fortunate that she can get the medical help she needs and I also think we are fortunate when she can let up on some of the extra meds some times. Thanks again for sharing your story about your dad. It is helpful to know that he is out and about too.

Great question I've been wondering about myself. My dad has CHF, aortic aneurysm, vascular disease. He's been told he is a candidate for a stroke for many years. CHF landed him in the hospital a couple years ago and it didn't look as if he'd make it but that got the fluid out and he did. He takes a ton if medicationbut doesn't want to talk about it. My mom died a few years ago and now he spends his time traveling. He paces himself and he can't walk much without needing to stop then he comes home and spends weeks resting. I figure if he's happy I am. Although I often wonder when the call will come from some official saying my dad has died in some far away hotel. We know he's on borrowed time and he seems to too.

I have a friend who is 46 and has CHF the botton of his heart is not working right
he had a defib put in in april and it has gone off 2 times he is very hard headed
and also a diabetic

The thing I've experienced with the classes is that my mom has gone in and out of each of those. For example, last January she went from 2 to 4, and after being in the hospital she came home at class 3. After a few months at home she was strong enough to pass a 1 hour driving test and return to her little exercise class at the library. Then in June she fell back to class 4. She is working her way back through 3 and today is again 2. I think the episodes are becoming more frequent, but of course we are very hopeful. I live 45 minutes from her so as a caregiver, some times I leave her at class three and when I speak to her on the phone the next day, she is touring around back in class 2, while I'm worried she will go back to 4. It's extremely stressful for her and for me, but I'm thrilled when she feels better. I think the thing we all have to learn to do is to help them to remain as healthy as possible and to understand that the frequency of reaching 4 will increase over time, but no one seems to know what length of time that is, and it's probably vastly different for different people, so it's hard to plan. As my mom says, " I don't know why this is happening. I'm up and down.... and up ... and down .... and up.... and..." I'm happy she still feels good some times for weeks, hopefully for months...

Heart failure is often graded on a scale of I to IV based on the patient's ability to function.
1.Class I is patients with a weakened heart but without limitation or symptoms.


2.Class II is only limitation at heavier workloads.


3.Class III is limitation at everyday activity.


4.Class IV is severe symptoms at rest or with any degree of effort.

The prognosis of heart failure patients is very closely associated with the functional class.

Sounds like you are doing everything right. What a good daughter you are. She is very lucky to have you as a caregiver. The only thing I would do different is I would let her eat whatever she wants. At 92 she deserves to eat what she wants to eat. Make her happy in her last days. Lays potato chips now has a low sodium chip.They are very good.Good luck to you both.

My 92 yr old mom has congestive heart failure. It's been years... She has such a tremendous attitude. When she was young she was a nurse on the hospital ship HOPE during WWII, then she became a stewardess. She married my dad and became a good mom. So now, I want to be a good daughter to her. I feel like my life is on hold, because although she lives 45 minutes from me, she wants to live independently and she will call typically early in the morning (which is the time when my dad died) and she gets scared. Everything that was described here, pace maker, coumedin, irregular heart beats, difficulty breathing, swollen ankles, etc, she has... She snuck out and got an intelligence test and driving test after her last hospital stay and they passed her! So she still drives within her neighborhood to a "healthy bones" exercise class and to her local hair dresser to get her hair done once a week. When she doesn't feel well I trust her not to drive. Some days are OK, many days are not so good. She doesn't like to eat anymore. I feel like I'm always struggling to find something good for her to eat. She was always a health nut when she was raising us kids. Now I find out she goes to the frozen foods section and grabs lasagna or something else with very high sodium. I keep trying to get her to stay with clean healthy food, but she loves potato chips (which are not the worst). She goes grocery shopping sometimes. She has someone come in every Friday to clean her house and this woman makes her healthy food. Sometimes she likes it, but mostly she just complains. It is so helpful for me to read the stories on this web site. I don't know if she will live for three months or three years. Right now I'm unable to do almost anything with my own life, because she calls me unexpectedly, often enough to send me into a tailspin. I either stay with her for a week, then we head to the hospital where they adjust her diuretic and other meds, then send her home again to recover. Then she gets better and just as I start to consider going back to work, or start consulting, she begins to fail again. She is very frail, but all I want to do is to be sure that her final days/years are somewhat joyful. I read somewhere that we should not ask what they want but we should be thoughtful and do nice things for them. I don't know what to do, because mom needs to eat, but she complains bitterly because she doesn't like anything that we bring, just because she doesn't like to eat anymore. My understanding from my web search is that the next stage is that she will continue to lose weight and then she won't want to drink. It is so hard to watch her being so frail... Any suggestions on how to be helpful to people who are struggling with their final stages of life would be most appreciated. As with everyone on this question... we just don't know if it will be moments or years... It is hard to know what is best to do. Thank you all for being here with me.

I'm 63 years old with possible congestive heart failure. I've had severe, getting worse, swelling in my legs and feet. It started off in the left leg, left foot; but now I have it in both feet and legs--really badly. My skin gets tight and warm. I can't breathe well at all; can't walk up the stairs, breathe heavily; can't sleep well or lying flat. I have a mitral valve prolapse and arrythmia. My father died at 27 years old with congestive heart failure / enlarged heart in the Pittsburgh VA Hospital Jan 20 1950 (he was a Marine in WWII in Pacific, got Malaria as well). Anyway, I have pneumonia in both lungs now (phlegm, pink), but I looked up on Mayo Clinic site and these could be symptoms of CHF as well. I'm a teacher, but I just don't think I can keep up this pace (language arts teacher, papers and more papers). I have difficulty even going down stairs...fire drills. My feet and legs constantly swell; I'm always huffing and puffing. I'm thinking of going on disability and maybe with proper diet, treatment, and exercise, I can beat this. Is this possible?

Ive been researching about copd online because my 69 year old grandfather has it and has been diagnosed to ber in the end stage. My brother in laws uncle just recently passed away because of advanced copd. There are four stages and several treatment opitions depending on the persons conditions try looking at these websites and I hope they help.