What Are The 4 Stages Of Congestive Heart Failure

When you or someone you love is diagnosed with heart failure, it can be a pretty scary time. We hear the word ‘heart’ and ‘failure’ in the same sentence and, of course, immediately suspect the worst. 

What Are The 4 Stages Of Congestive Heart Failure

Usually, having a little extra knowledge about the situation and the diagnosis can go a long way in helping those involved calm down and de-stress somewhat.

Now, by no means am I telling you not to be stressed or worried at all, of course not, it’s totally understandable, but just that dealing with the unknown is a lot scarier than knowing what to expect. 

And congestive heart failure does not automatically mean the end of life. I want you to know that right now.

In fact, the very earliest stage of heart failure is more of a pre-warning. It means that you have the chance of developing it should you not change your lifestyle. But we’ll get into that a little later on. 

What I thought would be really helpful, is a guide to the four different stages of congestive heart failure. So, then, you’ll know exactly where you stand and just how serious the diagnosis is. 

What Is Heart Failure? 

First, I thought I’d take a minute to actually define heart failure, as there can be some misconceptions about the term.

Heart failure doesn’t necessarily mean that your heart has lost all ability and capacity to function whatsoever. 

It actually means that the heart is unable or struggling to pump blood around the body properly or as effectively as it should. This can be because it’s too stiff or too weak. 

This is where the different stages and classifications come into play. Each stage refers to a level of severity of how much the heart is struggling to work at regular capacity.

So, basically, the earlier the stage the less difficulty and strain there is on the heart whereas the later stages refer to when the organ is very much having trouble functioning as it should. 

So, with this in mind, let’s take a closer look at each of the different stages and what they mean. 

The Four Stages Of Heart Failure

What Are The 4 Stages Of Congestive Heart Failure

In terms of heart failure, there are four different stages. The earliest of which is A, and then B, then C, and then the final stage D.

As I mentioned before, stage A usually means there is a high risk of developing heart failure, whereas stage D indicates that the patient has advanced heart failure. 

Stage A 

If you or someone you know has been diagnosed with Stage A heart failure, this means that you are at high risk of developing the disease not that you currently have it.

It’s more of a pre-warning that there’s a likelihood of the disease developing and that you should be carefully monitoring the situation. 

There are several reasons why you may be diagnosed with Stage A heart failure(see also: Is Heart Failure Reversible?). For example, if there is a family history of the disease or you currently have one or more of any of the following conditions: 

  • Diabetes
  • Metabolic syndrome
  • Coronary artery disease
  • Hypertension
  • Family history of cardiomyopathy
  • History of rheumatic fever
  • History of alcohol abuse
  • History of taking drugs that are known to damage the heart muscle

Treatment – At Stage A, a patient will usually be given prevention methods to ensure it never develops any further.

This can include lifestyle changes such as quitting smoking, exercising more regularly, or taking medication for underlying causes. 

Stage B

This stage is often known as asymptomatic or silent heart failure. Essentially, what this means is that you’ve been diagnosed with a heart condition without ever noticing any of the symptoms that come along with it. 

At this point, patients are usually diagnosed with systolic left ventricular dysfunction.

They have typically had an echocardiogram that has shown their ejection fraction to be under the value of 40%. 

There can be any cause for Stage B heart failure. 

Treatment – At Stage B, the patient will be recommended to continue pursuing the prevention methods outlined in the Stage A treatment. However, they may also be prescribed extra medication or undergo surgery. 

Stage C

At this point, a patient will have been diagnosed with heart failure and will have also experienced the signs and symptoms that the disease is known for.

These symptoms can be either current or previous, but a stage C heart disease patient will have experienced them at some point. 

If you’re unsure what the signs and symptoms of heart failure are, you can find them below: 

  • Shortness of breath
  • Struggling to exercise
  • Swollen abdomen, lower legs, ankles, and feet (known as oedema)
  • Fatigue/exhaustion 

Treatment – At Stage C, the patient will receive the treatment outlined in the two prior stages but may also receive further medication.

The patient will also have to monitor symptoms and signs more closely, for example, by weighing themselves every day to assess for fluid retention. Pacemakers and cardiac defibrillator therapy may also be required. 

Stage D

Stage D is the final and most serious stage of heart failure. At this point, the patient will experience advanced symptoms more regularly.

For example, they may experience the aforementioned symptoms above while doing small tasks or even resting. During Stage D, the symptoms do not typically respond to treatment. 

Treatment – At the final stage, a patient will still receive the aforementioned treatments but may also need to consider more advanced treatment options such as heart surgery, ventricular assist devices, or a heart transplant. In some cases, you may be referred to palliative or hospice care. 

Final Thoughts 

Hearing the words heart failure is undoubtedly going to make you pretty anxious. It’s a very scary thing to hear and there can be a lot of uncertainty ahead.

However, hopefully, this article has proven that the diagnosis might not always be quite as serious as it sounds. 

For example, Stage A heart failure is vastly different from Stage D. And remember, regardless of which stage you are diagnosed with, there are always treatment options available. 

So, never lose hope.

Clare McAfee
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