What is Stage 4 Congestive Heart Failure Prognosis?

Top Questions Answered by Health Professionals

What is congestive heart failure (CHF)?

Congestive heart failure
Congestive Heart Failure, Reverse Heart Disease

Here are some Top questions answered by health professionals for congestive heart failure. CHF is a progressive heart disease that effects pumping action of the heart muscles. This causes fatigue and shortness of breath. There are (more than 3 million cases per year in the United States). Generally, half of the population diagnosed with heart failure will survive 5 years. About 30% of the remaining population will live for up to 10 years. Your life span will depend on what caused your heart failure.

Stage 4 congestive heart failure prognosis means, this is the last stage of dying from congestive heart failure. The persons’ ability to do day to day work is severely affected and even the most mundane tasks can lead to severe tiredness and increased heart rate. In this stage, the organs are affected as well.

People with heart failure can lead a normal life and have same life expectancy compared to a person without heart failure, if the disease is well controlled with appropriate diet and medications. Each episode of hospitalization with heart failure exacerbation reduces one’s life expectancy and quality of life.

Live a normal life with congestive heart failure
Living a normal Life with Heart Failure

 Stage 4 Congestive Heart Failure   Prognosis:

People with stable stage 4 disease can live fairly normal lives. However, if the   kidney disease is progressing rapidly, it can be associated with more   complications such as anemia, bone disease and end stage renal disease with dialysis. It’s important to follow closely with a nephrologist (kidney specialist).

What are the 4 stages of congestive heart failure? Heart failure is a chronic long-term condition that gets worse over time. The stages are A, B, C, D. Ranging from “high risk” of developing heart failure to “advanced heart failure” require treatment plans.

Stage A

Considered to be pre-heart Failure, it means you are at high risk of developing heart failure. If you have a history of heart failure or you have one or more of these medical conditions:

Hypertension, diabetes, coronary artery disease, metabolic syndrome, history of alcohol abuse, history of rheumatic fever, family history of cardiomyopathy, history of taking drugs that can damage the heart muscle, such as some cancer drugs.

Stage A Treatment

Stop Smoking with Congestive Heart Failure
Choose Life

Stop smoking, exercise daily staying active and walking every day. Take your high blood pressure daily, and any treatment for high cholesterol. No alcohol or recreational drugs. Listen to your doctor and take all medications as prescribed.

Stage B

Considered a pre-heart failure. It means you have been diagnosed with systolic left ventricle dysfunction but never had symptoms of heart failure. Most people with stage B heart failure have an echo cardiogram that shows an ejection fraction (EF) of 40% or less. This category includes people who have heart failure and reduced EF due to any cause.

Stage B Treatment

The same treatment applies as for stage A. Take all medications prescribed by your doctor, including Beta-blockers, diabetes medication if you have it and then there is a possibility of surgery or intervention. You may need valve repair or replacement surgery.

Stage C

Patients with Stage C heart failure have been diagnosed with heart failure and currently or previously, had signs and symptoms of the condition. There are many symptoms of heart failure, the most common are: Shortness of breath, feeling tired and fatigued, less able to exercise, weak in the legs, waking up to urinate, swollen feet, ankles, lower legs and abdomen.

Stage C Treatment

Same treatments as A and B, adding other medications that slow the heart rate if your heart rate is faster than 70 beats per minute and you still have symptoms. A diuretic (water pill) if your symptoms continue. Daily limitation to sodium, keep track of your weight daily.

Tell your doctor if you gain or lose more than 4 pounds. Possible fluid restriction. Possible bi ventricular pacemaker and lastly, possible cardiac defibrillator implant.

Stage D

Patients with stage D have advanced symptoms that don’t get better with treatment. This is the final stage of heart failure.

Stage D Treatment

Stage 4 Congestive Heart Failure
Stage 4 Congestive Heart Failure

The same treatment as stage A, B, and C. Patients with HF-REF have advanced symptoms that do not get better with treatment, this is the final stage.

Treatment is the same as A, B, and C. Elevated treatment for more advanced options include Heart transplant, ventricular assist devices, heart surgery, continuous infusion of IV isotropic drugs, palliative of hospice and research therapies.


It’s up to you to take steps to improve your heart health. Take medications as instructed, follow a low-sodium diet, stay active or become physically active. Take notice of sudden changes in your weight, live a healthy lifestyle, keep your follow-up appointments, and track your symptoms.

Talk to your healthcare team about questions or concerns you have about your medications, lifestyle changes or any other part of your treatment plan.

Your prognosis for the future, will depend on how well your heart muscle is working, your symptoms and how well you respond to and follow your treatment plan.

How does Stage 4 Congestive heart failure affect your quality of life?

With the right care and treatment plan, heart failure may limit your activities, but many adults still enjoy life. How well you feel depends on how well your heart muscle is working, your symptoms and how well you respond to and follow your treatment plan.

Staying active and keeping track of your health and medications is key    to helping your doctor help you. Because heart failure is a chronic     long-term illness, you can complete an advance directive or living will   to let everyone involved know your desires. A living will details’   treatments you do or don’t want to prolong your life. It’s a good idea   to prepare a living will while you are well in case you can’t make these decisions later on.

Top Questions answered by health Professionals

What is the Link between smoking and heart failure?

stage 4 Congestive Heart Failure Q&As
Q&A’s for Healthier Living

Typically, smoking damages the heart and blood vessels. It reduces the amount of oxygen that reaches the heart. It speeds up the heart rate and raises blood pressure. Causes inflammation in blood vessels and increased atherosclerosis.

What is the longest you will live with heart failure?

Generally, half of the population diagnosed with heart failure will survive 5yrs. About 30% of the remaining population will live for up to 10yrs. The life span depends on what caused the heart failure

What should we change in our diet to reduce the risk of heart disease?

Begin dietary changes by selecting foods with low saturated fat, trans fat & sodium. Stay away from red meat as much as possible. Your diet should be made of fresh fruits & vegetables, fish, whole grains rich in fiber, legumes, and nuts. If possible, reduce red meat intake and eat white meat.

What are the complications of heart failure?

In patients with stage 4 congestive heart failure, the heart is not able to pump adequate amounts of blood and the remaining blood pools up in the heart and lungs. It leads to poor perfusion of all organs especially causing acute kidney injury.

How does heart failure affect the quality of life?

Heart failure has a poor quality of life. Various physical and emotional symptoms such as dyspnea, fatigue, sleeping difficulties, depression, and chest pain, anxiety affect their quality of life.

Eat heart healthy, get plenty of exercise and check out alternatives like yoga as opposed to sit-ups or mundane exercise. Have fun while you yoga and it also helps you sleep.

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Wishing you all the best, Sherry

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