What Is CHF Exacerbation?

By Eric Carter

CHF, or congestive heart failure, is a chronic heart condition in which the heart isn’t able to meet the body’s demand for oxygen. Individuals with CHF could experience shortness of breath, swelling, fatigue, or irregular heartbeats as a result of their condition. These symptoms may flare up during a CHF exacerbation, which is a temporary but dangerous worsening of symptoms. Let’s dive into CHF exacerbation — what causes it and how to treat it.


Seniors may notice the worsening of their CHF symptoms during a period of exacerbation. Their symptoms may include:

  • Fatigue
  • Shortness of breath
  • Coughing or wheezing
  • Feeling full after eating just a few bites
  • Weight gain
  • Swelling in legs and ankles
  • Bloating in the abdomen
  • Rapid heartbeat

RELATED CONTENT: 4 Stages of Congestive Heart Failure [INFOGRAPHIC] 


CHF exacerbations are caused primarily by lung infections, high sodium intake, or medications.

Lung infections

Lung infections, like pneumonia, can further prevent the body from getting the oxygen it needs. As a result, the heart tries to work even harder to meet the body’s demand for oxygen.

High sodium intake

Doctors generally recommend that seniors with CHF limit their salt intake. Salt can cause the body to retain fluid, and seniors with CHF are already prone to fluid retention. Higher fluid levels can put more strain on the body, and fluid can also settle around the heart, making it harder to pump blood effectively.


Some medications can cause CHF symptoms to flare up. These medications could include beta blockers, non-steroidal anti-inflammatories, or medications used to treat heart arrhythmia. That’s why it’s important for seniors to discuss their complete list of medications with their doctor.


If a senior notices a worsening of their symptoms, they should see their doctor as soon as possible. A doctor will ask about symptoms and perform a physical examination. They may also order lab tests or a chest X-ray to evaluate the lungs and determine how well the heart is pumping.


Seniors may be admitted to the hospital for treatment, depending on how severe their CHF exacerbation is. Treatment for CHF exacerbation involves addressing the symptoms that a senior is experiencing and helping them feel more comfortable. These treatments also aim to reduce the amount of fluid in the body and help ease the stress on the heart.

Doctors may prescribe medications to help the circulatory system or to remove excess fluid from the body.

  • Diuretics can help the body eliminate excess fluid.
  • Beta-blockers can help slow the heart rate and reduce strain on the heart muscle.
  • ACE inhibitors help relax the veins and arteries, so they widen and lower blood pressure.

Treatment options will depend on the underlying cause of the exacerbation. For example, if pneumonia has caused the flareup, then a doctor will treat the pneumonia. But if the exacerbation is caused by a new medication, then treatment would involve removing that medication or adjusting it.

RELATED CONTENT: The Importance of Home Care for Seniors with CHF 


The severity of CHF and the exacerbation could cause kidney damage as blood is reduced to the kidneys. It could also cause liver damage as too much fluid builds up around the liver.

CHF exacerbation can not only put excess strain on the heart and body, but it could also cause other chronic conditions to flare up. Additionally, almost 4 in 10 seniors who were hospitalized for CHF exacerbation passed away within 1 year.

Preventing CHF Exacerbation 

The best thing a senior with CHF can do is manage their condition and maintain a healthy lifestyle to try and prevent exacerbation. 

  • Manage salt. Seniors can discuss a proper diet with their doctor. However, seniors with CHF should watch their salt intake. Look for foods without additional salt added or low salt. Instead of cooking with salt, try boosting flavor with herbs and spices. For cooking ideas, see our post: Diet for Seniors with CHF. 
  • Maintain health precautions. Because CHF can be caused by a lung infection, seniors with CHF should take precautions to avoid getting sick — especially with COVID-19 or the flu, which can lead to pneumonia.  
  • Follow doctor’s orders. A senior should follow the recommendations of their doctor. This includes making adjustments to diet, physical activity, and other aspects of their lifestyle in addition to taking medications as prescribed. 
  • Understand the diagnosis. A big part of managing CHF and preventing exacerbation is understanding the condition. Studies on exacerbation have linked knowledge and understanding of CHF and the risk of exacerbation. The more you know about how to care for your condition, the better prepared you can be. 

If you or a loved one needs help managing CHF, reach out to a team of care experts near you! We understand the unique care needs of individuals with heart failure, and our caregivers can help tailor a care plan to help you prevent exacerbation.   

Personalized care for seniors with CHF

Tags: Heart health, CHF