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Congestive Heart Failure

Expert Care for Patients With CHF

An estimated 8 million people in the U.S. have congestive heart failure (CHF), a condition where the heart is unable to pump an adequate amount of blood to the rest of the body. Symptoms include shortness of breath, swelling of the legs, chest tightness and difficulty doing day-to-day tasks.

The Congestive Heart Failure Program at Montefiore Nyack Hospital, which brings you the same world-renowned care provided at Montefiore Einstein’s main campus in New York City, specializes in diagnosing heart failure and offers a variety of effective treatments that can improve heart function and help you live longer. Every heart failure patient is different—and your condition can change over time—so routine follow-ups will be an important part of your care plan.

In addition to CHF, the Program treats women with heart disease during pregnancy, as well as patients with heart valve disease, arrhythmias, heart muscle disease, pericardial disease and pulmonary hypertension.

Diagnosing CHF

If CHF is suspected, your cardiologist will order a comprehensive study of your heart muscle. This will likely include an echocardiography (echo) or other imaging tests to measure your ejection fraction. Your ejection fraction is the percent of blood in the lower left chamber of your heart (the left ventricle) that is pumped out of your heart with each heartbeat. Ejection fraction measures how well your heart pumps. This helps diagnose the type of heart failure you have and guides your treatment.

  • If 40% or less of the blood in your left ventricle is pumped out in one beat, you have heart failure with reduced ejection fraction.
  • If 50% or more of the blood in your left ventricle is pumped out in one beat, you have heart failure with preserved ejection fraction.
  • If your ejection fraction is somewhere between 40 and 50 percent, you may be diagnosed with heart failure with borderline ejection fraction.

Other advanced cardiac imaging tests used to diagnose CHF show how well your heart is working. These include cardiac CT scan, cardiac MRI and nuclear heart scan. You may also need cardiac catheterization with coronary angiography to look inside the arteries in your heart and see if they’re blocked.

Tests for your heart’s electrical activity also may be necessary. This might include an electrocardiogram (EKG) or a Holter monitor that you wear for 24 to 48 hours or more while going about your normal activities. A stress test might be ordered to measure how much exercise your body can handle and how well it works during physical activity.

Treating CHF

Though heart failure has no cure, treatment can help you live a longer, more active life with fewer symptoms. Your heart failure treatment plan may include:

  • Medication
  • Lifestyle changes
  • Cardiac resynchronization therapy. In this therapy, pacemakers are implanted to help both sides of your heart contract at the same time to relieve your symptoms
  • An implantable cardiovert defibrillator (ICD). This device checks your heart rate and uses electrical pulses to correct irregular heart rhythms that can cause sudden cardiac arrest
  • A mechanical heart pump, such as a ventricular assist device (VAD)
  • Heart surgery to repair a congenital heart defect or damage to your heart
  • A heart transplant if no other treatments have worked or heart failure is life-threatening
Sources: National Heart, Lung and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services

Most heart failure patients are diagnosed and treated at Montefiore Nyack Hospital, but those who are critically ill or who need a heart transplant can be treated at Montefiore Einstein. Patients also have access to investigational therapies that may allow them to keep their own heart instead of needing a transplant.

More Information


For appointments or more information about the Congestive Heart Failure program, call: