Dear Doctors: Our mother, who is 76 years old, was diagnosed with congestive heart failure. She worries that it means she will soon die. What happens in congestive heart failure? She was a heavy smoker for most of her life. Could that be the reason this is happening?

Dear Reader: If you have congestive heart failure, it means your heart can no longer pump blood efficiently enough to meet your body’s needs. The ventricles may not fill with enough blood during a heartbeat, or the heart muscle may be too weak to pump properly. In both cases, the amount of blood that the heart can pump to the tissues is reduced, and the tissues do not receive enough oxygen and nutrients. This causes symptoms such as shortness of breath. Weakness and fatigue. Arrhythmia; wheezing; persistent cough. and swelling of the ankles, feet, and legs.

An estimated 6.7 million adults in the United States currently live with congestive heart failure. It can occur suddenly when the heart muscle is damaged due to illness or injury. However, in most cases, this condition develops slowly and is often caused by a chronic medical condition. These include high blood pressure, diabetes, arrhythmia, various diseases that affect the heart muscles and valves, and chronic kidney disease. Being overweight or obese and being sedentary can also cause symptoms. Cancer treatments such as chemotherapy, radiation therapy, and some immunotherapies can also damage the heart and cause heart failure.

As you might imagine, smoking is often involved. Studies have shown that smokers are twice as likely to develop congestive heart failure as non-smokers. Nicotine, along with numerous chemicals added to tobacco products, causes physiological changes in the body. These include a sudden increase in blood pressure, inflammation of the cells lining blood vessels, and a buildup of plaque that narrows the arteries.

Although there is currently no cure for congestive heart failure, the condition can often be successfully managed. Treatment includes lifestyle changes, medication, and may require the use of medical devices such as pacemakers to keep the heart’s rhythm within a safe and healthy range. If someone is actively smoking, it is essential that they quit. A healthy, balanced diet and an exercise program tailored to your specific needs and abilities are also important.

Drugs are used to manage fluid buildup and reduce the risk of stroke. Patients are often advised to follow a medically supervised program known as cardiac rehabilitation. This includes supervised exercise, health education, and counseling to manage anxiety, stress, and depression.

The diagnosis of congestive heart failure can be very frightening. When you combine the words “heart” and “failure,” the outlook immediately becomes bleak. However, with proper medical care and adherence to lifestyle changes, it is possible for people with this diagnosis to live happy and productive lives.

Eve Glazier, MD, MBA, is a physician and associate professor of internal medicine at UCLA Health. Elizabeth Coe, MD, is an internal medicine physician and assistant professor at UCLA Health. Send questions to askthedoctors@mednet.ucla.edu or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Due to the volume of emails we receive, we are unable to respond personally.