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Fluid overload is one of the hallmark of these congestive heart failure patients. So it can be explained in different ways. One is the forward failure. The heart no longer can pump the blood, and the kidney gets less and less amounts of the blood. The kidney thinks that the bodys deprived of the fluid, and then it started to retain salt and water, so more fluid retention. And the second explanation is, as the heart cannot pump forwards, the pressures will be backed up in the venous system, increases the venous pressures. As the venous pressures increase, the blood vessels leak salt and water into the surrounding tissues. So these two can cause fluid and water retention. Along with that, the bodys adaptive mechanisms will also do more salt and water retention by increasing the neural hormonal release, which is the basic pathophysiology of the congestive heart failure, and also by renin angiotensin system. So by all means, the fluid will get accumulated in the body.
