Congestive heart failure (CHF) is a progressive disease characterized by the inability of the heart to provide enough oxygenated blood to meet the demands of the body’s tissues. CHF may be caused by hypertension, myocardial ischemia or chronic alcohol use. Symptoms with CHF include easy fatigue, dyspnea, and reduced exercise tolerance. Many CHF clients will also show signs of leg fatigue due to the build-up of lactate at very low levels of activity.