Hi, Noted the history about your friend who is obese but solid and not flabby, developed a softball sized lump in abdomen and is now hospitalized for some heart problem. To answer your specific answers: Hernia cannot cause congestive heart failure. Hernia is necessarily a bulge that increases on straining and is reducible. Since your friend is obese he may need assistance of Ultrasonography or CT scan for the conformation about the diagnosis. If there is a large hernia he needs surgery but this is possible only he becomes fit and fine from his medical conditions which you are not sure about. There is another condition called divarication of recti that develops between the two rectus abdominal muscles as there is weakness of the connective tissues between both. This is not a true hernia and does not need any surgery but needs strengthening exercises for abdominal muscles if the Cardiologist allows. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon