I believe you are in the right ballpark. CHF can cause the ends of the fingers to be club shaped, but it is not always true. I wonder what his legs and feet look like? Could be kidneys. His face doesn't look swollen enough to be steroids - although images can be altered. If he is on a boatload of HTN meds, that could also cause that type of swelling. At any rate, what we do know is that this is not a sign of someone that is healthy.