Congestive Heart Failure (CHF) - Heart Care/Surgery

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Congestive Heart Failure (CHF)


Congestive heart failure defines a condition where the heart muscle has lost some of its ability to efficiently pump blood through the body. This weakened pumping function causes a build-up or congestion of fluid in the lungs and body tissues. The heart isn't the only muscle affected by congestive heart failure. Other blood vessels as well as organs in the body, including the lungs and liver, may also be affected. A person's extremities may also be affected by edema or buildup of fluids, causing swelling, pain, and limited mobility.

Congestive heart failure is most frequently diagnosed in older individuals, and in more men than women. Some of the most common signs and symptoms of congestive heart failure include but are not limited to:

  • Shortness of breath not only during activities, but even after the person has lain down to rest for a while
  • Periods of weakness and fatigue
  • Wheezing and/or coughing
  • Swollen ankles, legs, and stomach
  • Loss of appetite, though often, a weight gain is seen, caused by water retention
  • Sleep apnea
  • Loss of muscle mass
  • Protruding veins in the neck
  • Decreased urine output but an increased desire to urinate at night
  • Inability to main focus or concentrate

A person dealing with congestive heart failure might find it easier to sleep in a semi-sitting or upright position, which reduces some symptoms.

What causes a CHF?

The definitive cause of congestive heart failure has not yet been determined. Medical experts believe that for some, age and ‘wear and tear’ generally cause damage and weakening to the muscles, blood vessels and valves of the heart. When the heart is unable to pump efficiently, optimal volumes of oxygen and nutrients are not delivered as effectively to the body to sustain proper function.

A number of situations may increase a person's risk for developing congestive heart failure. These include:

  • Damage caused by a previous heart attack
  • Heart valve disease
  • Uncontrolled high blood pressure
  • Coronary artery disease
  • Enlarged heart (cardiomyopathy)
  • Abnormal heartbeat or irregular heartbeat

Heart failure is mainly caused by the inability of the left ventricle (although sometimes the right ventricle is effected) to pump properly. The primary function of the left ventricle is to pump newly oxygenated blood to all areas of the body - except the lungs.  The right ventricle is responsible for pumping deoxygenated or oxygen-poor blood into the lungs.

Risks for developing congestive heart failure increase for those who smoke, have high cholesterol levels, who are obese, and those who abuse alcohol. A high-fat or high-salt diet, inactivity, and certain drugs may also increase one's risk to develop congestive heart failure.

Diagnosing congestive heart failure

A number of medical tests to diagnose congestive heart failure, in conjunction with observation of symptoms, may include but are not limited to blood studies, x-rays, and tests that gauge heart activity, size, and function.

In most cases, congestive heart failure is diagnosed through echocardiography or cardiac ultrasound, another term for an echocardiogram or ECG. This test can be completed in a doctor’s office and can show the doctor a number of signs that include issues or abnormalities regarding:

  • The pericardium or covering of the heart
  • The thickness and function of the heart wall
  • Size (increased or decreased) of the heart’s four chambers
  • Any issues with the heart valves
  • Velocity and direction of blood flow
  • Overall effectiveness of pumping functions

Treatment options

Treatment options for congestive heart failure are focused on improving heart pumping function and to prevent worsening or further damage to the heart. Treatments are also designed to reduce the symptoms and to improve a person's quality of life. Treatments may include one or a combination of drugs or medications, changes in lifestyle and surgery. Treatment options are also based on the stage or the definition of the stage of congestive heart failure with which a person might be diagnosed. 

Doctors have determined four basic stages of CHF:

Class I - A person who is a high risk of pre-heart failure or developing heart failure.

Class II - A person diagnosed with systolic left ventricular dysfunction but who do not otherwise have any symptoms of pre-heart or heart failure.

Class III - A patient with known systolic heart failure as well as prior or current symptoms.

Class IV - A patient with systolic heart failure as well as the presence of advanced and continuing symptoms even after receiving medical care.

Some of the most common treatment plants may include but are not limited to:

  • Change in diet
  • Increase in exercise
  • Treatment of high blood pressure or lipid disorders such as high cholesterol
  • Medications that include angiotensin converting enzyme inhibitors (ACE inhibitors) or beta-blockers, depending on scenario.
  • Surgical options include:
    • Valve replacement
    • Coronary artery repair
    • Implantable cardiac defibrillators ventricular assist devices
    • Heart transplant

Congestive heart failure is a progressive, and, without adequate treatment, will grow worse over time.

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