Congestive Heart Failure

Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from

• narrowed arteries that supply blood to the heart muscle — coronary artery disease
• past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work
• high blood pressure
• heart valve disease due to past rheumatic fever or other causes
• primary disease of the heart muscle itself, called cardiomyopathy.
• heart defects present at birth — congenital heart defects.
• infection of the heart valves and/or heart muscle itself — endocarditis and/or myocarditis

Congestive heart failure (CHF) is a condition in which the heart's function as a pump to deliver oxygen rich blood to the body is inadequate to meet the body's needs. Congestive heart failure can be caused by:

1. diseases that weaken the heart muscle,
2. diseases that cause stiffening of the heart muscles, or
3. diseases that increase oxygen demand by the body tissue beyond the capability of the heart to deliver.

CAUSES

Many disease processes can impair the pumping efficiency of the heart to cause congestive heart failure. In the United States, the most common causes of congestive heart failure are:

1. coronary artery disease,
2. high blood pressure (hypertension),
3. longstanding alcohol abuse, and
4. disorders of the heart valves

DIAGNOSIS

The physical examination is focused on detecting the presence of extra fluid in the body (breath sounds, leg swelling, or neck veins) as well as carefully characterizing the condition of the heart (pulse, heart size, heart sounds, and murmurs).

Useful diagnostic tests include the :
electrocardiogram (ECG)
chest x-ray

TREATMENT

Lifestyle modifications
Low Na intake / Restricting salt and fluid intake is often recommended
total amount of fluid consumed must be regulated
frequent measurement of body weight
Aerobic exercise, once discouraged for congestive heart failure patients

The "failing" heart keeps working but not as efficiently as it should. People with heart failure can't exert themselves because they become short of breath and tired.

As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Often swelling (edema) results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.

Heart failure also affects the kidneys' ability to dispose of sodium and water. The retained water increases the edema.

CHF usually requires a treatment program of
• rest
• proper diet
• modified daily activities
• drugs such as
o ACE (angiotensin-converting enzyme) inhibitors
o beta blockers
o digitalis
o diuretics
o vasodilators