Overview and Definition

Congestive Heart Failure (CHF), or simply heart failure, is a condition where the muscles of the heart do not pump blood adequately to meet the needs of the body. Contrary to its literal connotation, heart failure does not mean that heart has completely failed to work. With CHF, the heart’s ability to pump blood becomes diminished and less powerful. As such, the blood circulates through the heart and body at a much slower rate, causing increased pressure in the blood vessels. This results in blood vessels forcing its fluid into other body tissues, causing buildup in the lungs, liver, arms, legs and the gastrointestinal tract.

There are two common types of heart failure: systolic heart failure, where the heart muscle is unable to pump out or eject oxygen-rich blood well, and diastolic heart failure, wherein the heart muscles become stiff and are unable to accept or take in blood easily. In both cases, the pumping action of the heart becomes less effective. Congestive Heart Failure may affect only the right or left side of the heart, but in most cases, both sides are involved.

Causes of Congestive Heart Failure

Heart failure is a condition that occurs when the heart muscles become damaged due to several reasons. Most often, this weakening is caused by an underlying heart or blood vessel condition, or a combination of the following conditions:

  • Coronary Artery Disease (CAD). CAD is a condition where the arteries that carry oxygen-rich blood become blocked or narrowed

  • Heart attack. When a coronary artery becomes completely blocked, the blood flow to the heart muscle is also stopped, causing a physical damage to the heart muscle

  • Cardiomyopathy. A type of damage to heart muscles caused by infection, drug and alcohol abuse, or other causes not related to blood flow.

  • Overworking the heart. Heart conditions such as thyroid problems, kidney disease or diabetes that cause the heart to become overworked, ultimately leading to heart failure.

  • High blood pressure. Hypertension (high blood pressure) increases the amount of work the heart must perform. Over a long period, this can damage and weaken the heart muscles, leading to CHF.

  • Congenital heart diseases or certain genetic diseases

  • Prolonged serious arrhythmias. Abnormal heart rhythms can decrease the effectiveness of the heart to pump blood. The heart becomes overworked for a prolonged period as it tries to overcome rhythm disorders.

There is a lengthy list of other non-common causes of heart failure, including exposure to radiation, endocrine disorders, genetic predisposition, and complications of other non-coronary related disease. Furthermore, the risk of heart failure may be increased with:

  • Unhealthy habits such as smoking and excessive alcohol intake
  • High salt intake
  • Lack of exercise or obesity (which accompanies a spectrum of coronary diseases)
  • Non-compliance with medications or therapies for minor heart problems

Signs and Symptoms of Heart Failure

Heart failure can sometimes be asymptomatic, which means that you observe no symptoms at all. The symptoms can range from mild to severe, and may come and go for a period. Among commonly reported symptoms of heart failure include:

  • Unexplained dizziness, fatigue and body weakness due to lack of oxygen and nutrients circulating in the organs and muscles

  • Fluid and water retention due to decreased blood supply to the kidneys; this results in swollen ankles, legs or abdomen (edema), frequent urination, bloating, loss of appetite or weight gain

  • Congested lungs indicated by shortness of breathing or difficulty breathing even when at rest, dry cough or wheezing

  • Irregular or rapid heartbeats that indicate effort being made by the heart to provide enough blood supply

  • Chest pain that indicates an underlying heart condition, such as heart attack

When to See a Doctor and Treatments Available

If you are experiencing some of the signs and symptoms mentioned above, it is best to seek medical help immediately especially when symptoms are getting in the way of your normal life. Although these symptoms may not always indicate heart failure, they may indicate serious heart or lung conditions that must be treated immediately. If your general practitioner suspects heart condition, you will be referred to a cardiologist for proper diagnosis and treatment.

Your cardiologist will perform a physical test to look for signs of heart failure or other heart conditions. Tests will be recommended to determine the nature, cause and severity of the heart failure that may include the following:

  • Blood tests to evaluate cholesterol levels, kidney and thyroid problem
  • Chest x-ray to determine the size of the heart and check for fluid build-up
  • Echocardiogram, an ultrasound of the heart to show its structure, movement and function
  • Electrocardiogram (EKG or ECG), which records the heart’s electrical impulses
  • Stress test to check for heart difficulties during physical activity
  • BNP test (B-type Natriuretic Peptide), high levels of which indicate possible heart failure
  • Cardiac catheterization to check whether coronary artery disease is the main cause of the heart failure
  • Ejection Fraction (EF) test to classify the type and nature of heart failure (whether systolic or diastolic)

The results and information gathered from these tests will be used to grade your heart failure on a scale of 1 to 4, in order of increasing seriousness. This scale system will help your cardiologist determine the right prognosis and suggest the best treatment method.

Treatment for Congenital Heart Failure

There is currently a wide spectrum of treatment options available to cure heart failure. The main goals are to decrease the likelihood of the disease to progress, relieve its symptoms and allow the patient to enjoy a better quality of life. Treatment for congenital heart failure can be categorized into three, namely:

  • Lifestyle changes that include avoiding smoking, alcohol, too much salt, cholesterol and leading an active, well-rested lifestyle

  • Medications that can help the heart muscles to pump better, lower cholesterol, reduce heart damage, control abnormal heart rhythms or open up narrowed blood vessels

  • Surgeries and devices including coronary bypass surgery, angioplasty (with or without stenting), pacemaker or defibrillator
    References:

  • American Heart Association. “Heart Failure” Available: http://www.heart.org/HEARTORG/Conditions/HeartFailure/Heart-FailureUCM002019_SubHomePage.jsp

  • Chen, Michael MD. “Heart Failure Overview” Available: http://www.nlm.nih.gov/medlineplus/ency/article/000158.htm
  • Kulick, D.L. MD and Wedro, B. MD, “Congestive Heart Failure (CHF) Overview” Available: http://www.medicinenet.com/congestiveheartfailurechfoverview/page8.htm
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