CONGESTIVE HEART FAILURE

 

What is congestive heart failure?

Congestive heart failure (or heart failure) does not mean that the heart suddenly stopped working or that you are about to die. Heart failure is a condition in which the heart can't pump enough blood to meet the needs of the body's other organs. It is a common condition that usually develops slowly as the heart muscle weakens and needs to work harder to keep blood flowing through the body. Heart failure develops following injury to the heart such as the damage caused by a heart attack, long-term high blood pressure, or an abnormality of one of the heart valves. The weakened heart must work harder to keep up with the demands of the body.

Heart failure can result from:

• narrowed arteries that supply blood to the heart muscle - coronary artery disease
• previous 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
• defects in the heart present at birth - congenital heart disease
• infection of the heart valves and/or heart muscle itself - endocarditis and/or myocarditis

The "failing" heart keeps working but doesn't work as efficiently as it should. 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 commonly in the legs and ankles, but possibly in other parts of the body as well. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down. People with heart failure can't exert themselves.

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

Symptoms

• Shortness of breath, which can happen even during mild activity
• Difficulty breathing when lying down
• Weight gain with swelling in the legs and ankles from fluid retention
• General fatigue, weakness and feeling tired

Diagnosis & treatment of congestive heart failure

Your doctor is the best person to diagnose and treat congestive heart failure. Early diagnosis and treatment are very important. Today, so many people with heart failure can live normal lives and be less at risk for being hospitalized. If you are diagnosed with heart failure, there are a number of medications that work together to improve your symptoms. Taking these medicines, in addition to eating right and getting regular exercise, will help improve your health.

Congestive heart failure usually requires a treatment program consisting of:

• rest
• proper diet
• modified daily activities
• drugs such as
  • A.C.E. inhibitors
  • beta blockers
  • digitalis
  • diuretics
  • vasodilators

The various drugs used to treat congestive heart failure perform different functions. ACE inhibitors and vasodilators expand blood vessels and decrease resistance, allowing blood to flow more easily and making the heart's work easier or more efficient. Beta blockers can improve the function of the left ventricle. Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water.

When a specific cause of congestive heart failure is discovered, it should be treated or, if possible, corrected. For example, in some cases congestive heart failure can be treated by treating high blood pressure. Some are treated with surgery to replace abnormal heart valves. However, when the heart becomes so damaged that it can't be repaired, a more drastic approach, such as a heart transplant, should be considered.

Living with congestive heart failure

About two-thirds of all patients die within five years of diagnosis. People with heart failure are also at risk for sudden death. However, most cases of mild and moderate congestive heart failure are treatable and some patients live for many years. The outlook for an individual patient depends on the patient's age, severity of heart failure, overall health, and a number of other factors including the desire and ability to make lifestyle changes and take prescribed medications. To improve the chances of surviving with heart failure and to enhance quality of life, patients must make lifestyle changes and take care of themselves.

As heart failure progresses, the effects can become quite severe, and patients can lose the ability to perform even modest physical activity. Eventually, the heart's reduced pumping capacity may interfere with routine functions, and patients may become unable to care for themselves. The loss in functional ability can occur quickly if the heart is further weakened by heart attacks other conditions that affect heart failure, such as diabetes and coronary heart disease. Heart failure patients also have an increased risk of cardiac arrest caused by an irregular heartbeat.

The best defense against heart failure is the prevention of heart disease. Almost all of the major coronary risk factors can either be controlled or eliminated: smoking, high cholesterol, high blood pressure, diabetes, and obesity.

Tips for living with heart failure

1. Research your condition. Having knowledge about this condition is the first step to managing it and taking control of your health.
2. See your physician regularly and closely follow his or her instructions.
3. Don't smoke
4. Monitor your blood pressure, pulse and weight. Know your ideal weight and notify your doctor whenever body weight changes by more than 5 lbs. between visits.
5. Never stop taking prescribed medication without talking to your doctor. It is important for patients with heart failure to understand that their blood pressure needs to be lower than that of a person without heart failure.
6. Keep a current medication list in your wallet or purse for emergency situations. Include information about any blood thinners you may be taking and any artificial implants, valves, pacemakers or defibrillators that you have. Also note your diagnosis and your doctor's telephone number.
7. Know what you need to do to travel and go on vacation. With careful planning, many patients with heart failure can enjoy traveling.
8. Ask your physician about how much alcohol you are allowed to drink. Some patients can have a small amount and others can have none.
9. Ask your doctor about getting a flu or pneumonia shot. These can be important in preventing or lessening the effects of disease.