There are many causes for congestive heart failure, but the treatment is always aimed at keeping the heart stable. Find out more about living with a weakening heart.
Congestive heart failure is a condition in which the heart is unable to pump blood efficiently to all tissues. As a result, blood may back up instead of flow forward. It has many causes, often with several going on at once. It can gradually worsen without certain measures.
Causes
CHF can involve dysfunction with systole or diastole. Systolic dysfunction involves weakened heart muscle, like after a heart attack (myocardial infarction) or long-term alcohol use. Diastolic dysfunction involves cardiac muscle not relaxing enough to allow sufficient blood to enter the heart. Causes for this include high blood pressure (hypertension) or disease of the heart valves since the heart muscle is thickened from working so hard against high resistance. Note that this is only a sample of the many causes of CHF.
Symptoms and Signs
No matter what the cause is, the disease process is similar. Blood backs up into the lungs instead of entering the left side of the heart. This can lead to difficulty with breathing when exerting oneself or when lying down. Exercise tolerance drops so that there is shortness of breath and fatigue with less activity than before. Blood that is not able to enter the right side of the heart backs up and causes fluid accumulation in the legs and the abdomen, causing a rapid weight gain. Nausea, vomiting, and loss of appetite may occasionally accompany CHF.
Diagnosis
A physician makes the diagnosis of CHF based on suggestive information from a medical history, physical exam, and additional tests. A chest x-ray may show an enlarged heart and fluid in the lungs. An electrocardiogram may display wave patterns that suggest signs of old heart attacks or heart muscle thickening. A blood test showing elevated brain natriuretic peptide (BNP) can suggest heart failure in the context of its symptoms and signs.
A test that is often used is the echocardiogram. It is basically ultrasound imaging of the heart. It provides real-time images of the heart as it is pumping. The cardiologist viewing the images can see if there is any abnormality in the motion of the cardiac muscle and if there is disease of the valves. The cardiologist can also estimate the ejection fraction, the percentage of blood coming into the heart that is pumped out with contraction. All of this information can demonstrate what may be causing the heart failure as well as the overall condition of the heart itself.
Treatment
Management of CHF involves both lifestyle changes and medications. Because heart failure leads to fluid retention, one must restrict how much he or she eats and drinks each day and check weight daily for rapid weight gain. Medications would include diuretics to help help urinate more, ACE inhibitors to reduce resistance the heart pumps against, and beta-blockers to prevent the heart from overworking. If heart failure is difficult to control despite these medications, digoxin can be taken to make the heart contract better.
Various conditions, like a heart attack, may trigger the heart to go into failure again. Nevertheless, success of managing CHF depends greatly on consistent compliance with dietary and medication recommendations. Otherwise, there is an increased chance for the stabilized heart to decompensate, leading to recurrence of symptoms.
Final Words
Congestive heart failure is a chronic condition with life expectancy that can vary greatly from one person to the next. However, with appropriate management, one can still make the best out of life even with this condition.
