Congestive heart failure is the inability of heart to pump sufficient blood to meet the requirements of the body. It could be either a structural or a functional impairment of the heart leading to the condition.
It is a chronic condition and progresses over a period of time.
Heart failure often develops after other conditions have damaged or weakened your heart. Over time, the heart can no longer keep up with the normal demands placed on it.
Coronary artery disease (CAD) is one of the conditions which make the heart pathetic to pump sufficient blood required for body functions. In this the arteries supplying blood to heart get narrowed due to deposition of fats. This process is known as atherosclerosis. The arteries can not supply oxygen rich blood to some parts of the heart which makes them weak.
Along with CAD, high blood pressure, damage to heart muscles (cardiomyopathy), inflammation of heart muscles (myocarditis), congenital heart defects (heart defects at birth), faulty heart valves and heart arrhythmias (abnormal heart rhythms) can all cause heart failure.
Other conditions that can cause heart failure are: lupus, emphysema, amyloidosis, hypothyroidism, hyperthyroidism, hemochromatosis, diabetes mellitus and severe anemia.
The risk factors are family history of heart failure, heart attack, irregular heartbeats, high blood pressure, coronary artery disease, valvular heart disease, heart attack, diabetes, some medications for diabetes, sleep apnea, severe emphysema, some viruses, congenital heart defects, kidney failure, advanced age and chronic alcohol abuse. Men are at higher risk of heart failure than women. Presence of one of the risk factors is enough to cause heart failure but if more than one factor is present then the risk increases further.
The disease is slowly developing but the symptoms may be sudden like acute heart failure. The symptoms of chronic heart failure are fatigue & weakness, rapid or irregular heartbeats, shortness of breath, persistent cough or wheezing with blood tinged sputum, nausea and lack of appetite, difficulty in concentrating, decreased alertness, central sleep apnea (disordered breathing at night), sudden weight gain (due to salt and water retention), loss of muscle mass, abdomen swelling, edema of feet, ankle and legs and decreased capability to exercise.
The symptoms of acute heart failure are irregular heart beat with palpitations which may cause heart to stop working, unexpected and severe shortness of breath, chest pain and sudden fluid built up. Other similar signs and symptoms of chronic heart failure but they start suddenly and are severe.
The condition is diagnosed based on medical history, physical examination and some tests. Tests include blood tests (to check for cholesterol and lipid level, glucose level, thyroid function, red blood cells count), stress test, electrocardiogram, echocardiogram (for measuring the ejection fraction), imaging tests like radionuclide test, cardiac CT and magnetic resonance imaging, angiography and some marker tests. To diagnose whether the condition is acute or chronic it is important to find out whether the heart is not capable to pump blood or it gets filled with blood or both the possibilities.
Conditions causing heart failure can not be treated but signs and symptoms which lead to heart failure can be treated with medications. Lifestyle modification is an important part in the treatment and management of congestive heart failure. Lifestyle modifications include stress management, reducing intake of salt, more vegetable diet, avoiding oily and fatty food, physical exercise and most important is the weight reduction.
Physical exercise should be done only after consultation with the physician, it is not recommended for all the patients with congestive heart failure. In some cases bed rest is recommended.
The treatment of congestive heart failure is to treat and manage the conditions causing it. They are high blood pressure, high cholesterol levels, thyroid function, obesity, diabetes, and coronary artery disease.
Medications for thyroid problem, angiotensin converting enzymes, angiotensin receptor blockers, beta blockers and diuretics are used for the treatment of congestive heart failure. It is important to avoid non steroidal anti-inflammatory drugs and calcium channel blockers.
In some cases surgery or implantation of a medical device may be required. Surgery is targeted to treat the underlying cause like a heart valve replacement for a damaged valve or a coronary artery bypass grafting (CABG) for a blocked or severely narrowed coronary artery contributing to the heart failure. Implantations of medical devices are recent development and these include either an implantable cardioverter defibrillator (ICD) or a cardiac re-synchronization therapy (CRT), Heart Pumps called Left Ventricular Assist Devices (LVADs).
The last option is a heart transplant surgery as of now.
Congestive heart failure is associated with high death rate. But due to advanced treatment modalities there is progress in survival rate. Outcome of treatment for symptoms of heart failure is good.
Proper and controlled diet with less of fat and more of fruits and vegetables and regular exercise can prevent heart disease. Control on weight is a must.
