Congestive heart failure (CHF) does not mean that the heart has stopped working, but rather the heart is not working as efficiently, or pump blood normally. There are two problems that can occur when someone has CHF: systolic dysfunction and diastolic dysfunction.
Systolic dysfunction occurs when the heart can’t pump enough blood to provide the body’s organs with oxygen and nutrients. Diastolic dysfunction occurs when the heart does not accept all the blood that is being sent to it, which can cause blood to build up on other parts of the body.
Most people have both systolic and diastolic heart failure.
Causes of CHF
CHF is not caused by any particular virus or bacteria, instead it is usually the result of other health problems such as:
- Coronary artery disease
This is a condition in which the arteries that supply the heart with blood becomes damaged and narrowed due to built-up of plaque. Because blood cannot easily enter the heart, along with nutrients and oxygen, parts of the heart can become weakened and hurt.
- Heart valve disease
Occurs when heart valves become hardened, or when a valve does close tightly. This causes restricted blood flow to the heart. It is an abnormality that can be present since birth or developed over time.
- Persistent high blood pressure
This forces the heart to work against higher pressure, which can make the heart become weak over time.
- Heart attack
A heart attack can cause damage to the heart muscle. Those who have had a heart attack are 5 times more likely than average to develop CHF.
- Infection
When an infection occurs to the heart muscle, it can weaken the heart significantly.
- Diabetes
Both type 1 and type 2 diabetes increases the risk of CHF.
- Arrhythmias
This means the heart pumps too fast, too slow, or inconsistently. It can cause the heart to weaken over time, especially if one has the type of arrhythmias where the heart pumps too fast.
- Damaged heart valve
This can be caused by rheumatic disease or an infection that occurred.
- Hypertrophic Cardiomyopathy
This is a genetic condition in which the wall that separate the left and right side of the heart become enlarged.
- Kidney Conditions
Some kidney conditions can increase blood pressure as well as buildup of fluid. This places more stress on the heart as it is forced to work against higher pressure, and increases the risk of CHF.
- Drugs
Using drugs such as cocaine can weaken the heart and increase risk of CHF.
- Alcohol
Long-term, excessive use of alcohol can weaken the heart and increase risk of CHF.
Additionally, other factors that increases the chances of heart disease such as smoking and obesity can also increase the risk of getting CHF.
Symptoms and Complications
Symptoms of CHF may not show for many years. This is due to the fact that the heart tries to compensate in other ways when it does not pump properly:
- Forming a bigger pump by enlarging
- Adding new muscle tissue
- Beating at a faster rate
As the heart attempts to recuperate itself, it cannot pump blood well enough for blood to flow properly through the body then back to the heart again. Thus, blood is backed up into the legs and lungs, causing fluid buildup. Fluid buildup then causes swelling of the ankles and legs as well as shortness of breath.
Some common symptoms of CHF are:
- Having difficulties breathing when you are not exerting yourself; such as when one is lying down
- Coughing and wheezing
- Dizziness, fatigue and weakness
- Shortness of breath
- Swollen ankles or legs
Other symptoms can include:
- Abdominal pain
- Bloating
- Loss of appetite
- Fluid buildup in the abdomen
- Bluish skin around the mouth — this discoloration of the skin signals lack of oxygen in the blood
- Constipation
- Pale skin as well as cold hands and/or feet
- Frequent urination during the night
Diagnosing CHF
If you are showing symptoms that have been mentioned above, as well as one of the health conditions that can put you at risk for CHF, see a doctor as soon as possible. The doctor may examine you to check for swelling in the legs or fluid buildup in the lungs. As well, tests may be taken to check the conditions of your heart. These test can include blood and urine tests, an electrocardiogram (ECG), or a chest X-ray. An ECG is an ultrasound of the heart that diagnose heart failure by showing how much blood from your heart is being pumped out into your body.
Treating CHF
Treatments must be directed by a doctor, but typically it includes lifestyle adjustments as well as medication.
If you have CHF, it may be recommended you make some of these lifestyle adjustments:
- Cut back on fluids. To adjust fluid intake, you should weigh yourself daily
- Stay active, but avoid over-exerting yourself to prevent triggering CHF symptoms
- Lower sodium intake to 2 grams or less daily. If you have high blood pressure, it is recommended the intake be lowered to 1.5 grams or less.
- Wearing special elastic stockings that help reduce swelling in the legs
- Lose weight — this can be done by following an appropriate weight-loss program
Besides lifestyle adjustments, medication is also used to treat CHF. These medications include:
- ACE inhibitors (, )
Expands blood vessels to help blood flow more easily.
- Angiotensin receptor blockers (, )
Used if ACE inhibitors cannot be taken. In some cases, they can be taken in addition to ACE inhibitors.
- Certain beta-blockers (bisoprolol, , )
These are taken to improve heart function.
- Aldosterone receptor blocker (, spironolactone)
Blocks the effects of aldosterone, a hormone that can make CHF worse. It also helps eliminate excess salt and/or water in the body, and reduce the risk of death for those who have had a heart attack before and have CHF as a result.
Increases force of pumping in the heart.
- Diuretics (, hydrochlorothiazide)
Aids in removing excess water and/or salt in the body.
- and nitrates ( dinitrate, nitroglycerin patch)
Can be taken when both ACE inhibitors and Angiotensin receptor blockers cannot be used. Sometimes taken in addition with other medicines when symptoms continue to persist.
A combination of these medicines are typically taken in order to treat CHF. In some cases, surgery can be performed in order to improve the functionings of the heart.
Preventing CHF
CHF can’t always be prevented, especially if you have conditions that can result in CHF. Despite this, some lifestyle adjustments can be made to improve the health of your heart which not only lowers the chances of you getting CHF, but also lowers the chances of a heart attack, stroke, and coronary artery disease. Some of these adjustments/practices are:
Controlling high blood pressure
- Eating and maintaining a healthy diet — this means less greasy and fried foods, as well as sweets and other foods with high cholesterol
- Exercising
- Controlling blood sugar levels (this is especially important for those who have diabetes)
- Maintaining good blood cholesterol levels — this prevents buildup of plaque in your vessels
- If you smoke, quitting smoking. If you don’t smoke, don’t start!
- Reducing alcohol consumption
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