About Congestive Heart Failure (CHF)
Heart failure is a major cause of disability and death for
people over the age of 65. It results in more hospital admissions
than any other diagnosis for seniors. Although deaths from
CHF are declining, the number of heart failure cases appears
to be rising as the general population grows older.
Read on for more information, or click on a topic in the
list:
What is
congestive heart failure?
What are the symptoms?
What are the causes?
How is it diagnosed?
How is it treated?
What is
congestive heart failure?
Congestive heart failure (CHF) is the inability of the heart
to pump a sufficient amount of blood throughout the body,
or requiring elevated filling pressures in order to pump
effectively. With CHF, the flow of blood from the heart slows,
which causes blood returning to the heart to back up. The
slowed blood causes a buildup of congestion in the body.
CHF may involve the right, left, or both sides of the heart,
but most commonly occurs in the left ventricle. Left ventricular
heart failure usually causes breathing difficulties.
What are the symptoms?
Patients with heart failure are sensitive to small shifts
in their intravascular volume status. Increasing the volume
in their circulatory system can cause symptoms and signs
of decompensated heart failure, while decreasing the volume
in the circulatory system can cause hypotension. Symptoms
of CHF include:
- Dyspnea on exertion
- Fatigue
- Paroxysmal nocturnal dyspnea that occurs after lying
down
- Pulmonary edema
- Peripheral edema
- Kidney problems
- Decreased alertness
- Muscle wasting, paleness, and cold extremities in advanced
disease
What
are the causes?
The causes of CHF vary, but typical causes for the four
forms of heart failure are listed here:
- Systolic heart failure can be caused
by coronary artery disease; high blood pressure; metabolic
disorders, such as thyroid disease, vitamin deficiency,
or diabetes; infection; toxin exposure to cobalt, alcohol,
cocaine, and chemotherapeutic agents; infiltrative diseases,
such as cardiac amyloidosis and hemochromatosis; neuromuscular
disease; collagen vascular disease; valvular heart disease;
or peripartum cardiomyopathy.
- Diastolic heart failure can be caused
by coronary artery disease; high blood pressure; myocardial
relaxation; left ventricular elastic recoil; ventricular-ventricular
interaction; pericardial restraint; intrathoracic pressure;
or passive chamber properties.
- Left ventricular heart failure can be
caused by high blood pressure; hypertrophic cardiomyopathy;
anemia; hyperthyroidism; heart valve defect, such as aortic
valve stenosis and aortic insufficiency; congenital heart
defect; heart arrhythmias; myocardial infarction; or cardiomyopathy.
- Right ventricular heart failure can
be caused by pulmonary hypertension; lung disease, such
as chronic bronchitis and emphysema; tricuspid insufficiency;
or congenital heart defect.
How is it diagnosed?
Doctors should use a combination of assessment tools to
diagnose CHF including:
- Health history consisting of questions about symptoms
and how long they have been present, previous heart problems,
general health history, current lifestyle, and use of alcohol
or other drugs.
- Physical exam during which the doctor listens to the
heart for a rapid heartbeat or murmurs and the lungs for
congestion. The doctor should also look for evidence of
fluid buildup, such as swollen or enlarged neck veins,
an enlarged liver, an expanding abdomen, and swollen ankles.
- Chest x-ray to reveal an enlarged heart, swelling of
the space between tissues, and congestion in the lungs.
- ECG or EKG can indicate heart strain, an enlarged heart,
poor blood supply to the heart, an enlarged atrium, a fast
heart rate, and premature heartbeats.
- Radionuclide ventriculography can be used if necessary
to track the flow of blood through the heart.
How is it treated?
The Centers for Medicare & Medicaid
Services and Joint Commission for the Accreditation of
Healthcare Organizations have determined that the following
treatments are indicators of quality care for CHF:
- Tests on the left ventricle
- An ACE inhibitor
- Instructions for self-care upon discharge
- Advice to smokers on how to stop smoking
Doctors can find more information about
treating CHF in Best
Practices for Congestive Heart Failure.
Information in this document is compiled from Wikipedia.com,
2005, and HeartInfo.org, 2005.
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