Last updated: 4 Feb 2022 | 898 Views |
CONGESTIVE HEART FAILURE (CHF)
CHF is a condition in which the heart cannot (fails to) pump enough blood to organs and tissues. One side of the heart (or both sides) cannot force enough blood out, so blood backs up. Congestion, or abnormal buildup of fl uid, occurs in tissues or organs, and blood doesn’t move well through the vascular system. If the left side of the heart fails, the system on the right side
becomes congested. The congested side of the heart must work harder and may also fail. The same thing can happen on the right side.
Diseases that stress heart muscle can cause CHF. These conditions include high blood pressure, heart attack, heart muscle and valve diseases, infections, arrhythmias (abnormal heart rhythms), anemia, thyroid disease, pulmonary disease, and too much fl uid in the body.
When the left side of the heart fails, fl uid leaks into the lungs. Fatigue (tiredness), diffi culty breathing (especially at night when lying down), coughing, or shortness of breath can result. nIn right-sided heart failure, the liver swells, which may cause pain in the abdomen (belly). Legs and feet may swell also.
A physical examination will show changes, such as swelling in the legs or crackling breath sounds, indicating excess fl uid in the lungs. A chest x-ray can show an enlarged heart and signs of fl uid accumulation into the lungs. An echocardiogram (a test using sound waves to show the moving heart) can also reveal heart size and disease of the heart muscle or valve problems.
Initial symptoms should be managed so the failing heart doesn’t have to work as hard. The cause of CHF also needs treatment. For example, if a heart valve problem is the cause, surgery may be needed to repair or replace the valve. Lifestyle changes will be needed. Smoking lowers the blood oxygen level and makes the heart work harder, so avoid tobacco. Less fl uid and salt in the diet reduces fl uid in the body. Also, if overweight, losing weight will help. Dietitians and nutritionists can help plan a diet. Oxygen may be given to reduce the workload on the lungs. Medicines may be prescribed to reduce fl uid in the body or help the ventricle contract better. Diuretics remove fl uid. Nitrates open blood vessels so blood fl ows more easily. Angiotensin-
converting enzyme (ACE) inhibitors help the ventricle contract. Beta-blockers help by slowing the heart rate. Other drugs reduce blood pressure. All may have side effects, including dehydration, cough, dizziness, fainting, and fatigue. Pacemakers and implantable defi brillators may be used in some cases. Heart transplantation is an option in some patients when other treatments fail.
Things to do
Do maintain your ideal body weight.
Do take your medicines properly.
Do reduce salt and extra fl uid in your diet.
Doget your family involved in your care, especially the
needed lifestyle changes.
DO call your doctor if you have side effects from your
drugs or new or worsening symptoms, such as increasing
shortness of breath, chest pain, or fainting.
DON’Tforget to take all your medicines as directed.