Congestive Heart Failure

The heart muscle pumps an equivalent of 5000 to 6000 quarts of blood each day, sending oxygen and nutrients to the rest of the body. Congestive heart failure occurs when the pumping action of the heart is ineffective, which causes fluid to back up into the lungs leading to severe breathing difficulty and congestion. A primary disease of the heart muscle itself is called cardiomyopathy, or enlarged heart. When the heart is enlarged, it does not allow the heart to pump effecively and congestive heart failure ensues.

Congestive Heart Failure Can Be Caused by:

Narrowed coronary arteries, or heart disease Scar tissue due to previous heart attack, or myocardial infarction (MI). Hypertension (HTN or high blood pressure)Heart valve disease due to past rheumatic fever or other causes Cardiomyopathy (enlarged heart). Congenital heart defects. Endocarditis and/or myocarditis (inflammation of the heart)

People with heart failure become short of breath and tire easily with the slightest exertion.

As the blood flow out of the heart slows, blood returning to the heart through the veins backs up resulting in edema, usually swelling in the legs and ankles. Additionally, fluid backs up into the lungs which interferes with breathing causing shortness of breath, even when lying down.

Heart failure also affects the kidney's ability to dispose of sodium and water. The retained water increases the edema.

How is congestive heart failure diagnosed and treated?

Your doctor is the best person to make the diagnosis. The most common signs of congestive heart failure are:Swollen legs or ankles Difficulty breathing.Weight gain due to build up of fluids

Congestive heart failure (CHF) usually requires a specific treatment plan, including:

Using pillows to elevate edematous extremities above the level of the heart to reduce swelling Rest Proper diet Modified daily activities

Medications:

ACE (angiotensin-converting enzyme) inhibitors Beta blockers Digitalis Diuretics such as Lasix Vasodilators

Various drugs that perform unique actions can be used to treat congestive heart failure.

ACE inhibitors and vasodilators expand blood vessels and decrease resistance. This allows blood to flow more easily and makes the heart's work easier or more efficient.

Beta blockers can improve how well the heart's left ventricle pumps. Digitalis increases the pumping action of the heart, and diuretics such as Lasix help the body eliminate excess salt and water. Lasix comes in pill and injectable forms.

When a specific cause of congestive heart failure is discovered, it is treated and/or corrected with the proper teatment, such as maintaining proper blood pressure. If the heart failure is caused by an abnormal heart valve, the valve can be surgically replaced. Additionally, a heart transplant is an option if the condition is resistant to treatment, due to irreparable heart damage. Although this may be extreme, sometimes heart transplantation is the only option, and medications will then be needed to avoid organ rejection.

Over all, congestive heart failure can be successfully managed with the appropriate treatment, giving the patient a better quality of life.

by Barb Hicks, RN/LMT