Congestive Heart Failure: Diagnosis and Treatment
A Case of CHF
The Impact of Congestive Heart Failure on Families and Society
Congestive heart failure has a tremendous impact on the US health care system, as well as on the suffering individual and his or her family. Currently, 4.7 million Americans suffer with this potentially debilitating condition. Today, the five year mortality rate for congestive heart failure is 75% for men and 62% for women. Due to the aging of the U.S. population, the cases of congestive heart failure are expected to double over the next 17 years. Given the seriousness of this condition and the liklihood that it will impact many more in the coming years, it would be helpful for everyone to have a basic knowledge of what are the causes, symptoms and treatments of congestive heart failure. What is heart failure?
What is Congestive Heart Failure?
What is Congestive heart failure? CHF originates in the heart which is comprised of a right atrium and ventricle and a left atrium and ventricle. Between these four compartments are valves which allow blood to flow from one compartment to another and then prevent it from flowing backward into the previous compartment. When the heart fails due to diseased heart muscle, a condition known as cardiomyopathy, or heart valve disease, it is no longer able to efficiently pump blood throughout the body.
The primary function of the heart is to pump oxygen rich blood out to the body and to return oxygen depleted blood to the lungs to be replenished. When it fails at this task, serious consequences develop. Blood backs up in the venous system, pressure in this normally low pressure system rises and fluid from from the blood collects in the body’s tissues. This collection of fluid is known as edema and begins in the feet and lower legs due to gravity. Edema can continue to rise to the upper legs and even into the abdomen where it is known as ascites. Fluid often collects in lung tissue, called pulmonary edema, causing shortness of breath during short walks and when climbing stairs.
Cardiac Ultrasound: educational and fun to watch (less than 5 min)
What Causes CHF?
There are many potential causes of heart failure. Here are a few of the most common:
- Damaged or diseased heart muscle due to a previous heart attack.
- Damaged or diseased heart valves.
- Diseased coronary artery
- High blood pressure, as it causes thickening of the heart walls.
- Certain medications taken by people with underlying heart disease, such as non-steroidal anti-inflammatories (Aspirin, Ibuprofen, Diclofenac, Naproxen, Indometacin and more), some medications for diabetes such as rosiglitazone or pioglitazone, and some calcium channel blockers. Check with your doctor to see if you are at risk.
Edema, or Fluid Retention
Some Common Symptoms of CHF?
The most common symptoms of heart failure are as follows:
- Swelling in the feet and legs.
- Swelling of the abdomen.
- Shortness of breath.
- Frequent urination.
Proven Treatments for CHF?
The most common types of treatment for heart failure:
- Restricting sodium and fluid intake.
- Utilizing aerobic exercise.
- Surgery for coronary artery disease if indicated.
- Surgery to replace faulty heart valves if indicated.
- Controlling high blood pressure.
- Abstaining from alcohol if patient history indicates alcohol abuse.
- Use of medications to improve symptoms, e.g. ACE inhibitors, beta blockers, digoxin, diuretics.
- Heart transplant.
How to Slow the Progression of CHF
Many people consider congestive heart failure to be a death sentence. CHF is a progressive disease, but the rate at which it progresses is dependant on several things, including the following:
- Patient compliance to treatments, e.g. medications, exercise, sodium intake, etc.
- Extent and nature of the underlying heart disease.
- Degree of damage to related organs, e.g. kidneys, lungs, spleen, liver, thyroid.
- Degree of impairment due to symptoms.
A TED talk on health care by Dr. Atul Gawande (19 min)
- Atul Gawande: How do we heal medicine? | Video on TED.com
TED Talks Our medical systems are broken. Doctors are capable of extraordinary (and expensive) treatments, but they are losing their core focus: actually treating people. Doctor and writer Atul Gawande suggests we take a step back and look at new way
Breakthroughs for Treating Congestive Heart Failure
There is an “unprecedented optimism” among researchers and physicians today due to breakthroughs in new medications. And that on the tail of explosive breakthroughs over the past twenty years. There are devices being tested today in clinical trials that assist in, and even assume totally, the function of pumping a body’s blood. All of the treatments currently being used, combined with developing technologies, will continue to change and lessen the impact of congestive heart failure on patients, their families and on society. But it is important to keep in mind that this is a condition which can often be avoided completely or have its impact severely lessened by following a healthy lifestyle long before symptoms have a chance to develop.