Congestive Heart Failure
What is Congestive Heart Failure?
Congestive heart failure (CHF) is a term used to describe the heart’s
inability to pump enough blood to meet the body’s needs. Heart failure
does not mean that the heart has failed completely, but rather that the
heart is not strong enough to meet the body’s needs at times of stress
or increased activity. The left ventricle normally receives blood from
the lungs and pumps blood through the arteries to the brain, internal
organs and extremities. When the left ventricle is weak the patient may
experience symptoms of low cardiac output: fatigue and dizziness, and
symptoms of congestion: shortness of breath on exertion, inability to
lay flat and awakening at night-time with shortness of breath. If the
CHF becomes severe fluid may leak into the lungs causing “pulmonary
edema” and severe respiratory (breathing) difficulties. When the
right ventricle fails the patient may also have symptoms of low cardiac
output but also experience fluid build-up in the tissues of the body resulting
in leg swelling (edema) and congestion of the internal organs.
Causes of CHF
Weakness of the left ventricle can be caused by:
- Longstanding uncontrolled hypertension
- Heart attacks - damage to the heart muscle due to coronary artery
disease (blocked arteries)
- Valvular heart disease- longstanding leaking or narrowing of the aortic
or mitral valves
- Viral, toxic or metabolic disturbances damaging the heart muscle.
Alcohol is the commonest culprit.
- Longstanding rapid heart beating (racing) due to some form of arrhythmia
- Congenital abnormalities e.g. ventricular septal defect (a hole between
the left and right ventricle
Weakness of the right ventricle may be caused by:
- Failure of the left ventricle
- High blood pressure within the lungs
- Valvular heart disease-pulmonary valve stenosis (narrowing)/tricuspid
valve leaking
- Right ventricular infarction (heart attack) due to coronary artery
disease
- Congenital abnormalities e.g. atrial septal defect (a hole between
the left and right atria)
- Disease affecting the sac surrounding the heart (the pericardium)
such as fluid accumulation (effusion) or abnormal thickening (constriction)
Is CHF dangerous?
Untreated CHF can lead to severe respiratory difficulties which can be
life threatening. Fortunately there are many medications which are effective
in treating the symptoms and improving the prognosis of CHF. Lifestyle
modifications including proper diet and salt restriction can help reduce
or eliminate the symptoms of CHF.
It is important for you to recognize the symptoms of heart failure and
to alert your physician to any deterioration in your condition. If you
act early on, severe heart failure and the need for hospitalization may
be avoided.
More information on heart failure and prevention can be found in the
Exercise section.
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