Congestive Heart Failure
The Facts on Congestive Heart Failure
Congestive heart failure (CHF) occurs when the heart isn't able to pump blood normally. As a result, there is not enough blood flow to provide the body's organs with oxygen and nutrients. The term "heart failure" does not mean that the heart stops beating completely, but that the heart is not working as efficiently.
CHF affects over 6 million people in North America and is the most common cause of hospitalization for people over 65 years of age. Each year CHF is implicated in over 300,000 deaths.
Men are slightly more at risk than women. People of African descent are considerably more at risk than those of European descent and also have a higher risk of death.
There are two basic problems in congestive heart failure:
- systolic dysfunction occurs when the heart can't pump enough blood to supply all the body's needs
- diastolic dysfunction occurs when the heart cannot accept all the blood being sent to it
Many people have both systolic and diastolic heart failure.
Causes of Congestive Heart Failure
CHF is usually the result of other health problems:
- coronary artery disease, a condition that causes narrowing of the arteries that supply the heart with blood, can damage and weaken areas of the heart
- persistent high blood pressure forces the heart to pump against higher pressure, which causes it to weaken over time - people who have uncontrolled high blood pressure are more likely to develop CHF than those who don't
- heart attack damages the heart muscle - people who have had heart attacks are at 5 times the average risk of developing CHF
- diabetes also increases CHF risk
- arrhythmias (abnormal heart rhythms) can cause the heart to pump inefficiently
- heart valve disease may have been caused by abnormalities that have been present since birth or have developed over time
- heart valve damage may have been caused by rheumatic disease or infection
- viral infection of the heart muscle can seriously weaken the heart
- an enlarged wall between the heart chambers (a genetic condition) may be a cause
- certain kidney conditions that increase blood pressure and fluid buildup can increase the risk of CHF by placing more stress on the heart
In addition, all the risk factors that normally increase the chances of heart disease, such as smoking and obesity, also increase your risk of congestive heart failure.
Symptoms and Complications of Congestive Heart Failure
The appearance of symptoms of CHF can be delayed for years. This is because the heart tries to compensate when it is not pumping efficiently. The heart compensates in three ways:
- dilating (enlarging) to form a bigger pump
- adding new muscle tissue to pump harder
- beating at a faster rate
As the heart compensates, several things happen that can result in symptoms. The heart cannot pump well enough to pump the blood through the body and back to the heart again. Blood then backs up into the legs and the lungs, causing fluid buildup. This causes visible swelling of the ankles and legs and shortness of breath.
The most common symptoms of CHF include:
- breathing difficulties during the night or when lying down
- coughing and wheezing
- fatigue and weakness
- shortness of breath
- swollen ankles
Other symptoms of CHF include:
- abdominal pain, bloating, or loss of appetite
- accumulation of fluid in the abdomen
- bluish skin around the mouth
- pale skin and cold hands or feet
- urination at night
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