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Congestive Heart Failure

What is congestive heart failure?

Heart failure does not mean your heart has stopped working. Rather, it means that the heart’s pumping power is weaker than normal. When heart failure occurs, blood moves through the heart and body at a slower rate, and pressure in the heart increases.

As a result, the heart fails to deliver sufficient oxygen and nutrients to meet the body’s needs. The chambers of your heart may respond by stretching in order to hold more blood to pump through the body, or your heart may become stiff and thickened.

Either response helps keep the blood moving, but the heart muscle walls may eventually weaken to such an extent your heart becomes unable to pump as efficiently as it should.

As a result, the kidneys respond and prompt your body to retain fluid (water) and salt. As fluid builds up in the lungs, arms, legs, ankles, feet or other organs, the body becomes congested. Congestive heart failure is the term used to describe this condition.

What causes congestive heart failure?

Heart failure is caused by many conditions which inflict damage on the heart muscle.

Coronary artery disease causes congestive heart failure as decreased blood flow to the heart muscle starves it of oxygen and nutrients. Heart attack, which can induce heart failure, is characterized by a sudden blockage of the coronary artery, stopping the flow of blood to the heart muscle. When a heart attack damages the heart muscle, it scars an area that subsequently will not function properly.

Cardiomyopathy is a disease of the heart muscle with many causes and symptoms, including heart failure. Cardiomyopathy can damage the heart muscle from causes other than artery or blood-flow problems; among them are   infections or alcohol and drug abuse.

Conditions that overwork the heart can be responsible for heart failure, including valve disease, diabetes, high blood pressure, kidney disease, thyroid disease, or heart defects present at birth. In addition, heart failure can occur when several conditions or diseases are present simultaneously.

What are the common symptoms of congestive heart failure?

You may have symptoms that are mild to severe, or you may have no symptoms of heart failure at all. Symptoms may be constant or can come and go.

Symptoms can include: lung congestion as fluid backs up in the lungs, causing shortness of breath during exercise; or difficulty breathing at rest or when lying flat in bed. This lung congestion may also trigger a dry, hacking cough or wheezing. Water and fluid retention are common symptoms of congestive heart failure.

When blood distribution through your kidneys is reduced, fluids and water are retained. This results in swollen ankles, legs, abdomen and weight gain. An increased need to urinate during the night may also occur. Bloating in your stomach may cause nausea or a loss of appetite. Fatigue, dizziness, weakness and rapid or irregular heartbeats may also indicate congestive heart failure.

Is there more than one type of congestive heart failure?

There are two main types of congestive heart failure: systolic dysfunction (systolic heart failure) and diastolic dysfunction (diastolic heart failure.)

What is systolic heart failure?

Systolic dysfunction (or systolic heart failure) occurs when the heart muscle doesn’t contract with enough force to deliver sufficient oxygen-rich blood throughout the body.

What is diastolic heart failure?

Diastolic dysfunction (or diastolic heart failure) occurs when the heart contracts normally, but the ventricles fail to relax properly or are stiff; this prevents an adequate amount blood to enter the heart as it fills.

How is congestive heart failure detected?

Detecting congestive heart failure successfully is based on an analysis of your symptoms, your medical history, test results, and any conditions that may cause heart failure, including high blood pressure, heart valve disease coronary artery disease, diabetes, and angina.

Other factors to be considered include whether or not you drink, take drugs or smoke and how much, as well as your medication. A complete physical exam also contributes to your diagnosis. Your doctor will listen to your heart and look for signs of heart failure or indications of any other illnesses that might have caused your heart muscle to stiffen or weaken.

Certain tests are engineered to identify the cause and gauge the severity of your heart failure. These include: blood tests to evaluate kidney and thyroid function and to check  your cholesterol levels as well as the possible presence of anemia; blood tests to determine your B-type Natriuretic Peptide (BNP) levels, a substance which the heart secretes in response to changes in blood pressure that occur when heart failure develops or gets worse; a chest X-ray to reveal the size of your heart and whether there is fluid buildup around the heart and lungs; an echocardiogram, an ultrasound test to examine the heart’s function, structure, and movement; an ejection fraction (EF) to measure the effectiveness of each heart beat; an electrocardiogram (EKG or ECG) to track the electrical impulses traveling throughout your heart; cardiac catheterization, an invasive procedure to help reveal whether or not coronary artery disease is a cause of your congestive heart failure; and non-invasive stress tests to gather information about the odds of your getting coronary artery disease. Other additional tests may be ordered, depending on your condition.

Is congestive heart failure a common condition?

Heart failure affects nearly 6 million Americans. Roughly 670,000 people are diagnosed with heart failure each year. It is the leading cause of hospitalization in people older than 65 years of age.

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