What is congestive heart failure?
What are the signs of congestive heart failure?
What causes congestive heart failure?
How does my doctor tell if I have congestive heart failure?
How is congestive heart failure treated?
What is congestive heart failure?
Congestive heart failure is not the same as a heart attack, when some of your heart muscle dies. Congestive heart failure means your heart is not pumping well enough to deliver blood to your body's cells. This causes a buildup of fluid—congestion—in your lungs and other body tissues.
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What are the signs of congestive heart failure?
Congestive heart failure usually develops slowly, and patients may go for years without symptoms. But as your heart becomes weaker and weaker, you may:
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Have trouble breathing or lying flat |
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Feel tired, weak, and unable to exercise |
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Gain weight |
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Have chest pain |
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Lose your appetite, or feel like you have indigestion |
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Have swelling in various body parts, including neck veins, feet, ankles, and stomach. Your shoes may feel tight. |
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Have skin that is cold and sweaty |
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Have a fast or irregular heartbeat (pulse) |
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Feel restless and confused |
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Have trouble remembering things, or paying attention |
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Have trouble sleeping |
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Urinate more often, especially at night |
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Have a cough that produces white or pink mucus. |
Symptoms can help doctors find out which side of your heart is not working properly.
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What causes congestive heart failure?
Your heart is made of four chambers: two lower ventricles, and two upper atria. If your left ventricle loses its ability to contract or pump normally, pressures build up in the lungs, and some fluid seeps into the substance of the lungs, interfering with oxygen uptake. When your right ventricle loses pumping power, blood backs up into your veins, causing swelling in your legs and ankles.
The most common causes of congestive heart failure are:
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High blood pressure (hypertension) |
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Coronary artery disease, or arteriosclerosis—the narrowing of the arteries that carry blood to and from the heart |
Other factors that may cause congestive heart failure include:
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Previous heart attacks |
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Heart valve disease |
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Congenital heart disease or defects (inherited at birth) |
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Heart muscle disease (cardiomyopathy) or inflammation (myocarditis) |
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Prolonged rapid heartbeats |
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A lung disease |
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Heart tumor |
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Alcohol and drug abuse |
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Diabetes |
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Being overweight |
Heart failure is almost always a chronic, long-term condition.
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How does my doctor tell if I had congestive heart failure?
Your doctor may suspect congestive heart failure if you are short of breath and have swelling in your body parts. He or she will first listen to your chest with a stethoscope for the sounds of fluid in the lungs, faulty heart valves, or a rapid heartbeat. Your doctor also may use some of the following tests:
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Take a chest X-ray to see if your heart is enlarged and see if you have fluid in and around your lungs |
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An electrocardiogram (ECG or EKG) measures the electrical activity of your heart. It helps your doctor see how well your heart beats, and can tell if your heart muscle has been damaged in any way. A technician puts small metal disks—electrodes—on your skin to read the pattern of electrical impulses from your heart. The test only takes a few minutes, and is often used to diagnose a heart arrhythmia, or irregular heartbeat, or to see if you had a heart attack. |
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Give you an echocardiogram, which uses sound waves to make a picture of your heart. Your doctor sees this image on a television monitor, and can examine how well your heart works. The test takes about 45 minutes, and is painless. |
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Do a heart catheterization, which allows a doctor to record information from inside the heart. With the patient awake and under pain medicine, the doctor inserts a thin, flexible tube called a catheter into an artery in the leg, and guides it into the heart. The doctor can then perform many tests, including an angiography, where an injected dye shows the heart and its arteries. A doctor can also use heart catheterization to measure blood pressure and oxygen levels inside the heart, as well as the pumping ability of the heart muscle. |
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How is congestive heart failure treated?
| Non-surgical |
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Lifestyle changes |
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There
is no direct cure for congestive heart failure, but changing
your diet and
other habits can slow its effects. Patients with mild
to moderate congestive heart failure often can lead nearly
normal lives by: |
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Quitting smoking |
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Controlling your blood pressure, cholesterol levels, and diabetes |
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Limiting alcohol |
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Avoiding or limiting caffeine |
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Switching to a diet that is low in calories, saturated fat, and salt |
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Getting regular exercise |
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Reducing stress |
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Weighing yourself daily to watch for fluid buildup |
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Medications |
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Most people with congestive heart failure take a number of medications that work in different ways. |
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Diuretics rid your body of extra fluid |
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Beta-blockers decrease the heart rate and lower blood pressure by blocking the effects of adrenalin |
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ACE inhibitors and angiotensin II inhibitors open arteries and reduce the workload of the heart |
| Surgery |
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When heart failure is believed to be the result of narrowed heart arteries, your doctor may recommend treatment to open your arteries with balloons or stents. |
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A biventricular pacemaker serves to re-coordinate heart contractions and is often helpful in patients with advanced heart failure. The device is implanted near the collarbone after the surgeon makes a small "pocket" under the skin. In most cases, the procedure takes about one hour. The patient is awake, and pain medication is given throughout. Most patients are able to return home one day later. |
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Correction of congenital heart defects may be done in a single surgical procedure or require a series of procedures. Surgery may involve opening the heart. Heart surgery for children may take as many as 12 hours in the operating room. |
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In coronary artery bypass graft surgery, a segment of vein from the leg or a natural artery from the chest wall is used to route blood around a narrowed heart artery. Bypass surgery usually involves a hospitalization of about a week and a month-long recovery period. Most patients do not return to work until two to three months after surgery. |
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