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Congestive heart failure (CHF) occurs either when the heart muscle has become weakened, causing the heart
to pump less strongly or efficiently, or when a heart valve develops a problem. With CHF, less oxygen-rich
blood is delivered to the cells and organs of your body. When your heart is unable to pump enough blood to
meet the needs of your body, there is a gradual backup of pressure in your lungs, and this can cause fluid
buildup in the lungs. In addition, because less blood is being pumped out of the heart, some organs, such
as your kidneys, may not function properly.
Possible causes of CHF include:
Sometimes, a combination of these factors leads to CHF, and occasionally, the cause cannot be found.
The major symptoms of CHF are:
- Shortness of breath: This happens when fluid begins to collect in your lungs, making it difficult to breathe. At first, shortness of breath may only occur with certain higher levels of physical exertion, but later may happen with just a little activity or even at rest. This shortness of breath may wake you from your sleep at night or you may be unable to lie flat and need extra pillows. You may develop a cough (especially when you lay down) and, as more fluid builds up, bring up pink-tinged mucous.
- Swelling (edema): This usually starts in the ankles, feet, or lower legs as extra fluid from your veins seeps out into the surrounding tissue. This swelling will sometimes decrease when you sit down and elevate your legs and feet.
- Sudden weight gain: When your body holds extra fluid, your weight will increase. It may go up as much as three pounds a day.
- Fatigue: Because your heart works harder as it tries to pump blood to your body, the combination of the extra work and less oxygen getting to your cells will make you more tired than usual. Normal activities become more difficult.
If you have or develop any of these symptoms, contact your doctor.
There is excellent treatment available for congestive heart failure. Medications, lifestyle changes, and at times,
surgical procedures can provide the maximum benefit.
- Several types of medications might be prescribed. They include an ACE inhibitor or alternatively what is called an angiotensin blocker. These are long names for important drugs that "unload" the heart, allowing it to work less hard. Diuretics (water pills) are often required to reduce the body's level of salt and fluid; this also makes it easier for the heart to work. Digitalis (digoxin) is used to create a little more "oomph" or to help control abnormal rhythms. Finally, beta blockers that reduce the effect of adrenaline on the heart may be prescribed.
- If your CHF is caused by a damaged valve or blockage of the coronary arteries that supply blood to your heart muscle, surgery may be needed to correct the problem.
- You will need to decrease your intake of salt (sodium), not only from the salt shaker, but also by reducing your consumption of hidden salt found in most processed and packaged foods and many other un-suspected sources. This is very important.
- You will need to gradually rebuild your strength and energy. Your doctor will prescribe an exercise program that will help you do this. You will also be given instructions on how to conserve your energy as you go about your daily activities.
- If you are a smoker, it is imperative that you quit as soon as possible. This is absolutely necessary to prevent further damage to your heart muscle.
- Since alcohol can cause further weakening of the heart muscle, it is usually suggested that you keep alcohol intake to a minimum. Your doctor may advise you not to drink alcoholic beverages at all.
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Although the term "congestive heart failure" may sound frightening, this condition
can be controlled with medications, lifestyle changes, and sometimes even surgery.
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Finally, you will be asked to become an active participant in your own care in one other important way. You need
to weigh yourself every morning when you first get up, before eating or drinking. Changes in your weight will help
you and your doctor know how well your therapy is working. Your weight should be carefully recorded on a
calendar or chart. A weight gain of more than two to three pounds overnight or five or more pounds in a week often
indicates that you are retaining fluid, even if you do not notice any swelling. If this occurs, you'll need to let
your doctor know. Your doctor may give you instructions to take more diuretics when this occurs. Ask your doctor
what to do if you notice this kind of weight change.
When CHF is severe, requiring frequent hospitalizations, a number of more advanced or experimental therapies might be considered.
Copyright ©2005 Michigan Heart & Vascular Institute. All rights reserved.
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