Congestive heart failure (CHF)
Congestive Heart Failure and Pulmonary Edema - Congestive heart failure (CHF) is an imbalance in pump function in which the heart fails to maintain the circulation of blood adequately. The most severe manifestation of CHF, pulmonary edema, develops when this imbalance causes an increase in lung fluid secondary to leakage from pulmonary capillaries into the interstitium and alveoli of the lung. CHF can be categorized as forward or backward ventricular failure. A diagnosis of heart failure sounds scary, as if your heart could stop at any moment. But the underlying heart conditions that commonly cause heart failure, such as coronary artery disease or high blood pressure, typically develop slowly over many years. The development of heart failure usually means that your heart's ability to pump blood has weakened, so it can't circulate enough blood to meet your body's needs. Shortness of breath, fatigue and leg swelling may result. When fluid builds up, heart failure is called congestive. Sometimes the heart becomes too stiff to fill properly, and that also can lead to heart failure.
Although sometimes there's no way to reverse damage to your heart, treatments can significantly improve signs and symptoms. You can also make lifestyle changes, such as exercising, reducing salt intake, and losing weight, to help your weakened heart work as efficiently as possible.
Your best defense against heart failure is to prevent or control risk factors that lead to coronary artery disease, such as high blood pressure, high cholesterol levels, diabetes, smoking, alcohol abuse, inactivity and obesity.
Signs and symptoms
Heart failure typically doesn't occur suddenly. It develops slowly, over time. It's usually a chronic, long-term condition. The first and often only symptom may be shortness of breath. Signs and symptoms of heart failure can include:
Your circulatory system includes arteries and veins. Arteries deliver oxygen-rich blood to the organs and tissues of your body. Veins bring oxygen-poor blood back to your heart to be cycled through your heart and lungs and back out to the rest of your body, via your arteries.
Your heart, the center of your circulatory system, consists of four chambers. Throughout your life, your heart beats approximately once a second. In a single day, your heart beats about 100,000 times. Your heart's two upper chambers, the atria, receive blood. The two lower chambers, the ventricles, pump blood.
Blood returning to your heart enters the right upper chamber (right atrium) of your heart. From there, blood empties into the right ventricle underneath. The right ventricle pumps blood into your lungs, where blood is oxygenated. Oxygenated blood from your lungs then returns to your heart, but this time to the left side — to the left upper chamber (left atrium). Blood then flows into the left ventricle underneath — your heart's main pumping chamber. With each heartbeat, your left ventricle pumps blood into your body's largest artery (aorta) and onward to the rest of your body.
Your heart is composed of two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump ...
Heart failure can involve the left side, right side or both sides of your heart. Typically, heart failure begins with the left side — specifically the left ventricle, your heart's main pumping chamber. Your doctor may refer to your condition as left-sided or left ventricular heart failure. He or she may define it further as systolic heart failure (when the left ventricle loses its ability to contract vigorously) or diastolic heart failure (when the left ventricle loses its ability to relax or fill fully) or a combination of both. The distinction is important because the drug treatments for each type may be different. Right-sided heart failure can occur independently or be a consequence of left ventricular heart failure.
Heart failure often occurs because other cardiac conditions have damaged or weakened your heart, forcing it to work harder. A weakened heart can't pump blood efficiently throughout your body. This causes blood to pool in your legs, feet and ankles, your kidneys to retain excess water and sodium, and fluid to back up into your lungs, leading to shortness of breath. This buildup of fluid is called congestive heart failure.
Heart failure often results from the stress of a heart attack, high blood pressure, or other forms of heart disease such as valve disorders. In fact, all of the behaviors that you probably associate with heart attack or heart disease — such as smoking, being overweight, eating foods high in cholesterol and fat, and not exercising — also cause or contribute to heart failure. Sometimes, your heart becomes weakened without explanation, a condition known as idiopathic dilated cardiomyopathy.
If you have heart failure, chances are you've had one or more of the following conditions, which can damage or weaken your heart. Some of these can be present without you even knowing it:
Other diseases — such as diabetes, severe anemia, hyperthyroidism, kidney or liver failure, and emphysema — also may precipitate heart failure.
A single risk factor may be sufficient to cause heart failure, but a combination of factors dramatically increases the risk.
Risk factors include:
Blacks are more likely to develop heart failure, and the prognosis is generally worse.
When to seek medical advice
See your doctor if you experience any of the signs or symptoms associated with heart failure. Often signs and symptoms of heart failure initiate an emergency room visit, where the condition may first be diagnosed. Other heart and lung problems can cause signs and symptoms that are similar to heart failure.
If you have a diagnosis of heart failure, and if any of the signs or symptoms suddenly become worse or you develop a new sign or symptom, it may indicate that known heart failure is getting worse or not responding to treatment. Contact your doctor promptly.