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Congestive heart failure

Congestive heart failure

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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
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03/20/2013

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Congestive Heart FailureCHF 
Definition
Heart failure, also known as congestive heart failure (CHF), means your heart can't pump enough blood to meet your body's needs. Over time, conditions such ascoronary artery disease or high blood pressure gradually leave your heart too weak or stiff to fill and pump efficiently.You can't reverse many conditions that lead to heart failure, but heart failure can often be treated with good results. Medications can improve the signs and symptoms of heart failure and lead to improved survival. Lifestyle changes, such as exercising,reducing salt intake, managing stress, treating depression, and especially losing excessweight, also can help prevent fluid buildup and improve your quality of life.The best way to prevent heart failure is to control risk factors and aggressivelymanage any underlying conditions such as coronary artery disease, high blood pressure, high cholesterol, diabetes or obesity.
Symptoms
Heart failure typically develops slowly and is a chronic, long-term condition, althoughyou may experience a sudden onset of symptoms, known as acute heart failure. Theterm "congestive heart failure" comes from blood backing up into — or congesting — the liver, abdomen, lower extremities and lungs.Some of the signs and symptoms for chronic and acute heart failure are:
Type of heart failure Signs and symptoms
Chronic heart failure(A long-term condition with signsand symptoms that persist.)
 
Fatigue and weakness
 
Rapid or irregular heartbeat
 
Shortness of breath (dyspnea) when youexert yourself or when you lie down
 
Reduced ability to exercise
 
Persistent cough or wheezing with whiteor pink blood-tinged phlegm
 
Swelling (edema) in your legs, anklesand feet
 
Swelling of your abdomen (ascites)
 
Sudden weight gain from fluid retention
 
Lack of appetite and nausea
 
Difficulty concentrating or decreasedalertness
 
Acute heart failure(An emergency situation that occurswhen something suddenly affectsyour heart's ability to function.)
 
Signs and symptoms similar to those of chronic heart failure but more severe,and start or worsen suddenly
 
Sudden fluid buildup
 
Rapid or irregular heartbeat with palpitations that may cause the heart tostop beating
 
Sudden, severe shortness of breath andcoughing up pink, foamy mucus
 
Chest pain if caused by a heart attack In addition to characterizing whether your condition is chronic or acute, your doctor will need to know whether your heart fails to pump, or fills with blood, or acombination of both. 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 leftventricle, your heart's main pumping chamber.
Part of your heart affectedby heart failureDescription
Left-sided heart failure
 
Most common form of heart failure.
 
Fluid and blood may back up in your lungs,causing shortness of breath.Right-sided heart failure
 
Often occurs with left-sided heart failure.
 
Fluid and blood may back up into your abdomen, legs and feet, causing swelling.Systolic heart failure
 
The left ventricle can't contract vigorously,indicating a pumping problem.Diastolic heart failure(also called heart failure withnormal ejection fraction)
 
The left ventricle can't relax or fill fully,indicating a filling problem.While systolic heart failure was once thought to be more common and less serious,recent studies have shown this to be incorrect. Isolated diastolic heart failure, nowalso termed "heart failure with normal ejection fraction," is just as common as systolicheart failure and has a similar prognosis. Identifying the type of heart failure, whether systolic, diastolic, or a combination, is important because the drug treatments for eachtype may differ.
 
Causes
Chambers and valves of the heart 
Heart failure often develops after other conditions have damaged or weakened your heart. Over time, the heart can no longer keep up with the normal demands placed onit. The ventricles may become stiff and not fill properly between beats. Also, the heartmuscle may weaken, and the ventricles stretch (dilate) to the point that the heart can't pump blood efficiently throughout your body.Any of the following conditions can cause heart failure, which can damage or weakenyour heart over time. Some of these can be present without knowing it:
 
Coronary artery disease and heart attack.
Coronary artery disease is the most common formof heart disease and the most common cause of heart failure. Over time, arteries that supplyblood to your heart muscle narrow from a buildup of fatty deposits, a process called atherosclerosis. Blood moves slowly through narrowed arteries, leaving some areas of your heart muscle weak and chronically deprived of oxygen-rich blood. In many cases, the blood  flow to the muscle is just enough to keep the muscle alive but not functioning well. A heart attack occurs if plaque formed by the fatty deposits in your arteries ruptures. This causes ablood clot to completely block blood flow to an area of the heart muscle, weakening theheart's pumping ability.
 
 High blood pressure (hypertension).
Blood pressure is the force of blood pumped by your heart through your arteries. If your blood pressure is high, your heart has to work harder than it should to circulate blood throughout your body. Over time, the heart muscle maybecome thicker to compensate for the extra work it must perform, enlarging the heart. Eventually, your heart muscle may become either too stiff or too weak to effectively pumpblood.

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