What is Congestive Heart Failure?
Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from
The "failing" heart keeps working but not as efficiently as it should. People with heart failure can't exert themselves because they become short of breath and tired.
As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Often swelling (edema) results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.
About five million Americans are living with heart failure, and between 400,000 and 700,000 new cases are diagnosed every year. Heart failure is serious and can be life-threatening. About 250,000 people die annually of heart failure.
Shortness of breath - If you have congestive heart failure, you may have difficulty breathing, especially when you lie down. This happens because you have to work a little harder to breath when you lie down because of the fluid in your lungs. You may awaken at night short of breath and have to sit or stand up to get relief. You may find yourself more comfortable with your head and chest elevated. As the buildup of fluid in the lungs become very severe, you may cough up frothy, pink liquid.
Exercise Intolerance - You may find yourself unable to tolerate exercise or even mild physical exertion. This happens because a failing heart cannot pump quite enough blood to provide all the oxygen and other nutrients your body needs while it is exercising. Your ability to exercise, even to walk at a normal pace, may be limited by feeling tired (fatigue) and shortness of breath.
Fluid Retention and Swelling - You may notice puffy swelling (edema) in your legs, feet, and ankles. Often, the swelling is more noticeable in the ankles or on the lower leg in the front where the bone is close to the skin. If you press down on the skin in the puffy areas, the indentation where your finger pressed may be visible for a few minutes. This swelling may be so severe as to reach up to the hips.
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.
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:
If you have heart failure, your doctor will monitor you closely. This means having follow up appointments at least every 3 to 6 months, figuring out any underlying cause and treating it, and periodic testing of your heart function. For example, an ultrasound of your heart, called an echocardiogram, will be done once in awhile to give an estimate of how well your heart is pumping blood with each stroke or beat.
It is also your responsibility to carefully monitor yourself and help manage your condition. One important way to do this is to track your weight on a daily basis. Weight gain can be a sign that you are retaining fluid and that the pump function of your heart is worsening. Make sure you weigh yourself at the same time each day and on the same scale, with little to no clothes on.
Other important measures include:
Medications that your doctor will consider prescribing include:
American Heart Association (AHA)
National Heart, Lung and Blood Institute (NHLBI)