Heart Failure, also known as Congestive Heart Failure (CHF), results in the hearts inability to pump the amount of oxygenated blood necessary to meet the body’s needs. The human body is equipped with certain mechanisms designed to compensate for the failing heart and maintain sufficient blood flow to organs and tissue. These mechanisms include increased heart rate, vasoconstriction, and enlargement of the heart. Increased workload on the heart and physiological stressors, such as infection or strenuous physical activity, may cause these mechanisms to fail resulting in elevated blood pressure, sodium and water retention, decreased cardiac output, as well as circulatory and pulmonary congestion.
CHF is typically caused by disorders of the heart muscle due to hypertension, congenital heart disease, cardio myopathy, dysrhythmias, pulmonary embolism, chronic lung disease, hemorrhage and anemia, anesthesia and surgery, transfusions, infusions, increased body demands (fever, infection, pregnancy), drug abuse, physical stress, or emotional stress.
Initially, there may be isolated left ventricular failure, but in time the right ventricle fails due to excessive workload. Symptoms of left sided ventricular failure are shortness of breath, dyspnea (shortness of breath with pain) with exertion or at night, pulmonary edema, dry cough that often occurs at night, fatigue, insomnia, restlessness, and/or increased heart rate. Symptoms of right sided failure are swelling of the ankles, unexplained weight gain, upper abdominal pain, abnormal fluid in the abdominal cavities, anorexia, nausea, weakness and/or increased urination at night.
Tests to determine if CHF is the proper diagnosis may include ECG, chest x-ray, blood work to check the arterial blood gas (ABG) and liver function.
Treatment of CHF typically includes reducing the hearts workload. This is usually achieved by prescribing diuretics to decrease the excessive fluid and ventricular pressure. Your physician may also prescribe a medication to improve the heart’s ability to pump effectively. In some cases vasodilators are also prescribed to help decrease the heart’s workload. Additionally, ACE inhibitors may be taken to decrease heart rate, and beta blockers may also be used to decrease myocardial workload and protect against fatal dysrhythmias. In addition to any medications your physician may prescribe, a low sodium and fluid restricted diet may also be advised. In cases of advanced heart failure, a heart transplant may be recommended.
Some tips to help manage CHF at home are use supplemental oxygen as needed or as prescribed by your physician, keep the head of your bed elevated, promote physical comfort and avoid situations that cause anxiety. Weigh yourself at the same time everyday, reporting any weight gain in excess of 2-3 lbs within a few days to your doctor.
