Congestive heart failure (CHF) is a serious condition in which the heart is not pumping well enough to meet the bodyís demand for oxygen. This condition got its name because the heart is failing to pump efficiently, which often results in congestion of the lungs. As a result, the heart tries to overcompensate for the problem, which only makes the problem worse.
Conditions that can lead to CHF include coronary artery disease, hypertension, heart attacks, cardiomyopathy, heart valve disease and infections, congenital heart disease and pulmonary hypertension.
The initial symptoms of CHF, such as swelling of the ankles, seems so minor that patients may not seek treatment until significant heart damage has already been done. Once they seek medical help, a number of different conventional treatments may be prescribed. These include medications such as diuretics and invasive procedures such as a balloon angioplasty with coronary stenting. Severe cases may require surgery.
According to current statistics from the American Heart Association, 550,000 new cases of CHF are diagnosed in the United States every year, including 1% of people over the age of 65. Of all newly diagnosed patients, 50% of CHF patients die within 5 years of diagnosis. Males and females appear to be affected about equally, but somewhat more women die from the condition.
There are three general types of CHF.
- Diminished force of contraction of ventricles due to primary heart muscle diseases (cardiomyopathies) or coronory artery disease
- Mechanical failure in filling the ventricles during diastole due to narrowing of the mitral valve opening (mitral stenosis) or accumulation of fluid in the pericardium (pericardial tamponade)
- Overloading of the ventricles during systole due to:
-high blood pressure (hypertensive cardiovascular disease)
-narrowing and obstruction of aortic valve (aortic stenosis)
-incomplete closure of aortic valve (aortic valvular regurgitation)
-congenital defect in ventricular septum (ventricular septal defect)
If the force of contraction is decreased only moderately, the heart can meet the demand provided there is no excessive stress or exercise. This is called compensated heart failure.
Congestive (decompensated) heart failure occurs when force of contraction is decreased further. The primary signs and symptoms of decompensated CHF include:Left ventricular failure
results in pulmonary congestion and edema
and pleural effusion. This can be caused by aortic or bicuspid valvular disease, coronary heart disease and hypertension.Right ventricular failure
results in fluid accumulation and congestion in the liver and legs. This can be caused by chronic
lung disease and pulmonary hypertension or pulmonary or tricuspid valvular disease.Biventricular failure
results in symptoms of both and may be caused by myocarditis, idiopathic
cardiomyopathies or right -sided failure secondary to left-sided heart failure.