Congestive heart failure is a medical condition in which the heart is unable to pump enough blood in order to meet the needs of the body 2. Commonly, this happens over time as arteries narrow in the heart, or high blood pressure leaves the heart too weak or too stiff to pump and fill efficiently. Unfortunately, medical science has been unable to reverse the conditions that lead to heart failure, but has been able to develop medications and treatment protocols that improve the signs and symptoms and help support the heart. Early recognition, diagnosis and treatment greatly improve life expectancy.

Causes

According to Cedars-Sinai Hospital, causes of early congestive heart failure can be the end result of other diseases such as blood clots in the arteries of the lungs, amyloidosis, over or under active thyroid, anemia, lung disorders, constrictive pericarditis, disorders of the electrical conduction system in the heart, heart valve disorders, kidney failure, myocarditis or untreated or inadequately treated high blood pressure 12. Heart failure develops after these other conditions have damaged or weakened the heart muscle so that it can no longer keep up with the normal demands of delivering blood to the rest of the body. The main chambers or ventricles become stiff and do not fill properly, and the muscle itself may weaken.

Symptoms

According to Merck Manuals Online Medical Library, symptoms of heart failure can begin suddenly or gradually over years. If the heart has sustained significant damage, such as from a heart attack, the symptoms begin suddenly. The most common early symptoms of congestive heart failure are shortness of breath and fatigue 2. Older individuals may experience more vague symptoms such as sleepiness, confusion and disorientation when the brain is unable to receive enough oxygen. Heart failure will stabilize for short periods of time, but will often progress to the point of death. As the heart failure progresses, the individual may experience swelling in the legs, ankles and feet, as well is rapid or irregular heartbeats.

Diagnosis

Physicians will include a thorough medical history and physical examination when diagnosing congestive heart failure 2. Physical examination will usually reveal a weak or rapid pulse rate, reduced blood pressure, abnormal heart sounds and potential fluid accumulation in the lungs. The doctor may be able to feel an enlarged liver or visualize swelling in the abdomen or legs. According to physicians at the Mayo Clinic, the physician may request blood tests to check for kidney and thyroid function. Imaging studies may include a chest x-ray to evaluate the condition of the heart and lungs, an echocardiogram to distinguish the type of heart failure, and ejection fractions to measure how well the heart is pumping. An electrocardiogram may be done to record the electrical activity of the heart, and a stress test may be used to measure how the heart and blood vessels respond to exertion on a treadmill.

Treatment

According to Cedars-Sinai Hospital, treatment will be initiated on the underlying medical condition that causes the heart damage in the first place 1. Doctors will evaluate the severity of the symptoms and how well the body is able to accommodate to the reduced pumping effectiveness of the heart. Options for treatment include medications that may be used to improve heart function and slow the progress of the disease. Physicians may recommend biventricular pacing, which is a procedure used to coordinate the pumping of the lower left and right chambers, decreasing the amount of blood leakage through the valves and improving the efficiency of the heart. Doctors will also make recommendations about lifestyle changes, such as losing weight, exercise programs and dietary changes. Patients are advised to reduce the amount of salt and fat in the diet, quit smoking and avoid alcohol.

Prevention

Prevention of the early signs of congestive heart failure is accomplished by treating underlying medical conditions that may cause heart damage early 2. According to physicians at the Mayo Clinic, the key is to reduce risk factors that can be controlled or eliminated. These risk factors include high blood pressure, coronary artery disease and other lifestyle changes. Doctors recommend that patients remain physically active, eat a healthy, well-balanced diet, maintain a healthy weight, reduce stress and quit smoking.