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What is congestive heart failure?
Heart failure means your heart is not pumping blood
effectively enough to meet the needs of your body. It is sometimes called
congestive heart failure because congestion of the lungs causes some of the main
symptoms of heart failure. While it is not the same as cardiac arrest (when the
heart stops beating) or a heart attack (when the heart muscle is suddenly
damaged by an inadequate blood supply), it does require regular medical
attention
How does it occur?
Congestive heart failure may be the result of one or
more of the following:
- Damage to or weakening of the heart muscle, as occurs
after a heart attack
- High blood pressure that has gone untreated for years
- Damage to the valves inside the heart
- Drinking too much alcohol
- Hyperthyroidism (overactivity of the thyroid gland)
hypothyroidism (underactivity of the thyroid gland)
- Viral infections
- Coronary artery disease (blockage in the coronary
arteries)
The following factors can worsen or trigger congestive
heart failure in people with weakened hearts:
- Severe anemia (low levels of red blood cells or
hemoglobin, the oxygen-carrying chemical in the blood)
- High fever
- Rapid heartbeat
- Lung infection
- A blood clot carried to the lungs that is blocking blood
flow (called pulmonary embolism)
- High salt intake
- Drinking too much fluid
- Being overweight
- Working your body too hard
- Emotional stress
- Use of medications that slow the heart
What are the symptoms?
The major symptoms of congestive heart failure are:
- Tiredness
- Shortness of breath or difficulty breathing, at first
during exercise and later with any activity or even when you are at
rest
- Awakening at night with difficulty breathing or
difficulty lying flat in bed because of shortness of breath
- Swollen ankles and feet and weight gain due to too much
fluid in the body
- Loss of appetite
How is it diagnosed?
Your doctor will ask about your symptoms and do a
physical exam. The following tests may be done:
- Chest x-ray to look for lung problems and to view the
size of your heart
- Electrocardiogram (ECG), a recording of the electrical
activity of your heart
- Complete blood count
- Tests of a urine sample
Some people may need an echocardiogram. This is a
sound-wave test that can show heart size, heart function, and possible heart
valve disease.
How is it treated?
There are four goals in treating congestive heart
failure:
- Treat any underlying causes or factors that make it
worse.
- Use medications to increase the ability of your heart to
pump.
- Get rid of excess water in your body with medication,
diet, and rest.
- Reduce the workload on your heart.
Medications your doctor may prescribe are:
- ACE (angiotensin-converting enzyme) inhibitor drugs, which
dilate (widen) the arteries. Dilating the arteries reduces the work the heart
has to do. Then the heart can pump more effectively.
- Diuretics, which increase urination and help you get rid of
excess fluid in your body.
- Digitalis
drugs, which slow your heart rate and improve its pumping ability.
Ask your doctor about possible side effects of these
drugs. Report any side effects to him or her right away. Take all the
medication your doctor prescribes, even when you feel better.
Your doctor will also prescribe a low-salt (low-sodium)
diet. Too much sodium causes your body to retain water, which increases the
workload on your heart. Also, your doctor may want you to avoid nonprescription
medications that are high in sodium, including antacids, cough syrups, and
laxatives. Ask your doctor or pharmacist for advice on which nonprescription
medications to use.
Alternating rest periods with activities, and pacing
activities to avoid getting too tired, can decrease the amount of work your
heart has to do. Regular exercise under a doctor's supervision may improve your
symptoms.
How long will the effects last?
If left untreated, congestive heart failure can be
life-threatening because of the strain it places on your heart and other parts
of your body. Also, because of your weakened condition, you may be more likely
to get infections. For example, pneumonia is a common complication of heart
failure.
Medication should help improve symptoms of swelling and
breathlessness. If you follow your doctor's instructions on diet, rest, and
medications, you will probably enjoy many years of near-normal living.
How can I take care of myself?
Learn to live within the limits of your condition. The
following guidelines may help:
- Get enough rest, shorten your working hours if possible,
and reduce as much as possible the emotional stress in your life. Anxiety and
anger can increase your heart rate and blood pressure. If you feel you need help
with this, ask your doctor.
- Check your pulse rate daily.
- earn how to take your own blood pressure or have a
family member learn how to take it.
- Accept the fact that taking cardiac medications and
restricting salt in your diet are a permanent part of your life.
- Develop a system to make sure that you take your
medications on time.
- Weigh yourself at least every other day, at the same
time of day if possible. Contact your doctor if you gain more than 3 pounds in
1 week, or if you keep gaining weight over weeks to months. Weight gain may
mean your body is having trouble getting rid of excess fluid.
- Know the signs and symptoms of potassium loss, which
include muscle cramps, muscular weakness, irritability, and irregular heartbeat
(rare).
- Follow your doctor's instructions on how much fluid you
should drink.
- Consult a written diet plan and list of foods before you
prepare food.
- Avoid eating and drinking too much.
- Increase your activities gradually, making sure that
they do not cause you to become too tired or short of breath.
- Avoid extremes of hot and cold (including hot tubs),
which cause your heart to work harder.
- Keep regular appointments with your
doctor.s.
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