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What is Congestive Heart Failure? Print E-mail
Written by Mike Cohen   
Sunday, 18 October 2009

Congestive heart failure, also known as CHF, is a condition in which a weakened heart cannot pump enough blood to body organs. Since the pumping action of the heart is reduced, blood backs up into certain body tissues.

What is going on in the body?

CHF is caused by a number of complex problems that cause the pumping chambers of the heart to fail. The heart is divided into a left heart and right heart. In a healthy heart, the right heart receives oxygen-poor blood from the body and pumps it to the lungs. The blood receives a fresh supply of oxygen as it passes through the lungs. The oxygen-rich blood is then pumped back into the left heart, which pumps it out to the rest of the body.

If the pumping chambers of the heart do not function well, blood stays in the lungs or in the tissues of the body. These areas then become congested with blood and fluid. And that is the basis for the name congestive heart failure. In time, the organs and tissues begin to suffer from not getting enough blood and oxygen.

What are the causes and risks of the condition?
CHF can be caused by many diseases and conditions. Coronary heart disease, also called CHD, is a major cause of CHF. Multiple or severe heart attacks can lead to CHF as heart muscle is damaged. Other risk factors for CHF include:
- alcohol abuse
- certain infectious diseases common in underdeveloped countries
- congenital heart disease, which are heart defects present at birth
- diabetes
- heart valve damage, such as the scarring from a heart valve infection known as endocarditis
- high blood pressure
- high cholesterol levels
- obesity
- inactive lifestyle
- smoking
- some genetic disorders that lead to conditions known as cardiomyopathies

What are the treatments for the condition?
Many medicines are used to treat CHF, including:
- Angiotensin-converting enzyme inhibitors. Also known as ACE inhibitors, these medicines improve the pumping action of the heart. Examples include enalapril, fosinopril, or lisinopril.
- Digitalis. This type of medicine the heart muscles beat more strongly.
- Diuretics. Also known as water pills, this type of medicine helps relieve the buildup of fluid in the tissues. Examples include furosemide or triamterene-HCTZ.
- The mixed alpha-beta adrenergic blocker, carvedilol. This newer medicine has been shown to have a positive effect on heart failure.

In August 2001, the Food and Drug Administration approved a new treatment for severe CHF. Implantable cardiac resynchronization uses a device that stimulates the ventricles, which are the lower chambers of the heart. The device controls the beating of the ventricles so that they beat at the same time. Blood is pumped more efficiently. That helps reduce the effects of CHF.

A left ventricular assist device, called an LVAD, may be used in severe cases of CHF. An LVAD is a small pump that helps the left ventricle pump more blood through the body. It is generally used to support a person until a heart transplant can be performed. For some people, a heart transplant is the only treatment that can cure the CHF.

What are the side effects of the treatments?

Side effects vary with the medicines used:
- Diuretics can cause dehydration and salt imbalance.
- ACE inhibitors can cause a chronic dry cough.
- Too much digitalis can cause serious side effects. These may include vomiting and visual impairment.

What happens after treatment for the condition?
Most people with CHF will benefit if they exercise regularly. Every effort should also be made to reduce his or her coronary risk factors. These actions may include:
- starting a quit smoking program
- keeping other diseases and conditions such as diabetes and high blood pressure under good control
- eating a heart healthy diet

The doctor may need to adjust medicines until the person achieves the best response.

How is the condition monitored?
Periodic exams, blood tests, and imaging studies such as echocardiography are done to monitor CHF. Any new or worsening symptoms should be reported to the doctor.


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