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CAN YOU RECOGNIZE THE 8 COMMON SIGNS OF CHF?

Posted Apr 22 2010 12:00am
Apr
22

          About 5 million people in the United States suffer from congestive heart failure (CHF).  Approximately 550,000 new cases of the condition are diagnosed every year.  It is the most common hospital discharge diagnosis with more than one million hospital stays annually.  A person 40 years or more has a 1 in 5 chance of developing heart failure.  Congestive heart failure (CHF) affects 1% of the people aged 50 years, 5% people aged 75 years or older and 25% people aged 85 years or older irrespective of sex.  Congestive heart failure, or simply heart failure, is a condition where the heart fails to pump adequate blood to meet the body’s need.  Unlike a heart attack, the heart does not stop beating – rather, it weakens over the course of months or years so that it cannot pump enough blood. As a result, pulmonary congestion or fluid build up occurs in the lungs.  Congestive heart failure is mainly due to systolic dysfunction or diastolic dysfunction.  Systolic dysfunction is when the heart cannot pump oxygenated blood to suffice the body’s needs, where diastolic dysfunction is when the heart is unable to accept all the blood being sent to it.

          Common symptoms of Congestive heart failure include:

  • Fatigue – normal day to day activities such as sweeping, vacuuming, and pushing a lawnmower may lead to shortness of breath, cough and a feeling of tiredness.
  • Exercise intolerance – a mild physical exertion or intolerance to exercise is one of the major symptoms depicting a failing heart that cannot pump enough blood to provide nutrients to the body.
  • Dyspnea - when the congestive heart failure worsens, fluid backs up into the lungs and interferes with oxygen getting into the blood causing difficulty in breathing.
  • Nocturnal dyspnea - a patient suffering from congestive heart failure may awaken in the night due to shortness of breath and would require to sit up or stand up to get relief.
  • Edema - fluid build leads to sudden gain in weight, swelling of the legs, ankles and feet.
  • Loss of appetite - plus indigestion, nausea and vomiting sensation.
  • Swelling - of the veins in the neck and abdomen.
  • Increased urination - particularly during the night.

When fluid builds up in the lungs it produces a condition called pulmonary edema.  If pulmonary edema should occur, the patient may have a cough with pink froth, a sensation of drowning, or bubbling in the lungs and/or clammy, pale and bluish-tinged skin.  These symptoms (especially the symptoms of pulmonary edema) are serious and require immediate medical help.

          There are several risk factors of congestive heart failure.  First of all, age is a risk, because the disease is a progressive condition and it increases with age.  It is currently the most common reason for hospitalization in the elderly population.  CHF also tends to run in families, especially when caused by cardiomyopathies (diseases which damage the heart muscles and causes them to become too thin or too thick), so genetics do play a role in the disorder.  Men are more likely to develop CHF than women, although the difference narrows with advancing age.  Research has shown us that African Americans are at higher risk than Caucasians and have a higher mortality rate due to heart failure.  Chronic alcohol use can lead to high blood pressure, heart muscle damage and even cause cardiomyopathy.  Further, the carbon monoxide in cigarettes is thought to damage the heart muscle and increase the susceptibility to virus infection.  As one would guess, a sedentary lifestyle, lack of exercise and eating fatty foods can increase the risk of developing coronary artery disease, which can lead to heart failure.  Finally, the presence of other diseases (coronary artery disease, previous heart attack, high blood pressure, valve abnormalities, diabetes, emphysema, HIV, hyperthyroidism, myocarditis, etc.) can lead to increased risk of heart failure.  In rare instances, women can suffer heart failure during childbirth in a condition called peripartum cardiomyopathy.   

          Treating heart failure almost always means treating the underlying cause of this condition.  These include lifestyle changes (stop smoking and stop drinking alcohol) and dietary changes (eat healthier food, stop eating fatty diets) to treat coronary artery disease, treating high blood pressure and heart valve abnormalities, and so forth.  Medicines that improve heart function can also be prescribed, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, other vasodilators, inotropic medications and beta blockers.  Severe heart failure may require surgery, such as balloon dilation of artery blockages, heart transplantation, pacemaker implants to control the heart rhythm, and insertion of portable pumps to infuse medications.  In cases of valve defects, surgery to repair or replace the damaged valves may be necessary.  The prognosis of heart failure is fair to poor, although advances in medicine continue to greatly increase expected lifespan.  The annual mortality in people with mild, stable symptoms of heart disease is about 10%.  In those with severe and progressive disease, the mortality rate can be as high as 50%.

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