Why Congestive Heart Failure Can Be A Serious Condition
Congestive heart failure (or heart failure) is a condition in which the heart can't pump enough blood to meet the needs of the body's other organs. The word failure implies the heart has stopped and is no longer working when, in fact, it really means the heart is not working as efficiently as it can. Congestive heart failure is an underlying symptom of another disease process.
Congestive heart failure is not a disease in itself. It is a syndrome in which the heart is unable to pump an adequate supply of blood to meet the oxygen requirements of the body's tissues and organs. As a result, fluid accumulates in the heart and other organs such as the lungs and spreads gradually into surrounding tissues. The fluid accumulates in the part of the heart that is failing. This condition can occur suddenly or gradually. Symptoms for CHF can vary.
In reality, congestion (the buildup of fluid) is just one feature of the condition and does not occur in all patients. There are two main categories of heart failure although within each category, symptoms and effects may differ from patient to patient. The two categories are:
Systolic Heart Failure
This occurs when the heart's ability to contract decreases. The heart cannot pump with enough force to push a sufficient amount of blood into the circulation. Blood coming into the heart from the lungs may back up and cause fluid to leak into the lungs, a condition known as pulmonary congestion.
Diastolic Heart Failure
This occurs when the heart has a problem relaxing. The heart cannot properly fill with blood because the muscle has become stiff, losing its ability to relax. This form may lead to fluid accumulation, especially in the feet, ankles, and legs. Some patients may have lung congestion.
Congestive heart failure is frequently a symptom of another cardiovascular problem. Often the underlying disease process is identified as a result of the symptoms of CHF. The most common causes are:
Causes for CHF in younger patients can include:
Sometimes no cause can be identified. Signs and Symptoms of CHF are -
Heart failure caused by an excessive workload is curable by treating the primary disease, such as anemia or thyrotoxicosis. Also curable are forms caused by anatomical problems, such as a heart valve defect. These defects can be surgically corrected.
However, for the common forms of heart failure--those due to damaged heart muscle--no known cure exists. But treatment for these forms may be quite successful. The treatment seeks to improve patients' quality of life and length of survival through lifestyle change and drug therapy.
Patients can minimize the effects of heart failure by controlling the risk factors for heart disease. Obvious steps include quitting smoking, losing weight if necessary, abstaining from alcohol, and making dietary changes to reduce the amount of salt and fat consumed. Regular, modest exercise is also helpful for many patients, though the amount and intensity should be carefully monitored by a physician.
But, even with lifestyle changes, most heart failure patients must take medication. Many patients receive two or more drugs.
Several types of drugs have proven useful in the treatment of heart failure:
Diuretics help reduce the amount of fluid in the body and are useful for patients with fluid retention and hypertension.
Digitalis increases the force of the heart's contractions, helping to improve circulation.
Results of recent studies have placed more emphasis on the use of drugs known as angiotensin converting enzyme (ACE) inhibitors. Several large studies have indicated that ACE inhibitors improve survival among heart failure patients and may slow, or perhaps even prevent, the loss of heart pumping activity.
It is widely believed that anti-oxidant vitamins may decrease the risk of heart disease, although there is little clinical data to support this. Beta-carotene is an anti-oxidant found in many fruits and vegetables and has received attention as one anti-oxidant that may be beneficial if taken in larger amounts as a supplement. Folic acid is thought to protect against heart disease because it breaks down homocysteine and allows it to be cleared from the blood stream.
Whether or not to prescribe supplements continues to be debated. Several scientists have called for clinical trials to determine whether giving folic acid actually reduces heart attack risk. An editorial accompanying the Canadian study suggests including vitamins B6 and B12 in the trials, since these vitamins also influence homocysteine levels. An additional reason for giving vitamin B12 is that folic acid supplements can mask vitamin B12 deficiencies, which are not uncommon in the elderly and may cause neurologic damage if left untreated.
Growing evidence that folic acid may prevent heart attacks has led to recommendations that people consume 400 mcg. a day. This amount has been shown to maintain low homocysteine levels and also to prevent neural tube defects in the unborn. But, although 400 mcg. used to be the recommended daily allowance (RDA) for folic acid, the RDA was cut by half several years ago.
The nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.
Congestive heart failure (or heart failure) is a condition in which the heart can't pump enough blood to meet the needs of the body's other organs. The word failure implies the heart has stopped and is no longer working when, in fact, it really means the heart is not working as efficiently as it can. Congestive heart failure is an underlying symptom of another disease process.
Congestive heart failure is not a disease in itself. It is a syndrome in which the heart is unable to pump an adequate supply of blood to meet the oxygen requirements of the body's tissues and organs. As a result, fluid accumulates in the heart and other organs such as the lungs and spreads gradually into surrounding tissues. The fluid accumulates in the part of the heart that is failing. This condition can occur suddenly or gradually. Symptoms for CHF can vary.
In reality, congestion (the buildup of fluid) is just one feature of the condition and does not occur in all patients. There are two main categories of heart failure although within each category, symptoms and effects may differ from patient to patient. The two categories are:
Systolic Heart Failure
This occurs when the heart's ability to contract decreases. The heart cannot pump with enough force to push a sufficient amount of blood into the circulation. Blood coming into the heart from the lungs may back up and cause fluid to leak into the lungs, a condition known as pulmonary congestion.
Diastolic Heart Failure
This occurs when the heart has a problem relaxing. The heart cannot properly fill with blood because the muscle has become stiff, losing its ability to relax. This form may lead to fluid accumulation, especially in the feet, ankles, and legs. Some patients may have lung congestion.
Congestive heart failure is frequently a symptom of another cardiovascular problem. Often the underlying disease process is identified as a result of the symptoms of CHF. The most common causes are:
- Coronary artery disease and Myocardial infarction (heart attack)
- Cardiomyopathy (diseased heart muscle)
- Hypertension (high blood pressure)
- Heart valve abnormalities (particularly the aortic and mitral valves)
- Heart arrhythmia (abnormal heart rhythm)
- Congenital heart defects (those occurring at birth)
- Toxic substances (excessive alcohol and drug abuse)
Causes for CHF in younger patients can include:
- Hyperthyroidism
- Anemia
- Kidney disease
- Pregnancy
- Viral infections or
inflammation of the heart (myocarditis)
Sometimes no cause can be identified. Signs and Symptoms of CHF are -
- Fatigue or weakness (this is often the earliest symptom of CHF)
- Shortness of breath with or without activity
- Orthopnea (difficulty breathing while lying flat, often classified by how many pillows are required to breath easier when sleeping)
- Rapid or irregular pulse
- Edema (swelling) of legs, feet and ankles, abdomen, liver, spleen and lungs
- A chronic dry or frothy cough (may be blood-tinged or resemble foam)
- Nocturia (an increase in urination at night)
- Palpitations (feeling the heart beat)
- Oliguria (decreased urine output)
- Unexplained or unintentional rapid weight gain
- Distended (swollen) neck veins
- Loss of appetite, indigestion
- Cold, diaphoretic (sweaty) dusky colored skin
- Changes in behavior; restlessness, confusion, decreased attention span and memory.
Heart failure caused by an excessive workload is curable by treating the primary disease, such as anemia or thyrotoxicosis. Also curable are forms caused by anatomical problems, such as a heart valve defect. These defects can be surgically corrected.
However, for the common forms of heart failure--those due to damaged heart muscle--no known cure exists. But treatment for these forms may be quite successful. The treatment seeks to improve patients' quality of life and length of survival through lifestyle change and drug therapy.
Patients can minimize the effects of heart failure by controlling the risk factors for heart disease. Obvious steps include quitting smoking, losing weight if necessary, abstaining from alcohol, and making dietary changes to reduce the amount of salt and fat consumed. Regular, modest exercise is also helpful for many patients, though the amount and intensity should be carefully monitored by a physician.
But, even with lifestyle changes, most heart failure patients must take medication. Many patients receive two or more drugs.
Several types of drugs have proven useful in the treatment of heart failure:
Diuretics help reduce the amount of fluid in the body and are useful for patients with fluid retention and hypertension.
Digitalis increases the force of the heart's contractions, helping to improve circulation.
Results of recent studies have placed more emphasis on the use of drugs known as angiotensin converting enzyme (ACE) inhibitors. Several large studies have indicated that ACE inhibitors improve survival among heart failure patients and may slow, or perhaps even prevent, the loss of heart pumping activity.
It is widely believed that anti-oxidant vitamins may decrease the risk of heart disease, although there is little clinical data to support this. Beta-carotene is an anti-oxidant found in many fruits and vegetables and has received attention as one anti-oxidant that may be beneficial if taken in larger amounts as a supplement. Folic acid is thought to protect against heart disease because it breaks down homocysteine and allows it to be cleared from the blood stream.
Whether or not to prescribe supplements continues to be debated. Several scientists have called for clinical trials to determine whether giving folic acid actually reduces heart attack risk. An editorial accompanying the Canadian study suggests including vitamins B6 and B12 in the trials, since these vitamins also influence homocysteine levels. An additional reason for giving vitamin B12 is that folic acid supplements can mask vitamin B12 deficiencies, which are not uncommon in the elderly and may cause neurologic damage if left untreated.
Growing evidence that folic acid may prevent heart attacks has led to recommendations that people consume 400 mcg. a day. This amount has been shown to maintain low homocysteine levels and also to prevent neural tube defects in the unborn. But, although 400 mcg. used to be the recommended daily allowance (RDA) for folic acid, the RDA was cut by half several years ago.
The nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.
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