Congestive heart failure (CHF) is a condition in which the heart's function as a pump to deliver oxygen-rich blood to the body is inadequate to meet the body's needs.
- Shortness of breath with activity, or after lying down for a while
- Difficulty sleeping; needing to sleep upright
- Chronic fatigue
- Swelling of feet and ankles
- Sudden weight gain
- Swelling of the abdomen
- Chest pain
- Nausea and vomiting
- Need to urinate at night
Who has CHF?
According to the American Heart Association:
- About 4,900,000 Americans (2,500,000 males and 2,400,000 females) have heart failure.
- Heart failure is the single most frequent cause of hospitalization for people aged 65 and older.
- There are approximately 250,000 hospitalizations each year due to heart failure.
- About 400,000 new cases of heart failure occur each year. The incidence of heart failure approaches 10 per 1,000 population after age 65.
- 70 percent of men and 79 percent of women who have heart failure have hypertension.
- Heart failure rates are higher in people who survive heart attack. About 20 percent of heart attack victims will be disabled with heart failure within 6 years.
Patients with CHF are monitored closely by their doctors. Patients are often requested to track their weight on a daily basis. Weight gain can be a sign that they are retaining fluid and that the pump function of the heart is worsening.
Your doctor may consider prescribing the following medications:
- ACE inhibitors such as captopril, enalapril, lisinopril, and ramipril to open up blood vessels and decrease the work load of the heart
- Diuretics including thiazide, loop diuretics, and potassium-sparing diuretics to help rid your body of fluid and sodium
- Digitalis glycosides to increase the ability of the heart muscle to contract properly and help treat some heart rhythm disturbances
- Angiotensin receptor blockers (ARBs) such as losartan and candesartan to reduce the workload of the heart; this class of drug is especially important for those who cannot tolerate ACE inhibitors
- Beta-blockers such as such as carvedilol and metoprolol, which are particularly useful for those with a history of coronary artery disease
Other important measures include:
- Take medications as directed.
- Limit salt intake.
- Don't smoke.
- Stay active. Your doctor can provide a safe and effective exercise plan based on your degree of heart failure and how well you do on tests that check the strength and function of your heart. DO NOT exercise on days when your weight has gone up from fluid retention or when you are not feeling well.
- Lose weight if you are overweight.
- Get enough rest, including after exercise, eating, or other activities. This allows your heart to rest as well. Keep your feet elevated to decrease swelling.
Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. This condition may affect the right side, the left side, or both sides of the heart.
Congestive heart failure can be caused by diseases that:
- Weaken the heart muscle
- Cause stiffening of the heart muscles
- Increase oxygen demand by the body tissue beyond the capability of the heart to deliver
The most common causes of heart failure are:
- Coronary artery disease
- High blood pressure
Heart failure becomes more common with advancing age. You are also at increased risk for developing heart failure if you are overweight, have diabetes, smoke cigarettes, abuse alcohol, or use cocaine.
When to contact a doctor
Call your health care provider if weakness, increased cough or sputum production, sudden weight gain or swelling, or other new or unexplained symptoms develop. Go to the emergency room or call the local emergency number (911) if you experience severe crushing chest pain, fainting, or rapid and irregular heartbeat (particularly if other symptoms accompany a rapid and irregular heartbeat).