What Is Congestive Heart Failure?

Congestive Heart Failure is a condition in which the heart cannot adequately supply enough oxygenated blood to the rest of the body. Blood flowing out of the heart slows down, causing the blood returning to the heart to back up into the circulatory system and congest the tissues. Congestive Heart Failure can be caused by various conditions, including heart attack, high blood pressure, coronary artery disease, disease of the heart valve, deterioration of the heart muscle, irregular heart rhythms and heart defects existent at birth.

Identification

• Congestive heart failure can be identified by a series of tests, the first one usually being an electrocardiogram (ECG). This test documents heart impulses and electrical activity, allowing doctors to detect any potentially irregular heart rhythms.

  An echocardiogram is a multi-dimensional ultrasound of the heart. The clinical measurement to identify how adequately your heart is pumping out blood is calculated through an echo. This is called your ejection fraction (EF), and it measures the percentage of oxygen-rich blood your left ventricle is pumping out to the the other organs in your body. In the two main types of congestive heart failure, systolic and diastolic, the first is a condition where your EF decreases with the weakening of your heart. Patients with systolic heart failure have an EF of 50 percent or less. In diastolic heart failure, the left ventricle stiffens and has problems relaxing, which causes blood to push back into the circulatory system. Diastolic heart failure patients generally show a normal EF.

  Other common tests include angiograms, which identify the presence of coronary artery disease, exercise testing and blood tests designed to indicate different types of heart diseases.

Symptoms

• Symptoms of congestive heart failure include extreme fatigue; shortness of breath; swelling in your legs, ankles, feet, and abdomen; difficulty breathing when lying down; fast or irregular heartbeat; a persistent cough; trouble sleeping; and nausea. If you are experiencing any of these symptoms, call your doctor immediately.

Types

• In the two main types of congestive heart failure, systolic and diastolic, the first is a condition where your ejection fraction (EF) decreases with the weakening of your heart. Your EF is the clinical measurement that identifies how adequately your heart is pumping out blood. Through an echo, doctors calculate the percentage of oxygen-rich blood your left ventricle is pumping out to the the other organs in your body. Patients with systolic heart failure have an EF of 50 percent or less.

  In diastolic heart failure, the left ventricle stiffens and has a problem relaxing, causing blood to push back into the circulatory system. Diastolic heart failure patients generally show a normal EF. The condition is more prevalant amongst patients aged 75 and older, as the left ventricle can naturally begin to stiffen during the aging process.

Management

• Once diagnosed, a good mix of medications, proper monitoring by your cardiologist and the appropriate lifestyle changes help patients manage the condition and improve quality of life. Common medications used to treat systolic and diastolic congestive heart failure include beta blockers and ACE inhibitors, which lower blood pressure, slow the heart rate, and help reduce your heart's workload. They are the mainstay drug treatments for congestive heart failure. Other drugs, like diuretics, also known as water pills, remove all of the excess water and salt build-up in your body, causing you to urinate frequently.

  Medical devices or surgery are needed for some heart failure patients. Pacemakers and implantable cardioverter defibrillators (ICD's) are battery powered devices that are implanted under your skin. The device is attached to your heart by three wires, which send electrical impulses to the heart when needed. ICD's detect abnormal heart rhythms, and provide therapy by shocking the heart back into a normal rhythm. Pacemakers actually '"pace" your heart rate, monitoring it and making sure that it is beating in a coordinated rhythm.

  In some cases coronary bypass surgery is needed. Here, doctors re-route the blood around the arteries that have narrowed or clogged, allowing for a better oxygen-rich blood-flow to the heart. A heart transplant is needed for extreme cases of congestive heart failure, when the patient's heart needs to be removed and replaced with a healthy donor heart.

Expert Insight

• Congestive heart failure with an EF as low as 5 percent tends to feel like you are extremely tired, have indigestion and are severely bloated all at the same time. Walking from one end of the room to the other, climbing up stairs, lying in bed using fewer than three pillows and eating without being short of breath are all very challenging when suffering from this condition.

  The most obvious symptom seems to be the extreme fatigue, followed by the extra weight gain and swollen ankles. Feeling bloated and as though you have indigestion are a result of the fluid retention. Call your doctor immediately if you are suffering from any of these symptoms. As a habit, check your pulse regularly. This way you can monitor any abnormally fast or slow heart rhythms ahead of time, before any potential symptoms occur.