The Inability to Maintain Blood Flow

Heart failure (HF), also known as chronic heart failure (CHF), congestive heart failure (CHF), and congestive cardiac failure (CCF), is the inability of the heart to pump blood in a way that meets the needs of your body. Heart failure is often confused with a heart attack (damage to heart muscle) or cardiac arrest (blood flow stops). However, heart failure is its own distinct disease.

Although there are many different types of heart failure, the two main types are: heart failure with left ventricular dysfunction and heart failure with normal ejection fraction. For the first, the left ventricular is not able to contract appropriately. For the second, the heart is not able to relax effectively.

Heart failure is common in the United States and throughout the world. It is the reason for approximately 5% of hospital admissions and can be both costly and deadly. In a typical developed country's population, 2% of adults have heart failure and up to 10% of older adults over the age of 65 have heart failure. Once diagnosed, the risk of death is 35% in the first year and slightly less than 10% each year thereafter. Although we think of heart disease as a modern disease, it has been around for hundreds of years, with comments on it found on papyrus writings back from 1550 BCE.

Symptoms of Heart Failure

There are many classic symptoms is you are experiencing heart failure, including:

  • Shortness of breath that worsens with exercise, when lying down, and while sleeping
  • Being very tired, more than you should be for the work/exercise you are doing
  • Swelling of the legs
  • Reduced ability to exercise, even when being treated for Heart Failure

Common Causes of Heart Failure

There are many different causes for heart failure. Here is a list of the most common:

  • CAD (plaque in the arteries
  • Past myocardial infarction, also known as a heart attack
  • High blood pressure
  • Atrial fibrillation
  • Valvular heart disease
  • Cardiomyopathy

Each of these cause the heart structure to change or the heart function to change leading to failure of the heart.

Diagnosis and Treatment of Heart Failure

Typically, heart failure is diagnosed when a patient experiences symptoms and then is confirmed when a doctor makes a physical examination and performs an echocardiogram (EKG). Additionally, the doctor may order blood tests and chest x-rays to determine the cause. Other diseases can mimic heart failure, so your doctor will want to be sure to rule out anemia, kidney problems, liver problems, obesity, and thyroid disease.

The treatment of heart failure is dependent upon both the cause of the disease and how far the disease has progressed. Your doctor will determine how severe your disease is by your ability to function in daily activities. The more limited you are in your ability to exercise, the more severe the disease.

If your disease is stable, you are likely to be asked to undergo some lifestyle changes including the cessation of smoking, eating healthier, including less fatty foods, and adding an exercise regime.

Your doctor may also prescribe some medications. For those with left ventricular dysfunction, these may include beta-blockers and angiotensin converting enzyme inhibitors. If your heart failure has progressed to the severe level, you may be given aldosterone antagonists, an angiotensin receptor blocker or hydralazine with a nitrate. Additionally, a diuretic may be used to help the body rid itself of extra fluid.

In some cases, your doctor may feel that you need more than lifestyle changes or medication. If so, you may need a pacemaker or implantable cardiac defibrillator. For severe cases, a ventricular assist device or a heart transplant may be necessary.