Heart Failure

Definition

“Heart failure” or congestive heart failure (CHF) generally refers to dysfunction of the heart. CHF can result from either a reduced ability of the heart muscle to contract or from a mechanical problem, such as being too stiff, that limits the ability of the heart’s chambers to fill with blood under normal pressures.

What are some of the causes?

There are many causes of heart failure including: coronary artery disease, valvular heart disease, congenital heart disease, poorly-controlled high blood pressure, familial causes, viral infections, parasitic infections (Chagas disease), excessive alcohol consumption, illicit drugs use (including cocaine and amphetamines), chemotherapy drugs (such Adriamycin), complications during the last month of pregnancy or within 5 months of birth (peripartum cardiomyopathy) and idiopathic or unknown cause. From an epidemiological perspective, heart failure increases as we age, becoming much more common in one’s 50s and 60s, though certainly can affect the young. In patients over the age of 60, diastolic heart failure (a stiff heart) becomes more common than systolic dysfunction (a weak heart) as a cause for hospital admissions for congestive heart failure.

What symptoms might I have with congestive heart failure?

  1. Shortness of breath when you lie down or exert yourself.
  2. Swelling in your legs, ankles, or feet.
  3. Worsening fatigue and weakness.
  4. Rapid or irregular heartbeat.
  5. Reduced exercise tolerance.
  6. Persistent cough or wheezing.
  7. Abdominal discomfort, swelling, and loss of appetite.
  8. Unexpected weight gain.

When & why should I see a cardiologist?

If you already have a diagnosis of heart failure or any of the signs or symptoms possibly associated with CHF, it is recommended that you see a cardiologist. Not only may you be diagnosed with a treatable condition, but specialist-directed care by a cardiologist has proven to prolong one’s life and decrease future events requiring hospitalization. While CHF is a serious health risk, it is possible for patients to live with CHF and manage many symptoms effectively with proper treatment. The best way to prevent heart failure is to control risk factors and aggressively manage any underlying conditions such as coronary artery disease, diabetes, high cholesterol, high blood pressure, or obesity. Additonal therapeutic approaches include medical management (utilizing the correct combination of medications to attempt to strengthen the heart and get extra water/salt out of the body), advanced device care (pacemakers, defibrillators, and ventricular assist devices), behavior modification (paying close attention to a healthy lifestyle and limiting water and salt intake and increasing exercise), and lastly consideration for heart transplant if appropriate.