Congestive Heart Failure in the Elderly

Congestive heart failure is a common form of heart failure, that develops over time due to the inability of the heart to supply enough oxygenated blood required by body cells and tissues. It is more commonly found in elderly people, especially those older than 60 years. The condition results in low cardiac output and can severely reduce the amount of oxygen and blood reaching the brain and other tissues of the body. Congestive heart failure in the elderly is related to several other diseases that can either reduce the capacity of the heart to supply sufficient oxygenated blood or increase the requirement for oxygen and blood to such an extent that the heart fails to meet that demand.

Causes of Congestive Heart Failure
The main causes of congestive heart failure are coronary artery diseases or arteriosclerosis, which causes hardening of the arteries, myocardial infarction, inflammation of heart muscles, a hole in the heart, defects of heart muscles or valves, high blood pressure or hypertension, infection of the valves, congenital heart diseases and diseases that affect the pericardium.

In addition to all these, hyperthyroidism is also related to congestive heart failure, as it increases the rate of metabolism and thereby increases the requirement of blood. This puts extra pressure on the heart to circulate oxygenated blood more frequently. Ultimately, the heart succumbs to this pressure, leading to congestive heart failure. On the other hand anemia is associated with the reduction of red blood cells that carry oxygen to the cells and tissues. As a result, the amount of oxygen supplied to the body cells decreases and in order to provide more oxygen, the heart is required to circulate blood more frequently. This can also put excessive pressure on the heart and can cause congestive heart failure.

Symptoms of Congestive Heart Failure
An acute congestive heart failure can produce symptoms like fainting, shock and cardiac arrest and can even lead to sudden death. It generally occurs after a heart attack or myocardial infarction. On the other hand, chronic congestive heart failure is often found to be associated with increased fatigue in the early stages. However, fatigue cannot be regarded as a specific symptom, as it is associated with many other medical conditions. An important symptom of congestive heart failure in the elderly is edema in the feet and ankle. Shortness of breath, especially during physical exertion, is another important symptom of this condition. This is mainly caused by the accumulation of fluid in the lungs.

Individuals may experience breathing problems, especially when lying flat on a bed. Abdominal pain, nausea and loss of appetite can also occur, mainly due to the accumulation of fluid in the liver and intestines, because of the poor blood supply. Fluid accumulation in the body can also cause weight gain in many individuals. Increased urination is another symptom of congestive heart failure.

Diagnosis and Treatment for Congestive Heart Failure
A thorough study of the medical history of the patients, like previous heart attacks, coronary artery diseases, hypertension, diabetes and alcohol abuse, is required for diagnosing congestive heart disease before conducting a physical examination and laboratory tests. Some important examinations and tests required for a proper diagnosis of the disease include Chest X-ray and ECG (electrocardiogram) to detect conditions like heart enlargement and fluid accumulation around the lungs. Echocardiogram is carried out to check heart muscles and valves, while catheterization helps check the condition of the arteries and measure both heart performance and the pressure around it.

The treatment of congestive heart failure in the elderly depends on the underlying causes of the disease. So depending on the causes various medications like ACE inhibitors, beta blockers, digoxin, diuretics, vasodilators, digitalis, potassium supplements, etc. can be prescribed by the physicians. Sometimes, heart transplantation may also be required. Implantation of mechanical devices like a pacemaker, is another treatment option available for congestive heart failure.

However, in addition to medical treatment, changes in lifestyle, especially a modification in eating habits, is also essential to prevent any further worsening of the condition. Some of these important lifestyle modifications include reducing or limiting the intake of sodium and salt, reducing fluid intake and cholesterol. It has also been found that moderate aerobic exercise can significantly improve the overall quality of life in the elderly with congestive heart failure.