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 in 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 in Older Patients
The main causes of congestive heart failure is coronary artery disease or arteriosclerosis, which causes hardening of the arteries. As we grow old, the heart muscles weaken and are unable to pump the required amount of blood. This leads to the blood pooling up in the lower extremities of the body, giving rise to congestive heart failure. Other risk factors include 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, diabetes, kidney diseases, obesity, excess alcohol abuse, etc.

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. Ultimately, the heart succumbs to this pressure, leading to congestive heart failure. 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 has to pump harder to circulate oxygenated blood. This can also put excess pressure on the heart and can cause congestive heart failure.

Symptoms of Congestive Heart Failure in Older Patients
An acute congestive heart failure can produce symptoms like fainting, sudden shortness of breath, increased heartbeat, shock and cardiac arrest and can even lead to sudden death. It generally occurs after a heart attack or myocardial infarction. 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 ankles. 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 in Older Patients
A thorough study of the medical history of the patients, like previous heart attacks, coronary artery disease, 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 transplant 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 changes include reducing the intake of salt, and cutting back on foods high in cholesterol. Giving up smoking and limiting the use of caffeine and alcohol will prevent the condition from aggravating further. It is recommended that elderly patients get adequate rest and keep stress and depression at bay. It has also been found that moderate aerobic exercise, which will also help to keep the weight in check, can significantly improve the overall quality of life in the elderly with congestive heart failure.