Stage 4 Congestive Heart Failure

The human heart is one of the most vital organs of the human body. It is the key organ of the circulatory system of our body and performs the important task of pumping oxygenated blood to various parts of our body. The inability of the heart to pump blood and supply the oxygenated blood to other parts of the human body is medically referred to as congestive heart failure (CHF). When the heart is unable to pump sufficient amounts of blood required for fulfilling body's requirements, it causes a back flow of blood into the other organs. This might cause retention of fluid in lungs. Left-sided heart failure is the most common form of heart failure, and it often leads to right-sided heart failure. The inability of the left ventricles to pump blood or fill with blood are medically referred to as systolic heart failure and diastolic heart failure respectively. CHF is divided into four stages. The fourth stage is the final stage of this heart disease. During the fourth stage, any form of physical activity puts strain on the heart, and symptoms might be experienced even while one is resting. CHF must not be confused with a heart attack or a cardiac arrest. Unlike heart attack which is signified by blockage of flow of blood or a sudden cardiac arrest which results in loss of heart function, CHF is associated with the impairment of the pumping mechanism of the heart.

Causes

The human heart is divided into four chambers. The two upper chambers and the two lower chambers are referred to as atria and ventricles respectively. While the right atrium and right ventricle get the deoxygenated blood from the veins and pump it into the lungs, the left atrium and left ventricle, receive the oxygenated blood from the lungs and pump this blood to the various parts the body. There are a variety of medical conditions that can affect the pumping mechanism of the heart. The coronary arteries that supply blood to the heart may get constricted due to buildup of fat deposits. This could affect the flow of blood and weaken the heart muscle. Blood pressure, which is the pressure exerted by blood on the walls of the artery may increase. Due to high blood pressure, the heart would have to work harder for pumping and supply blood to other parts of the body. Flow of blood might also get affected due to heart valve disorders. Those with congenital heart defects or those who have already had a heart attack or cardiac arrest are also susceptible to CHF. If these conditions are not treated soon, the disease would progress to end stage CHF.

Symptoms

Now that you have some idea about the causes of heart failure, let's find out more about the symptoms experienced during the four stages. CHF develops gradually, and symptoms may not be prominent in the initial stage. One might just feel slightly tired or fatigued after indulging in a physical activity. In the second stage, any form of physical activity might lead to shortness of breath, heart palpitations and severe fatigue, however, the symptoms would disappear on taking rest. The symptoms become more pronounced in the third stage and thus, one's ability to perform routine exercises or physical activity may become limited. Other symptoms such as swollen legs or ankles, shortness of breath, dizziness, rapid heartbeat and severe fatigue on performing even mild physical activity might be experienced. Stage 4 congestive heart failure is marked by the patient's inability to perform any physical activity without discomfort. One experiences shortness of breath even while resting. Very mild physical activity could also cause strain on the heart, which in turn, leads to palpitations, severe fatigue and persistent cough. Fluid retention in the body causes swelling especially in the lower extremities. One may experience unexplained weight gain. Inadequate supply of oxygenated blood may also affect internal organs of the body adversely.

Treatment

The treatment may vary depending on the stage. In the early stages, use of drugs such as ACE inhibitors or beta blockers might help in dilation of blood vessels and thus increase the flow of blood. These drugs are extremely helpful in case of people suffering from coronary artery disease or hypertension. Beta blockers are often used for blocking the effect of epinephrine or norepinephrine that cause an accelerated heart rate, rapid breathing or increase in high blood pressure due to physical activity. In advanced stages, diuretics might also be prescribed for treating the fluid retention in the body. Digitalis medication is usually prescribed for enhancing the heart's ability to pump blood. Doctors may follow a symptomatic approach and prescribe medicines for treating specific symptoms caused by the underlying disease that might be affecting the heart's ability to pump and supply blood. Certain disorders associated with the valves may be treated with the help of surgery. Coronary bypass surgery might be performed for widening the constricted arteries. In severe cases, other surgical options might be considered for the patient in the final stage. Ventricular assist devices such as a pacemaker are surgically implanted so as to help the heart to pump blood. In some cases, a biventricular pacemaker may be implanted to facilitate the contraction of both sides of the heart at the same time. Use of implantable cardioverter-defibrillator, which is a device that helps to monitor the heart rhythm, may be suggested. In severe cases, cardiac transplantation might be required. The prognosis of this heart ailment is generally poor, but the use of sophisticated treatment options and self-care measures may enable one to manage the symptoms in a better way. The life expectancy varies depending on the time when the condition is diagnosed. If diagnosed in the final stage, the prognosis and life expectancy would be poor.

A healthy heart is essential for the healthy functioning of the body, so, make sure that you lead a healthy lifestyle. Hypertension, coronary heart disease and various other medical conditions make one susceptible to this heart disease. Those who have a family history of cardiomyopathy are also at a great risk. Smoking, alcohol abuse or drug abuse also make one prone, so, refrain from making any such poor lifestyle choices. CHF is a serious disease, and therefore, an early diagnosis can certainly improve one's chances of a better life. So, make sure that you consult a doctor if you experience symptoms of heart failure. The fourth stage is the end stage of this deadly disease, and if the diagnosis is made when one reaches this final stage, managing the disease would be more difficult. So, pay attention to your heart's health and keep it in a good condition.