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Congestive heart failure (CHF), which is also referred to as congestive cardiac failure (CCF) or simply heart failure, is a medical problem, wherein, the heart loses its ability to fill with or pump adequate amount of blood to the various parts of the body as well as the organs, which causes fluid retention in the body. This condition occurs due to various factors, such as:
  • The narrowing of the arteries supplying the heart muscle with blood, known as coronary artery disease
  • Myocardial infarction, in which, there is a scar tissue that hinders the normal working of the heart
  • Impairment of the heart valve because of rheumatic fever in the past, or other reasons
  • Congenital defects of the heart
  • High blood pressure
  • Cardiomyopathy, which is a disorder of the heart muscle or myocardium, generally of unknown causes
  • Endocarditis, which is an inflammation of the heart valves and the endocardium
  • Myocarditis, which is the inflammation of the muscular tissue of the heart, or myocardium
The impaired heart continues to work, but not as efficiently as it does normally. Those who are affected with this condition, lose their ability to exert themselves as they tire faster and experience shortness of breath.

Effects

As there is a slow down in the blood flow from the heart, the blood that returns to the heart via the veins, begins backing up, resulting in the tissues becoming congested. Often, this results in edema, or swelling, usually in the ankles and legs, although it can also affect other areas of the body as well as organs. For instance, the impaired heart muscles may be incapable of supplying the kidneys with enough blood, causing them to lose the ability to excrete water and sodium, which in turn, causes increased fluid retention in the body. There is also a buildup of fluid in the lungs, known as pulmonary edema, which results in shortness of breath, hence, diminishing the individual's exercise capacity. Likewise, fluids may get accumulated in the liver, because of which, it loses its ability to get rid of toxins from the body as well as make essential proteins. Fluid retention also affects the intestines, which makes them lose their ability to absorb nutrients as well as medications efficiently. If left untreated, eventually, congestive heart failure can affect almost every organ in the body.

As a matter of fact, it is one of the leading causes of people above the age of 65 getting hospitalized. There is a 10 percent mortality rate annually, even with the best of treatment methods. In addition, the condition often goes undiagnosed because of difficulties in the diagnosis, especially at its initial stages or when it occurs in its mild form.

Signs and Symptoms

One of the earliest indications is fatigue, accompanied by the affected person's diminished capacity to exercise. In fact, most people don't even realize this reduction, with them usually compensating subconsciously by reducing their activities in order to adapt to this limitation.

Sometimes, the affected person may wake up at night gasping for breath. Some even have to sleep sitting in an upright position. The excessive fluid in the body also results in an increase in urination, especially at night. When the fluids accumulate in the intestines and liver, it may result in a decrease in the appetite, pain in the abdomen, and nausea.

Treatment Options

The treatment usually includes, adequate rest, a balanced diet, modification in daily activities, and drugs like, angiotensin-converting enzyme, or ACE inhibitors, beta blockers, vasodilators, digitalis, and diuretics.

Vasodilators and ACE inhibitors help to expand the blood vessels as well as decrease the resistance of the blood flow in them. This enables the easier flow of blood, easing the working of the heart, thus making it more efficient. Digitalis is a powerful heart stimulant. Beta blockers improve the pumping of the left ventricle. And, diuretics help in eliminating the excess fluid and salt from the body.

Sometimes, when a specific cause is identified, treating that or correcting it can alleviate this disorder. For instance, sometimes treating high blood pressure can ease CHF, or if an abnormal heart valve is found to be the cause, surgically replacing it can ease the condition.

A more drastic step, like a heart transplant, has to be taken in case of the heart becoming so damaged that repairing it becomes impossible.