Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscle. Show
While often referred to simply as heart failure, CHF specifically refers to the stage in which fluid builds up within the heart and causes it to pump inefficiently. You have four heart chambers. The upper half of your heart is made up of two atria, and the lower half of your heart is made up of two ventricles. The ventricles pump blood to your body’s organs and tissues, and the atria receive blood from your body as it circulates back from the rest of your body. CHF develops when your ventricles can’t pump enough blood volume to the body. Eventually, blood and other fluids can back up inside your:
CHF can be life threatening. If you suspect you or someone you know has CHF, seek immediate medical treatment. In the early stages of CHF, you most likely won’t notice any changes in your health. If your condition progresses, you’ll experience gradual changes in your body. Chest pain that radiates through the upper body can also be a sign of a heart attack. If you experience this or any other symptoms that may point to a severe heart condition, seek immediate medical attention. Symptoms of heart failure in children and infantsIt can be difficult to recognize heart failure in infants and young children. Symptoms may include:
These symptoms can easily be misunderstood as colic or a respiratory infection. Poor growth and low blood pressure can also be signs of heart failure in children. In some cases, you may be able to feel a resting baby’s rapid heart rate through their chest wall. You and your doctor may consider different treatments depending on your overall health and how far your condition has progressed. Congestive heart failure drugsThere are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more. ACE inhibitorsAngiotensin-converting enzyme (ACE) inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you can’t tolerate ACE inhibitors. You may be prescribed one of the following:
On April 22, 2022, Pfizer issued a voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake (ADI) as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall. ACE inhibitors shouldn’t be taken with the following medications without consulting a doctor, because they may cause an adverse reaction:
This is an abbreviated list, so always speak with your doctor before taking any new medications. Beta-blockersBeta-blockers decrease the work the heart has to do and can reduce blood pressure and slow a rapid heart rhythm. This may be achieved with:
Beta-blockers should be taken with caution with the following medications, as they may cause an adverse reaction:
Some medications may not be listed here. You should always consult your doctor before taking any new medications. DiureticsDiuretics reduce your body’s fluid content. CHF can cause your body to retain more fluid than it should. Your doctor may recommend:
Diuretics should be taken with caution with the following medications, as they may cause an adverse reaction:
This is an abbreviated list with only the most common drug interactions. You should always talk with your doctor before taking any new medications. Surgeries and proceduresIf medications aren’t effective on their own, more invasive procedures may be required. Angioplasty, a procedure to open up blocked arteries, is one option. Your cardiologist may also consider heart valve repair surgery to help your valves open and close properly. As mentioned, early signs of congestive heart failure may not be very noticeable. Here are some early warning signs to discuss with your healthcare provider:
When the heart isn’t able to pump blood effectively, blood can get backed up in veins and tissues. Blood and other fluids can back up in certain areas and cause swelling (edema). The ankles, feet, legs, and abdomen are common places that can swell. Here is an example of edema: CHF may result from other health conditions that directly affect your cardiovascular system. This is why it’s important to get annual checkups to lower your risk for heart health problems, including:
HypertensionWhen your blood pressure is higher than normal, it may lead to CHF. Hypertension has many different causes. Among them is the hardening of your arteries, which increases pressure in the arteries. Coronary artery diseaseCholesterol and other types of fatty substances can block the coronary arteries, which are the small arteries that supply blood to the heart. This causes the arteries to become narrow. Narrower coronary arteries restrict blood flow and can lead to damage in your arteries. Valve conditionsYour heart valves regulate blood flow through your heart by opening and closing to let blood in and out of the chambers. Valves that don’t open and close correctly may force your ventricles to work harder to pump blood. This can be a result of a heart infection or defect. Other conditionsWhile heart-related diseases can lead to CHF, there are other seemingly unrelated conditions that may increase your risk, too. These include:
Severe infections and allergic reactions may also contribute to CHF. Left-sided CHF is the most common type of CHF. It occurs when your left ventricle doesn’t properly pump blood out to your body. As the condition progresses, fluid can build up in your lungs, which makes breathing difficult. There are two kinds of left-sided heart failure:
Right-sided CHF occurs when the right ventricle has difficulty pumping blood to your lungs. Blood backs up in your blood vessels, which causes fluid retention in your lower extremities, abdomen, and other vital organs. It’s possible to have left-sided and right-sided CHF at the same time. Usually, the disease starts in the left side and then travels to the right when left untreated. About 6.2 million U.S. adults had heart failure between 2013 and 2016. A report from the American Heart Association estimates that about 50 percent of people diagnosed with CHF live past 5 years. An older study showed results that some lower-risk patients who were diagnosed prior to the age of 50 had life spans of about 20 years after diagnosis. Age at diagnosis, other conditions, and sex also contributed to variables in life expectancy, with some under 3 years after diagnosis. The prognosis and life expectancy for congestive heart failure can vary based on many factors. Generally, early diagnosis and following a treatment plan can lead to better management and a longer life. After reporting your symptoms to your doctor, they may refer you to a heart specialist, or cardiologist. The cardiologist will perform a physical exam, which will involve listening to your heart with a stethoscope to detect abnormal heart rhythms. To confirm an initial diagnosis, a cardiologist might order certain diagnostic tests to examine your heart’s valves, blood vessels, and chambers. There are a variety of tests used to diagnose heart conditions. Because these tests measure different things, your doctor may recommend a few to get a full picture of your current condition. Blood testsBlood tests can check for abnormal blood cells and infections. This includes testing for blood count, kidney function, and liver function. They can also check the level of BNP, a hormone that rises with heart failure. Chest X-rayChest X-rays can be used to asses heart size and fluid build up in the lungs and blood vessels. This is usually one of the first tests your doctor will recommend. ElectrocardiogramAn electrocardiogram (EKG or ECG) records your heart’s rhythm. Abnormalities in your heart’s rhythm, such as a rapid heartbeat or irregular rhythm, could suggest that the walls of your heart’s chamber are thicker than normal. That could be a warning sign for a heart attack. EchocardiogramAn echocardiogram uses sound waves to record the heart’s structure and motion. The test can determine if you already have poor blood flow, muscle damage, or a heart muscle that doesn’t contract normally. Stress testStress tests show how well your heart performs under different levels of stress. Making your heart work harder makes it easier for your doctor to diagnose problems. Cardiac catheterizationCardiac catheterization can show blockages of the coronary arteries. Your doctor will insert a small tube into your blood vessel and thread it from your upper thigh (groin area), arm, or wrist. At the same time, the doctor can take blood samples, use X-rays to view your coronary arteries, and check blood flow and pressure in your heart chambers. MRIAn MRI takes pictures of your heart. With both still and moving pictures, this allows your doctor to see if there’s damage to your heart. Some factors are based on our genetics, but lifestyle can play a role as well. There are several things you can do to lower your risk of heart failure, or at least delay onset. Avoid or quit smokingIf you do smoke and haven’t been able to quit, ask your doctor to recommend products and services that can help. Secondhand smoke is also a health hazard. If you live with a smoker, ask them to smoke outdoors. Maintain a well-balanced dietA heart healthy diet is rich in vegetables, fruits, and whole grains. You also need protein in your diet. Things to avoid include:
ExerciseAs little as 1 hour of moderate aerobic exercise per week can improve your heart health. Walking, bicycling, and swimming are good forms of exercise. If you haven’t exercised in a while, start with just 15 minutes a day and work your way up. If you feel unmotivated to work out alone, consider taking a class — it can even be online — or sign up for personal training at a local gym. Watch your weightHaving obesity or overweight can be hard on your heart. Follow a healthy diet and exercise regularly. If you aren’t at a healthy weight for your body, talk with a doctor about how to move forward. You can also consult a dietitian or nutritionist. Other preventive stepsDrink alcohol only in moderation and stay away from illegal drugs. When taking prescription medications, follow instructions carefully and never increase your dose without a doctor’s supervision. If you’re at high risk for heart failure or already have some heart damage, you can still follow these steps. Be sure to ask your doctor how much physical activity is safe and if you have any other restrictions. If you’re on medication for high blood pressure, heart disease, or diabetes, take them exactly as directed. See your doctor regularly to monitor your condition and report any new symptoms right away. Your condition may improve with medication, surgery, or lifestyle changes. Your outlook depends on how advanced your CHF is and whether you have other health conditions to treat, like diabetes or high blood pressure. The earlier your condition is diagnosed, the better your outlook. Talk with your doctor about the best treatment plan for you. Read this article in Spanish. How does congestive heart failure affect blood pressure?If you have heart failure, there's a good chance you also have high blood pressure, or "hypertension." About two-thirds of people whose hearts can't pump enough blood because of the condition also have high BP or once did.
Why do heart failure patients have low blood pressure?Heart problems: Among the heart conditions that can lead to low blood pressure are an abnormally low heart rate (bradycardia), problems with heart valves, heart attack and heart failure. Your heart may not be able to circulate enough blood to meet your body's needs.
Does blood pressure increase or decrease with congestive heart failure?Heart failure doesn't mean the heart has stopped working. Rather, it means that the heart works less efficiently than normal. Due to various possible causes, blood moves through the heart and body at a slower rate, and pressure in the heart increases.
How is low blood pressure treated in heart failure?As such, most patients with low BP tolerate ACEI and β-blockers if given separately or apart from diuretics. Another important strategy is cardiac resynchronization therapy which may result in an increase in SBP6 and may reduce the incidence of hypotension in HF.
|