Diagnose and Treat Congestive Heart Failure

What is heart failure?

Heart failure means your heart muscle does not pump as much blood as your body needs. Failure does not mean that your heart has stopped. It means that your heart is not pumping as well as it should. Congestive heart failure can be caused by:

1. Diseases that weaken the heart muscle,

2. Diseases that cause stiffening of the heart muscles, or

3. Diseases that increase oxygen demand by the body tissue beyond the capability of the heart to deliver.

CHF is summarized best as an imbalance in Starling forces or an imbalance in the degree of end-diastolic fiber stretch proportional to the systolic mechanical work expended in an ensuing contraction. This imbalance may be characterized as a malfunction between the mechanisms that keep the interstitium and alveoli dry and the opposing forces that are responsible for fluid transfer to the interstitium.

How is CHF diagnosed?

Most doctors can make a tentative diagnosis of CHF from the presence of edema and shortness of breath.

With a stethoscope, a doctor can listen to your chest for the crackling sounds of fluid in the lungs, the distinct sound of faulty valves (heart murmur), or the presence of a very quick heartbeat. By tapping on your chest, doctors can find out if fluid has built up in your chest.

Various drugs are used to treat congestive heart failure. They perform different functions. ACE inhibitors and vasodilators expand blood vessels and decrease resistance. This allows blood to flow more easily and makes the heart’s work easier or more efficient. Beta blockers can improve how well the heart’s left lower chamber (left ventricle) pumps. Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water.

If you have been experiencing any of the symptoms listed below, it is essential to seek a medical evaluation. Physicians will obtain a detailed medical history, perform a physical examination to check for signs of lung congestion or abnormal heart rhythms, and check for risk factors including high blood pressure.

Treatment

Treatment of congestive heart failure consists primarily of treating the symptoms. Vital signs should be taken regularly, and often diuretics will be prescribed to facilitate expulsion of accumulated fluid from the body. While in the hospital fluid intake and output will be measured very carefully. Patients will probably be placed in an upright position to assist in moving fluid from around the heart and lungs, given potassium supplements and prescribed bed rest for a period of time.

It is also your responsibility to carefully monitor yourself and help manage your condition. One important way to do this is to track your weight on a daily basis. Weight gain can be a sign that you are retaining fluid and that the pump function of your heart is worsening. Make sure you weigh yourself at the same time each day and on the same scale, with little to no clothes on.

In some cases, heart failure can be treated by correcting the underlying cause. For example, controlling a fast heart rhythm may reverse structural heart abnormalities. While in many cases structural abnormalities cannot be corrected, treatment can usually markedly decrease symptoms and increase life expectancy and quality of life.