Congestive Heart Failure
Have you ever heard of Heart failure? This is a term we commonly hear. Sometimes, sudden unexpected deaths are reported and when possible causes are investigated, pathology post-mortem test results state that heart failure would have been the cause.
CHF is a type of heart failure. Although, it does not mean that the heart has failed as the name suggests. It simply means that the muscles of the heart becomes unable to contract over time or there is a mechanical problem limiting the hearts ability to get filled with blood.
It is a chronic condition that occurs as a result of heart pump failure resulting in inability of heart to adequately supply body tissues. One long term result of this complication is that it leads to collection of blood and body fluids in the legs and lungs as time goes by.
This clinical syndrome is complex, being that it is characterized by inefficient myocardial abilities to perform properly.
Prevalence and Epidemiology
Prevalence increases with age;
- 55 years old or less; 1-2%
- 75 years and above; 10%
Over 6 million people in the United States suffer from congestive heart failure. It’s the most common diagnosis in hospitalized patients over the age of 65 years.
One in nine deaths is attributed to heart failure as a contributing cause.
Forms of CHF
3 kinds of heart failure exist;
- Left-sided heart failure; most common cause of right-sided heart failure
- Right-sided heart failure
- High-output heart failure
Risks
Risk factors for congestive heart failure include:
- Being older than 70.
- Use of tobacco products
- Consumption of salty foods
- Sedentary lifestyle.
- Obesity
- Hyperactive thyroid
- Coronary artery disease.
- Anxiety
- Family history of congestive heart failure
CHF causes
- Certain radio-therapy and chemotherapy drug types
- Diabetes type 2
- Hypertension – blood pressure higher than upper normal range
- Genetic or viral cardiomyopathy
- Arrythmia
- Renal disease
Signs & Symptoms
- Arrhythmias- irregular heart beat
- Impairment in thinking pattern
- Shortness of breath/ dyspnoea
- Fatigue and weakness
- Lack of appetite
- Swelling/ oedema
- Persistent/ chronic dry cough and wheezing
Diagnostic tests
Common tests done to establish CHF , its stage and causes are;
- Cardiac catheterization
- Magnetic Resonance Imaging of the Heart
- ECHO
- EKG/CKG
- Multi-gated Acquisition Scan(MUGA scan)
- Chest X-ray
Management and treatment
Treatment depends on heart failure and its cause.
Apparently, heart failure does not have a direct therapeutic agents.
The aims of treatment;
- To prevent patient from moving forward through the stages
- To slow down progression of the diseases
Stage A treatment
- Angiotensin-converting enzyme inhibitors (ACE-Is)
- Angiotensin II receptor blockers(ARBs)
Stage B treatment
- Aldosterone antagonists/ mineralocorticoid receptor antagonists (MRAs)
- ACE-Is
- Beta-blockers
Stage B treatment
- Sodium-glucose transport 2 inhibitors
- Hydralazine
- Diuretic
- Aldosterone antagonist
- Implantable cardiac defibrillator
- Dietary salt restriction
Stage D treatment
- Heart transplant
- Ventricular assist devices
- Heart surgery
- Palliative or hospice care
Prevention
- Avoid excessive intake of alcohol
- Regular physical exercise
- Foods that are healthy for your heart
- Do not use drugs recreationally
- Normal Body Mass Index Range (18.5-24.9 kg/sq. metre)