Congestive Heart Failure

Congestive heart failure is one of the most common heart conditions in the United States.  With the healthy heart, oxygen-poor blood returning from muscles and organs is pumped to the lungs while oxygen-rich blood from the lungs goes back to the rest of the body.  If the heart muscle is not pumping efficiently, fluid builds up in the lungs causing shortness of breath or causing lower extremity swelling.  This is called Congestive Heart Failure or CHF for short.  When the heart muscle beats less efficiently, the kidneys sense the decreased blood flow and react by holding on to salt and water.  Unfortunately, this makes the situation worse because the body gets more and more fluid overloaded.  The fluid buildup in the lungs gets worse and the legs get more swollen.

Congestive heart failure usually develops because of an underlying condition with the heart.  Anything that weakens the muscle of the heart or makes it less efficient can lead to CHF.  Problems with the valves of the heart, irregular heart rhythms, chronic stress on the heart from high blood pressure, and weakness in the muscle from heart attacks or infections are the most common causes of CHF.

CHF can cause a number of symptoms.  People with CHF often gain weight and have visible swelling of the legs and ankles.  When CHF is not treated people can experience shortness of breath with activity or even at rest.  Often there is a persistent cough that can produce mucus or blood-tinged sputum.  In severe cases people loose their appetite and experience persistent nausea.  Your physician can diagnose CHF based on your symptoms, the physical exam and some laboratory studies.

While there is no cure for CHF, there are many effective treatments.  CHF is a condition where is it very important to have a close partnership with your physician and medical team.  There are a number of different medications that either treat the underlying problem with the heart or control the symptoms of CHF.  These medications often need to be adjusted over a period of time based on the response to treatment.  Treatments include medicines to help the heart beat stronger, decrease the work of the heart so it is more efficient, and to help the kidneys expel more water. 

There are also a number of lifestyle changes patients living with CHF need to make. One of the most important is to control the amount of salt in the diet.  Salt is in many prepared foods and it can be very difficult control the amount of salt in the diet if you rely on frozen and canned foods or eat in restaurants.  It is also important to loose weight, stop smoking and limit alcohol use. Once you know your baseline weight, daily tracking of your weight can be an important part of managing the disease.  An increase in weight is a sign that fluid is building up and you and your physician may need to adjust your medications. 

Congestive heart failure is a common and serious health problem.  A close partnership with your health care team, an understanding of the condition and the right medicines can help minimize the symptoms and maximize your health.   

Steve Bromer, MD