Congestive heart failure (CHF) occurs when the heart isn’t able to pump blood normally. As a result, there is not enough blood flow to provide the body’s organs with oxygen and nutrients. The term “heart failure” does not mean that the heart stops beating completely, but that the heart is not working as efficiently.
CHF affects over 6 million people in North America and is one of the most common causes of hospitalization for people over 65 years of age. Approximately half a million Canadians are living with congestive heart failure.
Men are slightly more at risk than women. People of African descent are considerably more at risk than those of European descent and also have a higher risk of death.
There are two basic problems in congestive heart failure:
Many people have both systolic and diastolic heart failure.
CHF is usually the result of other health problems:
In addition, all the risk factors that normally increase the chances of heart disease, such as smoking, diabetes, and obesity, increase your risk of congestive heart failure.
The appearance of symptoms of CHF can be delayed for years. This is because the heart tries to compensate when it is not pumping efficiently. The heart compensates in three ways:
As the heart compensates, several things happen that can result in symptoms. The heart cannot pump well enough to pump the blood through the body and back to the heart again. Blood then backs up into the legs and the lungs, causing fluid buildup. This causes visible swelling of the ankles and legs and shortness of breath.
The most common symptoms of CHF include:
Other symptoms of CHF include:
If you have the symptoms mentioned in the previous section, along with one of the conditions that puts you at risk, your doctor may suspect CHF. Your doctor will examine you to see if your legs are swollen or if your lungs are filled with fluid.
Your doctor may also order tests to check your heart. They may send you for blood and urine tests, an electrocardiogram (ECG), or a chest X-ray, which can show the excess fluid in the lungs. An echocardiogram (an ultrasound of the heart) will help diagnose heart failure. An echocardiogram can also tell the doctor how much of the blood in your heart is actually being pumped out to the rest of the body. The proportion of blood that gets pumped out is called the ejection fraction.
All treatment for CHF should be carried out under the supervision of a doctor. CHF usually is managed with lifestyle adjustments and medications. If you have CHF, you may have to make some of the following lifestyle adjustments:
Congestive heart failure can be treated with the following medications:
Your doctor may prescribe these medications, usually in combination, to manage your CHF. In some cases, surgery (e.g., surgery to insert a pacemaker) may be necessary to help improve heart function.
CHF can’t always be prevented, but there are many things you can do to help. Try preventing CHF by practising good heart health. This will also guard against heart attack, stroke, and coronary artery disease. Tips to follow include:
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
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