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Congestiveheartfailure(CHF)

Summary

Chronicheartfailure(CHF)referstotheheartsinabilitytopumpenoughbloodtosatisfytheneedsofthe
body.
ThemajorcauseofCHFiscoronaryheartdisease,alongwithahistoryofpastheartattacks.
Treatmentincludesmedications,lifestylechangesandsurgery.

Chronicheartfailure(CHF),alsocalledcongestivecardiacfailure(CCF),isanongoingconditioninwhichtheheart
muscleisweakenedandcantpumpaswellasitnormallydoes.Themainpumpingchambersoftheheart(the
ventricles)becomelargerorthicker,andeithercantcontract(squeeze)orcantrelaxaswellastheyshould.This
triggersfluidretention,particularlyinthelungs,legsandabdomen.
ThemajorcausesofCHFincludecoronaryheartdisease,hypertension,cardiomyopathyandotherheartdiseases.
Ofthese,coronaryheartdisease(usuallyaccompaniedbyahistoryofpastheartattacks)isbyfarthemost
common.

Themajorfactorsthatcontributetocoronaryheartdiseaseinclude:
obesity
adiethighinsaturatedfatsandcholesterol
highbloodpressure
diabetes
smoking
physicalinactivity.
Chronicheartfailureismorecommoninelderlypeople.Thesurvivalrateforpeoplewiththisdisorderdependson
theseverityoftheircondition.Treatmentsincludemedication,lifestylechangesand(sometimes)surgery.

Symptomsofchronicheartfailure
Symptomsofchronicheartfailureinclude:
neworworseningshortnessofbreath(particularlyduringphysicalactivityorwakingyouupatnight)
weightgain
muscularfatigue,tiredness
swellingofanklesorlegs
swellingofabdomen
dizziness
heartpalpitations
chestpainordiscomfortinpartsoftheupperbody
unexplainedcoughingandwheezing
lossofappetite
constipation.

Causesofchronicheartfailure
Theheartisadoublepumpmadeupoffourchambers.Deoxygenatedbloodfromtheveinsenterstherightupper
chamber(rightatrium),ispassedtotherightlowerchamber(rightventricle),andthenpumpedtothelungs.

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Oxygenatedbloodfromthelungsenterstheleftupperchamber(leftatrium)andthenenterstheleftlower
chamber(leftventricle).Thebloodisthenpumpedaroundthebody,underpressure,viaarteries.

InapersonwithCHF,theleftventricledoesnotemptyproperly.Thisleadstoincreasedpressureintheatria
(upperchambers)andthenearbyveins.Thisbacklogofbloodaffectsthekidneysinterferingwiththeirfunction
andleadingtofluidretention(oedema)inthelungs,abdominalorgansandlegs.

Insomepeoplewithheartfailure,ratherthanfailedpumpingofthebloodfromtheleftventricle,thereisfailed
relaxationoftheleftventricle.Thisalsoleadstobloodpoolingunderback-pressure.

CHFcanbecausedbyseveralconditions,including:

pastheartattacksfromcoronaryheartdiseasethiscanleadtoscarringintheheartmuscleandisthemost
commoncauseforCHF
highbloodpressure(hypertension)thehighpressureinthearteriesmeansthattheheartmustkeep
pumpingmoreforcefully.Itmaynotbeabletokeepitup
heartvalvediseasedamagedheartvalvesmayallowthebloodtoflowbackwardsormayobstructforward
flow
congenitalheartdiseaseheartabnormalitiesmaybepresentfrombirth,suchasdefectivevalvesor
abnormalcommunicationsbetweenheartchambers
cardiomyopathythisconditionischaracterisedbyenlargementoftheheartmuscle,wheretheleftventricle
enlargestocompensateforpoorcontraction
myocarditisvirusesorotherinfectionsmaydamagetheheartmuscle
heartarrhythmiarapidheartbeatwithirregularity,overalongperiodoftime,canalsoleadtoinefficient
contractionandheartfailure
thyroiddiseasethethyroidglandproducestoomuchofitshormone,thyroxine.Thisincreasestheworkof
theheartandcanleadtoheartfailure.

FactorsthatcanworsensymptomsofCHF
ThesymptomsofCHFcanbeworsenedbyanumberoffactors,including:

anaemia
toomuchsaltoralcoholinthediet
pregnancy
someinfections
kidneydiseases
lungdiseases.

DiagnosisofCHF
CHFcanbeconfirmedwithavarietyoftests,including:
x-rays
echocardiography
exercisestresstest
electrocardiogram(ECG)
lungfunctiontests
angiography
bloodtests.

TreatmentforCHF
TreatmentforCHFmayinclude:
medicinessuchasdiuretics(toremoveexcessfluid),ACEinhibitors(toopenupbloodvessels,reduce
bloodpressureandreducesodiumretentionandwaterretention),digitalis(tohelptheheartpumpmore
effectively),vasodilators(toopenupbloodvessels)andcertainbeta-blockers(toslowtheheartrateand

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reduceitswork)
addressingtheunderlyingdisorderforexample,treatmentofhighbloodpressure
lifestylechangessuchasregulargentlephysicalactivity,losingexcessbodyfat,stoppingsmoking,adhering
toalow-fatandlow-saltdiet,restrictingalcoholandhavingadequaterest
surgerytoreplacenarrowedorleakingheartvalves
coronarybypasssurgeryinsomecases
hearttransplantinextremecases.

Wheretogethelp
Yourdoctor
HeartFoundationHealthInformationService.Tel.1300362787

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HeartFoundation

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