Diseases of the heart are the leading cause of death in America. “Nearly 5 million people in the United States have congestive heart failure. Each year, there are an estimated 400,000 new cases, and half of those diagnosed with the condition will be dead within five years”( “Two New Treatments for Congestive Heart Failure”). Generally congestive heart failure begins with a dysfunctional ventricle in the heart; however this event usually occurs before any symptoms of the disease become apparent (Cohn). Essentially, Congestive Heart Failure is due to the heart making valiant attempts to make up for its weakened pumping abilities that is caused by this dysfunctional ventricle. It does this by enlarging and pumping faster to make up for the loss of strength.
Recent studies are finding that the most indicative pre-existing risk factors for developing Congestive Heart Failure is hypertension, but there are many more risk factors to be considered as well (Levy, Larson, Vasan, Kannel, & Ho). If the patient has had any previous heart attacks or coronary artery disease, an irregular heartbeat or arrhythmia, any disease of the heart muscle itself or cardiomyopathy, a disease affecting the heart valves particularly that of the mitral and aortic valves, and any kind of congenital heart disease then they are at a considerably higher risk to develop Congestive Heart Failure as well. Alcohol and drug abuse have also been linked to the development of this disease (Cohn; Congestive Heart Failure). Symptoms of Congestive Heart Failure are often dependent upon which side of the heart has been afflicted.
If the left side of the heart is the damaged side “blood and fluid back up into your lungs. You will feel short of breath, be very tired, and have a cough (especially at night). In some cases, patients may begin to cough up pinkish, blood-tinged sputum” (“Congestive Heart Failure”). If the dysfunction is in the right side of the heart then the fluid will build in the veins as opposed to the lungs. Edema of the legs, ankles, and feet will occur because of this collection of fluid. “Sometimes edema spreads to the lungs, liver, and stomach.
Because of the fluid buildup, you may need to go to the bathroom more often, especially at night. Fluid buildup is also hard on your kidneys. It affects their ability to dispose of salt (sodium) and water, which can lead to kidney failure” (“Congestive Heart Failure”). In addition to these site-specific symptoms, the patient may find it difficult to breathe, feel weak or tired causing an inability to participate in physical activities, develop chest pain, loss of appetite, swollen veins in the neck, clammy skin, a fast or irregular pulse (“Two New Treatments”; “Congestive Heart Failure”). Additionally the patient may feel confused and restless, and suffer from memory lapses and difficulty in concentration.
Often a diagnosis of Congestive Heart Failure can be made by a physical examination of the patient based on the development and reporting of the symptoms above. The development of fluid in the lungs can be heard through a physical examination with a stethoscope, as can an indication of arrhythmia or a hastened heartbeat. A tapping on the chest can help the doctor determine whether there has been any build up of fluid in the chest. While these diagnostic efforts are generally quite accurate, verification of diagnosis of Congestive Heart Failure can be achieved through chest x-rays which will reveal the enlarged heart and the development of fluid in the lungs.
An EKG can be used to verify the arrhythmia and any other abnormalities of rhythm or pace of the heart. A sonogram-type examination of the heart called echocardiography can take a rather detailed look at the physical structure of the heart and can evaluate valve function, motion of the heart, and can again detect an enlarged heart size. Nuclear ventriculography, a technique where a radioactive material is injected into the veins and its path through the body can be traced through special cameras, as well as angiography, a method where a catheter is fed through the femoral artery in order to take site-specific internal x-rays (“Angiography Test”), are both used to provide sure verification of the diagnosis and to determine how far alone the disease has come (“Congestive”).
There are multiple ways in which Congestive Heart Failure can be treated, many that are used together to ensure effective management of the disease. Lifestyle Changes such as smoking cessation; management of risk factors such as hypertension, diabetes and high cholesterol; a restricted low-calorie, low-fat, low-salt diet; a sensible limit set on alcohol consumption; monitoring any weight gain that could be due to continued fluid buildup; and, of course, an approved aerobic exercise program are all in the first line of defense both against Congestive Heart Failure and in the treatment of the disease once it is diagnosed. Beyond these lifestyle changes, medications are also extremely helpful in both controlling symptoms and in prolonging the life of an individual diagnosed with the disease. Medicines called inotropics (which are usually delivered directly to the heart through a catheter) work to strengthen the heart’s pumping action, while vasodilators (such as nitroglycerin) help open up narrow blood vessels. Diuretics help reduce the buildup of fluid. ACE inhibitors keep vessels open and are used to keep blood pressure in check (Cohn; “Congestive”). These as well as other medications that a doctor may feel helpful in the treatment of the disease can all be used in orchestration to both alleviate symptoms and manage the disease itself. More intrusive therapies are often used in emergency and extreme situations.
Angioplasty is a technique where the arteries are “puffed up” with a small balloon. This effectively pushes any fatty buildup of plaque in the heart up against the artery wall, thus opening it up again for more healthy heart functioning. Stents, mesh-like metal inserts, are often placed at the time of angioplasty to keep the artery from collapsing (“Congestive”).
Surgery is also an option, though this is usually reserved for the most extreme cases, or for those whose other treatments are no longer effective. Correction of any congenital heart defects should be tackled first to avoid any further development of the disease and to facilitate any other kind of surgical procedures. Hear valves can be repaired or completely replaced, as can the entire heart by transplantation. Bypass surgery has been quite successful as well. Insertion of mechanical devices to help sustain the heart’s functions, such as pacemakers, is also a viable option in these extreme cases (“Congestive”). With the help of good medical support and the various treatments available, those who suffer from Congestive Heart Failure can continue to live full, happy lives.Works Cited“Angiography Test.” Cleveland Clinic Health Information Center.
2005. 28 August 2006. “Congestive Heart Failure.” Texas Heart Institute Heart Information Center. July 2006.
28August 2006. < http://www.texasheart.org/HIC/Topics/Cond/CHF.cfm>.
Cohn, Jay. “Preventing Congestive Heart Failure.” American Family Physician. 15 April 1998.Levy, D., M. Larson, R.
Vasan, W. Kannel and K. Ho. “The Progression of Hypertension toCongestive Heart Failure.” The Journal of the American Medical Association.
“Two New Treatments for Congestive Heart Failure.” FDA Consumer. 35.6 (2001).