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Congestive Heart Failure

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Also known as: Heart Failure

What is congestive heart failure?

Congestive heart failure (CHF), also called heart failure, does not mean that the heart has stopped beating. It means that the heart can no longer pump blood as efficiently as it used to. This causes blood and fluids to back up in the body – particularly in the liver, lungs, hands, and feet.

The heart has two sides and four chambers. The right side of the heart receives oxygen-depleted blood from the body and sends it to the lungs. The left side of the heart receives oxygen-rich blood from the lungs and pumps it out to the body.Thumbnail diagram of heart

If blood backs up from the right side of the heart, symptoms of CHF typically start with swelling of the legs and ankles that gets worse when the person stands and improves when he lies down. If blood backs up from the left side of the heart into the lungs, it can cause shortness of breath and coughing, especially during exercise such as walking up stairs or when lying down flat in bed. Many people with heart failure have symptoms related to blood backing up on both the right and left sides of the heart.

In addition to swelling (edema) and shortness of breath, symptoms can include heart palpitation or rapid pulse, weakness and fatigue, exercise intolerance, coughing or wheezing, sudden weight gain, and loss of appetite or nausea.

CHF is a serious, progressive condition that is usually chronic and can be life-threatening. It can affect the right, left, or both sides of the heart and results in reduced amounts of oxygen and nutrients being delivered to the body's organs, which can cause damage and loss of function.

Although CHF is due to failure of the heart to adequately pump out enough blood, there can be many different causes. Most often, CHF occurs because the heart has been damaged, either by high blood pressure (hypertension), previous heart attacks, or direct damage to the heart muscle (termed cardiomyopathy). CHF can also occur when there is damage to the valves within the heart or with scarring in the pericardium, the membrane surrounding the heart. Rarely, CHF occurs when the heart is forced to beat much more strongly than normal, such as with severe hyperthyroidism, and cannot keep up with the demand. Risk is increased for those who are overweight, have diabetes, smoke, or who abuse alcohol or cocaine.

CHF is common in the elderly as the heart becomes less efficient with age. The National Heart Lung and Blood Institute estimates that about 5.8 million people in the United States have heart failure and the Journal for the American Medical Association says that for people over the age of 65, it is the most common cause of hospitalization.

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