Congestive heart failure (CHF) is a condition where the heart muscle is weakened and cannot pump enough blood to the body. Fluid builds up in the lungs, liver, and lower body. Symptoms include shortness of breath, fatigue, leg swelling, and irregular heartbeats. CHF is treated through medications like ACE inhibitors, beta-blockers, and diuretics to open blood vessels, strengthen heart contractions, and remove excess fluids from the body. More invasive options like angioplasty or heart valve repair may be considered if medications are not effective.

1. Presented by,
Zeynab Atta
(physiotherapist to be)

2. Congestive Heart Failure (CHF)
• Congestive heart failure (CHF) is a chronic
progressive condition that affects the
pumping power of your heart muscle.
• While often referred to simply as heart failure,
CHF specifically refers to the stage in which
fluid builds up within the heart and causes it
to pump inefficiently.

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• You have four heart chambers. The upper half
of your heart is made up of two atria, and the
lower half of your heart is made up of two
ventricles.
• The ventricles pump blood to your body’s
organs and tissues, and the atria receive blood
from your body as it circulates back from the
rest of your body.

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• CHF develops when your ventricles can’t
pump enough blood volume to the body.
Eventually, blood and other fluids can back up
inside your:
• lungs
• abdomen
• liver
• lower body

6. SYMPTOMS
• Heart failure can be ongoing (chronic), or your
condition may start suddenly (acute).
• Heart failure signs and symptoms may include:
• Shortness of breath (dyspnea) when you exert yourself
or when you lie down
• Fatigue and weakness
• Swelling (edema) in your legs, ankles and feet
• Rapid or irregular heartbeat
• Reduced ability to exercise

7. When to see a doctor?
• See your doctor if you think you might be
experiencing signs or symptoms of heart failure.
Seek emergency treatment if you experience any
of the following:
• Chest pain
• Fainting or severe weakness
• Rapid or irregular heartbeat associated with
shortness of breath, chest pain or fainting
• Sudden, severe shortness of breath and coughing
up pink, foamy mucus

8. How is congestive heart failure
treated?
There are several medications that can be used to
treat CHF, including ACE inhibitors, beta-blockers,
and more.
• Medications:
• Vasodilators expand blood vessels, ease blood
flow, and reduce blood pressure.
• Diuretics correct fluid retention.
• Aldosterone inhibitors help with fluid retention
and improve chances of living longer.

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• ACE inhibitors improve heart function and life
expectancy.
• Digitalis glycosides strengthen the heart’s
contractions.
• Anticoagulants or antiplatelets such as aspirin
help prevent blood clots.
• Beta-blockers improve heart function and
chances of living longer.
• Tranquilizers reduce anxiety.

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• Lifestyle changes. These are the same changes
as those for preventing heart failure. In
addition, you may be advised to avoid salt
(because of fluid retention) and caffeine
(because of heartbeat irregularities). Your
doctor will advise how much fluid and what
kinds to drink, as sometimes fluid intake
should be limited.

11. ACE inhibitors
• Angiotensin-converting enzyme (ACE)
inhibitors open up narrowed blood vessels to
improve blood flow. Vasodilators are another
option if you can’t tolerate ACE inhibitors.
• ACE inhibitors prevent an enzyme in your
body from producing angiotensin II, making
your blood vessels relax and widen. This, in
turn, lowers your blood pressure and
improves blood flow to your heart muscle.

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You may be prescribed one of the following:
• benazepril (Lotensin)
• captopril(Capoten)
• enalapril (Vasotec)
• fosinopril (Monopril)
• lisinopril (Zestril)
• quinapril (Accupril)

13. Beta-blockers
• Beta-blockers are a class of medication used
to block the effects of stress hormones such as
adrenaline on the heart. They’re often
prescribed for irregular heartbeats, high blood
pressure, and after heart attacks.

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• Different types of beta-blockers work
differently. In general, these medications
enhance the heart’s ability to relax. Your heart
will beat slower and less forcefully when beta-
blockers are working. This can help reduce
blood pressure and alleviate irregular heart
rhythms.

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Commonly prescribed beta-blockers include:
• acebutolol(Sectral)
• atenolol(Tenormin)
• bisoprolol (Zebeta)
• carteolol (Cartrol)

16. Diuretics
Diuretics, also called water pills, reduce your
body’s fluid content. CHF can cause your body
to retain more fluid than it should.
• Your doctor may recommend:
• Loop diuretics. These cause the kidneys to
produce more urine.

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• Examples include furosemide (Lasix),
ethacrynic acid (Edecrin),
and torsemide (Demadex).
• Potassium-sparing diuretics. These help get
rid of fluids and sodium while still retaining
potassium. Examples include triamterene
(Dyrenium), eplerenonel(Inspra), and
spironolactone (Aldactone).

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• Thiazide diuretics. These cause blood vessels
to widen and help the body remove any extra
fluid. Examples
include metolazone (Zaroxolyn), indapamide(L
ozol), and hydrochlorothiazide (Microzide).

19. Surgeries and procedures
• If medications aren’t effective on their own,
more invasive procedures may be required.
• Angioplasty, a procedure to open up blocked
arteries, is one option.
• Your cardiologist may also consider heart valve
repair surgery to help your valves open and
close properly.