Congestive heart failure occurs when the heart muscle is unable to pump efficiently, causing blood to back up in the lungs and body. It can be caused by conditions that weaken or stiffen the heart muscle like heart attacks, or from long-term high blood pressure. Symptoms include shortness of breath, fatigue, and fluid retention. Treatment focuses on managing symptoms with medications and lifestyle changes.

1. Congestive
Heart/Cardiac Failure

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Definition
• Heart failure, also called "congestive heart failure," is a disorder where the
heart loses its ability to pump blood efficiently.
• The result is that the body doesn't get as much oxygen and nutrients as it needs,
leading to problems like fatigue and shortness of breath.
• Heart failure is almost always a chronic, long-term condition that is managed
with medications and lifestyle changes. (Although it can sometimes develop
suddenly.)

3. Causes
• Occurs due to diminished pumping ability of the ventricles
• Congestive heart failure can be caused by:
Diseases in which the heart muscle weakens
Diseases in which the heart muscles stiffens
Conditions where oxygen demand by the body tissue is beyond the capacity of
the heart (It is the heart that has to deliver adequate oxygen-rich blood)
• These causes include:
• Weakened heart muscle
• Damaged heart valves
• Blocked blood vessels supplying the heart muscle (coronary arteries), leading to a heart
attack
• Toxic exposures, like alcohol or cocaine
• Infections
• High blood pressure that results in thickening of the heart muscle (left ventricular
hypertrophy)
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4. • Pericardial disease, such as pericardial effusion (a large collection of fluid
around the heart in the space between the heart muscle and the thick layer of
pericardium surrounding the heart) and/or a thickened pericardium, which does
not allow the heart to fill properly
• Congenital heart diseases
• Prolonged, serious arrhythmias
• While these conditions often combine to produce CHF, sometimes the causes
of diseased heart muscles are not known; this is called idiopathic
cardiomyopathy or heart muscle disease of unknown cause.
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5. • CHF is often a result of the following lifestyle habits:
• Unhealthy habits, such as smoking and excessive use of alcohol, are often to
blame.
• Obesity and lack of activity may contribute to CHF, either directly or indirectly
through accompanying high blood pressure, diabetes, and coronary artery
disease.
• Years of uncontrolled high blood pressure damages both heart and blood
vessels.
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6. Pathology
• Congestive heart failure (CHF) is an imbalance in pump function in which the
heart fails to maintain the circulation of blood adequately.
• The most severe manifestation of CHF, pulmonary edema, develops when this
imbalance causes an increase in lung fluid secondary to leakage from
pulmonary capillaries into the interstitium and alveoli of the lung.
• CHF can be categorized as forward or backward ventricular failure.
• Backward failure is secondary to elevated systemic venous pressure, while left
ventricular failure is secondary to reduced forward flow into the aorta and
systemic circulation.
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8. • Furthermore, heart failure can be subdivided into systolic and diastolic
dysfunction.
• Systolic dysfunction is characterized by a dilated left ventricle with impaired
contractility, while diastolic dysfunction occurs in a normal or intact left
ventricle with impaired ability to relax and receive as well as eject blood.
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9. Symptoms and Signs
• People with congestive heart failure (CHF) sometimes do not suspect a
problem with their heart.
• The early symptoms are often shortness of breath, cough, or a feeling of not
being able to get a deep breath.
• If you have a known breathing problem, such as asthma, chronic obstructive
pulmonary disease (COPD), or emphysema, you may think you are having an
"attack" or worsening of that condition.
• If you usually do not have breathing problems, you may think you have a cold,
flu, or bronchitis.
• To make matters worse, any or several of these conditions may coexist along
with congestive heart failure.
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10. Congestive heart failure has the following 3 major
symptoms
• Exercise intolerance
• Shortness of breath
• Fluid retention and swelling
 As the buildup of fluid in the lungs becomes very severe, a frothy,
pink liquid may be coughed up
 Daily weight checks are mandatory in persons with heart failure
because the amount of fluid retention is usually reflected by the
amount of increasing shortness of breath and weight gain.
 Persons with heart failure should know what their dry weight is or
what they weigh when they feel good with no pitting edema.
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11. • Diagnosis
• Chest x-ray
• Electrocardiogram (ECG)
• Blood tests: You may have blood drawn for lab tests.
• Blood cell counts: Low blood cell counts (anemia) may cause
symptoms much like CHF or contribute to the condition.
• Sodium, potassium, and other electrolyte levels, especially if the
person has been treated with diuretics and/or has kidney disease
• Tests of kidney function
• B-type natriuretic peptide (BNP)
– This is a hormone produced at higher levels by the failing heart muscle.
This is a good screening test; the levels of this hormone generally increase
as the severity of heart failure worsens.
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12. • Treatment
• Use of diuretics, nitrates, analgesics, and inotropic agents are indicated for the
treatment of CHF and pulmonary edema
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