Congestive Heart Failure

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Congestive Heart Failure
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Basic Definition

• Heart failure is a medical term that describes an
  inability of the heart to keep up its work load
  of pumping blood to the lungs and to the rest of
  the body.

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Statistic

• It is estimated that as many as two million
  Americans suffer from congestive heart failure
  and that up to 29, 000 die annually from this
  chronic disorder.
• Cannobio, Mary. Cardiovascular Disorders.
• Missouri C.V. Mosby Company, 1990.

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Symptoms(involving gravity/exhaustion of heart

• Swelling of the ankles, legs, and hands
• Orthopnea, or the shortness of breath when lying
  flat
• Shortness of breath during exertion

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Symptoms(involving circulation)

• Cyanosis, or a bluish color that is seen in the
  lips and fingernails from a lack of oxygen
• Fatigue or weakness
• Rapid or irregular heart beat
• Changes of behavior such as restlessness,
  confusion, and decreased attention span

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Symptoms(involving congestion)

• Unexplained or unintentional weight gain
• Chronic cough
• Increased urination
• Distended neck veins
• Loss of appetite or indigestion

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Congestive heart failure is a syndrome that can
be caused by multiple underlying diseases such as

• Congenital heart disease
• Atherosclerosis
• Rheumatic fever
• Cardiomyopathy
• Valve disorders
• Ventricular failure
• Left or right-sided failure
• Hypertension
• Prolonged alcohol or drug addiction
• Previous heart attack
• Diabetes
• Chronic rapid heartbeats

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Congenital Heart Disease

• CHD affects one out of every one thousand babies.
  In these babies the marvelously intricate
  combination of chambers, valves, and vessels
  making up the heart and circulatory systems fails
  to form properly before birth. Septal, atrial,
  and ventricular defects are the most common.

Heart. The World Book Encyclopedia. 1996 ed.
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Rheumatic Fever

• Strep throat from the streptococcal infection
  begins a disease process where the heart valves
  are damaged. This condition is called rheumatic
  fever and it affects the connective tissues of
  the body.

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Betty Mae Donnell

• Rheumatic fever as a child
• Died at age 48 (relatively young)

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Cardiomyopathy

• Cardiomyopathy is the stretching and enlarging of
  the heart cavity that occurs making the heart
  weak so it does not pump correctly

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Ventricular Failure

• Ventricular failure occurs when there are weak
  spots in the ventricular walls causing a bulge,
  or an aneurysm.

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Atherosclerosis

• Atherosclerosis is the gradual clogging of the
  arteries by fatty, fibrous deposits. A tiny lump
  of fibrous tissue grows as the artery tries to
  repair the damage. Cholesterol accumulates and
  more tissue builds up. The arteries are
  thickened and hardened making a loss of
  elasticity causing congestion.

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Left-sided/Right-sided Failure

• Blood backs up causing congestion and thus
  swelling of extremities and internal organs

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Other Contributors

• Hypertension
• Prolonged Alcohol or Drug Addiction
• Previous Heart Attack
• Diabetes
• Chronic Rapid Heart Beats

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Evolutionary Aspect (mainly a disease of
civilization)

• Workaholic vs. Neanderthal
• Stress
• Pressure of getting everything accomplished
• Less demands
• Diet
• Hitting fast food instead of planned meal
• Ate what could be found/body not prepared for
  fatty foods
• Exercise
• Lacking time to work on health
• Search for food

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The body tries to overcome heart failure
automatically but usually only worsens the
condition

• If the blood meant for less essential organs
  instead flows to the brain and other vital organs
  the heart has to work harder to get it to all
  parts of the body.
• When the activity of the heart is increased, a
  more forceful contraction causes an increased
  heart rate.

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• A study by Chin and Goldman involved the
  hospitalization of 435 patients with congestive
  heart failure symptoms
• Interesting percentages of symptoms
• Acute anginal chest pain 33
• Uncontrolled hypertension 15
• Noncompliance with medications 15
• Diet 6
• Other 31

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• In this study, about half of the patients with
  prior CHF and new onset CHF were women
• CHF is found more often in white people of this
  study
• CHF patients are usually over the age of 61
• Medicare

Chin, M. Goldman, L. (1997). Factors
contributing to the hospitalization of patients
with congestive heart failure. American Journal
of Public Health, 87. 643-8.
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Treatment

• When a treatable underlying cause of congestive
  heart failure exists, correcting the cause may
  resolve, or at least greatly improve, the degree
  of heart failure

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Valve Surgery

• If a defective heart valve is responsible for
  heart failure, it may be treated by heart valve
  surgery

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Angioplasty

• Angioplasty, which is catheterization using a
  balloon to flatten fatty deposits, can be used to
  treat atherosclerosis or other conditions with
  blocked arteries.
• An artery of an arm or leg is used to guide the
  catheter through to the blocked artery.
• An uninflated balloon on the top of a smaller
  tube is threaded through the larger tube and
  centered in the plaque narrowed area.
• The balloon inflates compressing the plaque
  against the walls and increasing the open area.

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Drugs

• Digitalis-strengthen the hearts contractions
  increasing blood flow
• Diuretic-increase the output of salt and water in
  urine
• Vasodilators-relax blood vessels which lowers the
  resistance to blood flow. More blood reaches the
  tissues and the heart works no harder than before.

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In conclusion, congestive heart failure is often
assumed to be a disease when in fact it is a
syndrome caused by multiple disorders.
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