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CONGESTIVE HEART FAILURE (CHF) Symptoms Causes Treatment Preventions & More All you need to know

December 29, 2021

You must have heard about heart failure, ever tried to know what it is? Congestive heart failure is a condition in which the muscles of the heart are unable to pump blood efficiently towards organs and body parts.

CHF is a chronic disease of the heart which alters and affects the pumping of the blood.

Congestion refers to a condition in which the blood builds up in the heart and lungs because the heart muscles are unable to push the blood towards the body with thrust.

The heart pumps the blood throughout the body with a certain pressure.

When the cardiac muscles are unable to work efficiently as they should this results in an improper flow of blood to the body tissues and the backflow of blood towards the lungs is more.  

This causes congestion of the lungs.  Meanwhile, pressure on the heart increases as the heart is unable to push the blood with greater force.

The heart has four chambers; two atria are present in the upper chamber of the heart while two ventricles are present in the lower chamber.

Ventricles pump the blood towards body tissues and organs while atria receive the blood from body tissues and organs.

Congestive heart failure develops when any issue in the ventricles develops and the heart is unable to pump the blood with the same force and efficiency.

Blood may come back into the heart, lungs, liver, abdomen.

CONGESTIVE HEART FAILURE (CHF) Symptoms Causes Treatment Preventions

What are the symptoms of Congestive Heart Failure?

Symptoms of congestive heart failure can be acute at the start but these develop and can lead to a chronic condition. Symptoms may vary from mild to severe depending on the degree of effect on cardiac muscles.

Symptoms can include:

  • Shortness of breath during strenuous activity or more exercise. Because the oxygen supply is not much efficient.
  • Weakness, dizziness, and fatigue which is caused by the decreased blood supply towards limbs which results in lactic acid production causing fatigue in patients.
  • Swelling or edema at abdomen, feet, lower body. A generalized condition of edema called anasarca can also develop.
  • Irregular and rapid heartbeat.
  • Coughing with blood-tinged mucus in it. This occurs because the blood is congested in the lungs which cause inappropriate air exchange leading to coughing with blood.
  • Rapid fluid build-up and edema leading to increased weight gain.
  • Lack of appetite and nausea.
  • Chest pressure and pain may persist for a longer period.

What are the types of Congestive Heart Failures?

There are two basic types of congestive heart failure.  It can be either left-sided heart failure, right-sided heart failure, or both. Each type manifests some specific symptoms in the affected person.

Right-sided Congestive Heart Failure:

This condition develops when the right ventricle is affected and it is unable to pump the blood towards the lungs.

In this case, backflow of the blood occurs causing water retention in blood vessels, and that ultimately leads to edematous swelling in the lower limbs and abdomen.

Left-sided Congestive Heart Failure:

This is the most common form of congestive heart failure than right-sided heart failure.

When the left ventricle is unable to continue the blood supply effectively this results in generalized fluid retention, especially, around the lungs.

Left-sided CHF can be further categorized into two types.

  • Diastolic CHF: When cardiac muscles get stiffer diastolic CHF occurs and the heart chamber is not relaxed properly. Due to the absence of relaxation, the chamber is unable to refill properly that ultimately pumps a lesser amount of blood to the body tissues.
  • Systolic CHF: When the left ventricle is impotent to pump the blood with sufficient force resulting in decreased supply to the body. This occurs because contraction of left ventricle muscles is not optimum.

What are the causes of Congestive Heart Failure?

Congestive heart failure can develop if the cardiac muscles are either too weak or in some cases too stiff to contract. Following factors may contribute to heart failure.

  • Coronary Artery Diseases: This is the most common reason for congestive heart failure. Arteries which are supplying blood to the heart get deposited with fatty acids which reduce the contraction power of the blood vessels.

Blood flow is decreased in such arteries leading to chronic congestive heart failure or myocardial infarction.

  • Abnormal functioning of heart valves: Valves control the direction and the amount of blood flow in and out of the heart.

 Due to an infection or muscle defect heart valves can be damaged resulting in the strenuous workload on the heart that weakens it.

  • Damaged cardiac muscles: Any infection, alcohol consumption, drug reaction, chemotherapy, or any disease which may affect the cardiac muscle may predispose to congestive heart failure.
  • Myocarditis: Inflammation of the heart muscles disrupts normal pumping and circulation of the blood.

Myocarditis is more common in viral infections including recently pandemic Covid-19 also causes myocarditis which leads to congestive heart failure.

  • Hypertension: In high blood pressure, the heart has to pump more than usual which leads to either stiffening or weakening of heart muscles both may lead to congestive heart failure.
  • Congenital heart anomalies: in certain cases, either the chambers of the heart or the vales are not formed in a correct position which alters the normal functioning of the heart. This may predispose to CHF.
  • Arrhythmias: These lead to an extra workload on the heart as the heart has to pump more to supply the blood to different organs and body tissues. Thus, affecting the muscles of the heart.
  • Other diseases: Some other diseases like Diabetes, HIV, Viral infections, thyroid dysfunction, allergic reactions, and abnormal iron metabolism may also lead to congestive heart failure.

What are the risk factors for Congestive Heart Failure?

Certain risk factors can predispose to congestive heart failure. These include:

  • Age: With increasing age, the flexibility of the vessels decreases as the elastic tissue in the veins shrinks. It results in extra pressure and workload on the heart, hence the heart muscles deteriorate with age.
  • Obesity: People who are overweight and obese have a higher risk of developing congestive heart failure.
  • Smoking: Smoking or using tobacco increases the chances of lung and heart infections long term smoking leads to CHF.
  • Alcohol consumption: Drinking alcohol for a long time affects the vital organs including the heart which gets stiff and may result in CHF.
  • Sleep Apnea: A condition in which the breathing is abnormal while sleeping resulting in decreased oxygen levels in the body. In response to that, the heart has to work with greater force and the contractions are greater.
  • Diabetes: Increased blood pressure occurs in diabetes that ultimately affects the blood vessels and heart pumping.
  • Lack of exercise: People who spend most of their time sitting at the same place for hours and not doing any exercise may become obese which is the predisposing factor of congestive heart failure.
  • Viral infections: Mostly, chronic viral infections last a long-term effect on the heart by causing infections. So, any long-term viral infection may have its effects on heart functioning.
  • Unhealthy diets: Another major reason for congestive heart failure is eating junk foods or high cholesterol diets of oily nature. An increased LDL cholesterol level in the body may lead to CHF.

What complications are possible in Congestive Heart Failure?

Complications of congestive heart failure may depend upon the age and the extent to which the heart or chambers of the heart are affected.

  • Kidney failure: In long-term congestive heart failure, blood flow towards the kidney is decreased because the heart is not pumping with greater force. If the condition is left untreated without taking measures, it can lead to kidney failure.
  • Anasarca: Lower limb edema or generalized edema may occur if the congestive heart is severe and chronic. Fluids are retained in the body causing generalized edema.
  • Liver damage: When the extra and useless fluids from the body are not excreted through urine because the kidney is not functioning due to decreased heart output.

These may cause increased pressure on the liver leading to liver damage.

  • Myocardial infarction: In some cases of acute congestive heart failure, the heart may stop working and death may occur because of myocardial infarction which is also called a heart attack.
  • Stroke: In prolonged and chronic congestive heart failure blood vessels may get shortened resulting in decreased supply to the brain. Brain tissue may die and a person can perish in few minutes of a stroke.
  •  Aneurysm: A bulge may appear anywhere in the arteries which may burst inside the vessel causing hemorrhage and internal bleeding which may worsen the condition.

When to see a doctor in Congestive Heart Failure:

Symptoms may not be prominent at the start, however, if they prolong and get worse then see the doctor immediately. Call the doctor if you observe the following disease pattern.

  • Shortness of breath even without doing exercise.
  • Chest pressure and cardiac arrhythmias are prolonged.
  • Sudden weight gain, more than 5 pounds in a week.
  • Swollen or edematous legs, ankles, abdomen, or belly.
  • Fatigue in doing small chores requires less effort.
  • Higher heart rate and anorexia.
  • Coughing with fresh blood-tinged fluids.

How can you diagnose Congestive Heart Failure?

First and foremost, the thing about diagnosis is the clinical check-up in which the doctor would ask you a complete history of clinical signs and symptoms correlating with other possible causes.

For accurate diagnosis and confirmation, the following steps can be followed.

Blood test: A doctor may suggest you go for a blood test. A blood test may give a notion about kidney functioning status, thyroid anomalies, cholesterol level, and BNP.

BNP is a substance that is secreted from the heart in response to elevated blood pressure.

X-ray: A complete and zoomed X-ray of the heart may give an idea about hypertrophy or increased size of the heart that may be co-existing with congestive heart failure.

Echocardiogram: This can be used to check the complete status of the heart. It may show the structure, functioning, and movement of the heart.

Electrocardiogram: This is used to diagnose the impulses produced by the heart. This can be used to check the thrust by which the heart is pumping the blood.

Other techniques like cardiac catheterization, exercise tolerance test, and stress test can be used to diagnose congestive heart failure.

What is the treatment of congestive heart failure?

Congestive heart failure can be treated by following the medication plan and lifestyle. The main purpose of the treatment of CHF is to stop the further worsening of the condition.

Following treatment protocols can be followed:

  • Following medicines can be used according to the prescription of a doctor.
  • ACE inhibitors
  • Beta-Blockers
  • Blood vessel dilators
  • ARB blockers
  • Digoxin
  • Diuretics
  • Calcium channel blockers
  • Heart pump medications, SN node inhibitors, sGC stimulators can be used.
  • Diuretics can be used to flush the extra fluid from the body which is retained as edema.
  • Exercise and a healthy diet are suggested alongside pharmacological treatment.

What is the home remedy that we can use to treat Congested Heart Failure?

Following home remedies can be used to avoid or treat CHF occurrence.

  • Decrease salt usage.
  • Eating anti-oxidant rich diets
  • Eating healthy food with lower cholesterol levels.
  • Note the weight gain every day and take measures accordingly.
  • Eating diets and fruits rich in potassium helps in avoiding vascular calcification.
  • Exercise daily, sleep well; and stay stress-free. 

What preventive measures can be taken to avoid Congestive Heart Failure?

Following healthy steps can be taken to prevent congestive heart failure occurrence.

Quit Smoking and Alcohol: Both of these are predisposing factors to lung damage and congestive heart failure. Avoid them to rule out the possibility of heart diseases.

Exercise regularly: If you are healthy now doesn’t mean you are not prone to heart diseases. Exercise daily to keep the blood flow and heart functioning normally.

Eat a balanced diet: Avoid consuming diets that are high in cholesterol and LDL lipids. Avoid high salt diets.

Maintain Optimum weight: Avoid getting obese because it is the root of CHF. Stay active to lose extra weight.

Control BP: Don’t let your BP stay high for a longer duration because this might lead to congestive heart failure because high BP can affect blood vessels leading to increased pressure on the heart.  

Abdur Rashid
Medically Reviewed By Abdur Rashid
MSC Public Health, MCSP, MHCPC
BSC (Hon) Physiotherapy
Consultant Neuro-spinal & Musculoskeletal Physiotherapist

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