What causes congestive heart failure?
Congestive heart failure, or a weakening of the heart muscle, can be caused a variety of ways. Sometimes heart attacks caused by severe blockages in the blood vessels leading to the heart permanently injure the heart muscle. Also, if the heart is forced to work hard over a prolonged period of time, it can slowly weaken. This can happen when it has to pump against a high blood pressure or when the valves inside the heart do not open or close well. Certain environmental factors can also cause heart failure, such as specific viral infections or toxins. In fact, alcohol and cocaine use can cause heart failure as well. There are also medications, such as certain chemotherapy agents given for cancer, that can cause heart failure at a later date. In addition, certain genetic causes of heart failure exist where the heart muscle weakens with time. Unfortunately, there is also a significant proportion of patients where the cause remains unknown.
How do I know if I have congestive heart failure?
Congestive heart failure is essentially an inability of the heart to meet the demands of the body. As a result, you may begin to feel much more fatigued than usual. In addition, you may begin to feel increasing shortness of breath during levels of activity that previously did not cause any strain. There may be signs that your body is retaining more water: swollen feet, an increase in weight, or a bloated abdomen. Also, there may be increased fluid in your lungs that causes a new cough. You may experience sudden shortness of breath while lying down that is relieved after sitting upright. You may, in fact, require extra pillows to sleep at night because lying flat makes it difficult to breath.
While all of these symptoms can occur with congestive heart failure, many of them may have other causes. If you have experienced any of these symptoms, it is important to bring them to the attention of your doctor so that he or she can further evaluate you.
How well do medications work in CHF?
Many new medications are being used to effectively manage and treat congestive heart failure. ACE inhibitors are a class of drugs that have proven extremely beneficial for heart failure. They have been shown to decrease hospitalizations, improve symptoms, and extend life. While there are many potential explanations for how these drugs work, most physicians agree that they slow the progressive enlargement and weakening of the heart muscle. Most physicians would consider these to be first-line drugs in the treatment of congestive heart failure. In addition, diuretics, or drugs that help the body eliminate excess water, can also help to relieve swelling in the legs and some of the shortness of breath. Another drug, Carvedilol or Coreg, is also beneficial for the treatment of certain types of heart failure. It blocks the undesirable effects of the body's own hormonal system and slows the progression of heart failure. It has been shown to reduce the risk of death by up to 33 percent. Another drug that has been used for many years, Digoxin, is also helpful in preventing recurrent hospitalizations in patients. It works by making the heart pump a little stronger. While these drugs can offer significant benefit, many can cause you to have certain side effects and some may actually cause your heart failure to get worse before it gets better. In addition, other medical problems you may have may prevent the safe use of these medications. A thorough evaluation by your physician will help to identify which medications are appropriate.
How do pacemakers work in CHF? How well do they work?
Congestive heart failure results essentially from a weakening of the heart muscle. There also appears to be a dysfunction of the electrical system of the heart. This is important since the heart relies on this system to signal it to contract and subsequently pump blood out to the rest of the body. It is thought that in advanced heart failure, the various chambers of the heart and perhaps various portions of the same heart chamber lose their intrinsic synchronicity, and as a result, do not pump blood in the most efficient manner. The pacemaker sends electrical signals in a specific pattern to cause contraction of specific chambers of the heart. The aim of the new pacemaker therapy approach is to reestablish this synchronized contraction of the various heart chambers and thereby improve the pumping ability of the heart. Unfortunately, there is not enough data to support its widespread use as yet. However, trials are being conducted to determine if this will be a helpful form of therapy.
How well does heart transplant work in the treatment of CHF?
Heart transplantation is generally reserved for patients with severe heart failure. Patients will generally have shortness of breath at rest or very minimal exertion. They will also require prolonged periods of hospitalization to receive intravenous medication to help the heart pump better and help the body get rid of excess fluid. The use of new medications has dramatically improved the success of heart transplantation over the last decade. The most recent data suggest that nearly 80 percent of heart transplant recipients are alive after one year and 65 percent after five years. If patients received just medicines for severe heart failure, only 50 percent would be alive after one year and much less after that. Though transplantation has achieved much success, there are major drawbacks. During the first year, infection and rejection (where the body rejects a foreign organ) are major causes of hospitalization and even death among transplant recipients. In addition, there is no guarantee that a suitable donor organ will be found in time for patients requiring a transplant. In fact, the majority of patients who are awaiting a donor heart never receive one because of the incredibly small number of donor hearts available.
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