Congestive heart failure (CHF) is a condition in which the heart is unable to pump enough blood to support other organs in the body, resulting in the lack of oxygen in the other organs. The task of the heart is to pump blood from its chambers into the systemic circulation. However, when the heart’s pumping system malfunctions, it causes blood or fluid pooling in its chambers causing fluid to backflow into the lungs. This is called “pulmonary edema”.
Symptoms of congestive heart failure include fatigue, exhaustion and dizziness. CHF can also cause kidney failure which is the result of chronic starvation of oxygen in organs and exhaustion from pulmonary edema. Patients with this condition cannot lie flat as they suffer from swelling (edema) of the legs or face.
There are 2 types of Congestive Heart Failure:
- Heart failure with reduced ejection fraction (HFrEF)
- Heart failure with preserved ejection fraction (HFpEF)
Both types of congestive heart failure cause all of the above symptoms. Some 5–10% of patients will die within the first year of diagnosis of congestive heart failure. Patients with heart failure and reduced ejection fraction have high mortality rates. Congestive heart failure also causes disabilities, poor quality of life, and time-consuming treatments when they are relapsing and have to be admitted to the hospital. This results in loss of economy as well.
Causes of Congestive Heart Failure
Congestive heart failure is caused by many diseases, but the main cause is due to complications from myocardial ischemia. In addition, there are other causes such as flu or some viruses, some types of cardiac arrhythmias, drinking alcohol, or having received chemotherapy or radiation before.
Diagnosis:
Congestive heart failure can be diagnosed by history, physical examination, and diagnostic work-up including echocardiography, blood tests along with N-terminal pro B-type natriuretic peptide (NT-pro-BNP) measurement and more important is the detection of diseases that cause this condition such as coronary angiography to determine if the patient has coronary artery disease in order to promptly eliminate the cause of the disease.
Therapy and treatments:
- Therapy and treatments mainly focus on the elimination of the cause of the condition. If the condition is caused by coronary artery disease, the patient should receive coronary angiography treatment to remedy blood vessels as soon as possible to stop the disease.
- Medication to slow disease progression and restore the heart’s function.
- Adjust the amount of fluid in the body by diet, curbing fluid intake per day, and proper diuretic adjustment.
- Use cardiac resynchronize therapy (CRT), as well as wearing an implantable cardioverter defibrillator (ICD) in patients with indications.
In fact, more than half of the patients with congestive heart failure can be treated and their heart functions can return to normal, especially those caused by myocardial infarction if detected early. Patients who have been in this condition for a while without proper treatments before going to the doctor might be too late for treatment. Therefore, in this group of patients it is necessary to have a doctor and a multidisciplinary medical team to assist with special care. As we can see in medical schools or leading hospitals in the country, it is necessary to have “Congestive Heart Failure Clinic” to take care of this group of patients with the purpose of reducing the recurrence of edema and prevent unnecessary hospital admissions. Also, the clinic provides healthcare knowledge to the patients and their relatives, which enables the patients to take care of themselves and to live in the society almost near their previous life conditions.
If you or your relatives have congestive heart failure, cardiomegaly, and edema that requires seeing the doctor too often, please contact a medical professional at “Congestive Heart Failure Clinic” in Heart Disease Center of Bangkok Hospital Phuket.
