Congestive Heart Failure (CHF)

Congestive heart failure (CHF) is a chronic progressive disease that affects the pumping strength of your heart muscle.

Although often simply known as heart failure, CHF specifically refers to the stage in which fluid builds up in the heart and causes it to pump ineffectively.

You have four chambers of the heart. The upper half of your heart consists of two atria, and the lower half of your heart is made up of two ventricles.

The ventricles pump blood to the organs and tissues in your body, and the atria receive your body’s blood as it flows from the rest of your body.

CHF develops when your ventricles cannot pump required blood to the body. Eventually, blood and other fluids can get inside your:

  • lungs
  • abdomen
  • liver
  • lower body

CHF can be life threatening. If you think you or someone you know has CHF, get medical help right away.

What are the symptoms of congestive heart failure?

In the early stages of CHF, you probably won’t notice any changes in your condition. If your condition changes, you will experience gradual changes in your body.

Symptoms You May Notice First

  • tired
  • swelling of the ankles, feet and legs
  • weight gain
  • increased need to urinate, especially at night

Symptoms that indicate your condition has worsened

  • irregular heartbeat
  • a cough that develops from congested lungs
  • wheezing
  • shortness of breath, which may indicate pulmonary edema

Symptoms indicating severe heart disease

  • chest pain that radiates to your upper body
  • Rapid breathing
  • skin appearing blue due to lack of oxygen in your lungs
  • fainting

Symptoms of heart failure in children and infants

It can be hard to recognize heart failure in infants and young children. Symptoms may include:

  • Bad nutrition
  • excessive sweating
  • difficulty in breathing

These symptoms can easily be misinterpreted as colic or respiratory infection. Poor growth of children and low blood pressure can also be signs of heart failure in them.

In some cases, you can feel a resting baby’s rapid heart rate through their chest wall.

How is congestive heart failure treated?

You and your doctor may consider different treatments depending on your general health and how your condition is improving.

Drugs for congestive heart failure

There are several drugs that can be used to treat CHF, including ACE inhibitors, beta blockers, etc.

ACE inhibitors

Angiotensin converting enzyme (ACE) inhibitors open narrowed blood vessels to improve blood flow. Vasodilators are another option if you cannot endure ACE inhibitors.

You may be prescribed one of the following:

  • benazepril (Lotensin)
  • captopril (Capoten)
  • enalapril (Vasotec)
  • fosinopril (Monopril)
  • lisinopril (Zestril)
  • quinapril (Accupril)
  • ramipril (Altace)
  • moexipril (Univasc)
  • perindopril (Aceon)
  • trandolapril (Mavik)

ACE inhibitors should not be taken with the following medicines without consulting a doctor, as they may cause an adverse reaction:

  • Thiazide diuretics. These can cause further decrease in blood pressure.
  • Potassium-sparing diuretics. These diuretics can cause potassium to build up in the blood, which can lead to abnormal heart rhythms. Examples include: eplerenone (Inspra), riamterene (Dyrenium) and spironolactone (Aldactone).
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as aspirin, ibuprofen, and naproxen can cause sodium and water retention. This may reduce the effect of the ACE inhibitor on your blood pressure.

This is a short list, so always discuss it with your doctor before taking any new medicines.

Beta-blockers

Beta blockers make the heart work less and can lower blood pressure and slow a fast heart rate.

Also Read: Effective Yoga Mudras For Your Healthy Heart

This can be achieved with:

  • atenolol (Tenormin)
  • bisoprolol (Zebeta)
  • carvedilol (Coreg)
  • esmolol (brévibloc)
  • metoprolol (Lopressor)
  • nadolol (Corgard)
  • nebivolol (Bystolic)

Beta blockers should be consumed with caution with the following medications, as they may cause an adverse reaction:

  • Antiarrhythmic drugs. These can increase cardiovascular effects, including slowing the heart rate. One example is amiodarone (Nexterone).
  • Antihypertensive drugs. These medicines can also increase the likelihood of cardiovascular effects and include lisinopril (Zestril), candesartan (Atacand), and amlodipine (Norvasc).
  • Albuterol (AccuNeb). The effects of albuterol on bronchodilation may be reversed by beta blockers.
  • Antipsychotics. Some antipsychotics, such as thioridazine (Mellaril), can also cause hypotension in some people.
  • Fentora (fentanyl). This can lead to low blood pressure.
  • Clonidine (Catapres). Clonidine can cause high blood pressure.

Some drugs may not be listed here. You should always take advice of your doctor before taking any new medication.

Diuretics

Diuretics reduce the fluid content in your body. CHF can cause your body to preserve more fluid than it should.

Your doctor may recommend:

  • Loop diuretics. These cause the kidneys to produce urine. This helps in removing excess fluid from your body. Examples are ethacrynic acid (Edecrin), furosemide (Lasix), and torsemide (Demadex).
  • Potassium-sparing diuretics. These help get rid of fluids and sodium while retaining potassium. Examples include eplerenone (Inspra), spironolactone (Aldactone), and triamterene (Dyrenium).
  • Thiazide diuretics. These cause the blood vessels to widen and help the body to flush out any excess fluid. Examples are hydrochlorothiazide (Microzide), indapamide (Lozol), and metolazone (Zaroxolyn).

Diuretics should be consumed with caution with the following medications, as they may cause an adverse reaction:

  • ACE inhibitors. These can cause a decrease in blood pressure, including lisinopril (Zestril), benazepril (Lotensin), and captopril (Capoten).
  • Tricyclics. Also called tricyclic antidepressants (TCAs), they can lower blood pressure. Examples include: amitriptyline and desipramine (Norpramin).
  • Anxiolytics. Anxiolytics are anti-anxiety drugs that can lower blood pressure. Common anxiolytics include chlordiazepoxide (Librium), alprazolam (Xanax), and diazepam (Valium).
  • Hypnotics. Sedatives such as zolpidem (Ambien) and triazolam (Halcion) can cause low blood pressure.
  • Beta-blockers. Beta blockers, such as metoprolol (Lopressor) and carvedilol (Coreg), can also cause low blood pressure.
  • Calcium channel blockers. CCBs can cause a drop in blood pressure. Examples include amlodipine (Norvasc) and diltiazem (Cardizem).
  • Nitrates. These drugs, such as nitroglycerin (Nitrostat) and isosorbide-dinitrate (Isordil), can lower blood pressure.
  • NSAIDs. These drugs can cause liver toxicity.

This is a shortened list containing only the most common drug interactions. Before taking any new medicine you should always consult your doctor.

Surgeries and procedures

If the drugs are not effective on their own, more invasive procedures may be needed.

An option is angioplasty, a procedure to open blocked arteries.

Your cardiologist may also recommend heart valve repair surgery to help your valves open and close properly.

Signs of congestive heart failure

As mentioned, the first signs of congestive heart failure may not be very noticeable. Here are some warning signs to discuss with your healthcare professional:

  • excess fluid in body tissues such as the ankles, feet, legs, or abdomen
  • coughing or wheezing
  • shortness of breath
  • weight gain that cannot be attributed to anything else
  • general fatigue
  • increased heart rate
  • lack of appetite or a feeling of nausea
  • feeling confused or disoriented

What are the causes of CHF?

CHF can result from other health problems that directly affect your cardiovascular system. That’s why it’s important to have annual checkups to lower your risk of heart health problems, including:

  • high blood pressure (hypertension)
  • coronary artery disease
  • valve conditions

Hypertension

When your blood pressure is higher than normal, it can lead to CHF.

Hypertension has many different causes. Among them, the hardening of your arteries, which increases the pressure in the arteries.

Coronary artery disease

Cholesterol and other types of fat can block the coronary arteries, which are the small arteries that supply blood to the heart. This causes narrowing of the arteries.

Narrower coronary arteries restrict blood flow and can damage your arteries.

Valve conditions

Your heart valves regulate blood flow through your heart by opening and closing them to let blood in and out of the chambers.

Valves that don’t open and close properly can force your ventricles to work harder to pump blood. This can be the result of a heart infection or a defect.

Other conditions

While heart disease can lead to CHF, there are other seemingly unrelated conditions that can increase your risk as well.

These include:

  • Diabetes
  • thyroid disease
  • obesity

Severe infections and allergic reactions can also contribute to CHF.