Congestive Heart Failure (chf)

Congestive Heart Failure

Congestive Heart Failure (CHF) is a major problem in the U.S. affecting approximately 4.6 million people "about 550,000 new cases yearly". CHF is also the leading cause of hospitalization in people older than 65 years of age. Heart failure is the hearts inability to pump as well as it should and is unable to keep up with the body's constant need for oxygen and nutrients. The walls of the heart stretch to hold more blood. The heart walls thicken to pump stronger. The kidneys cause the body to retain fluid and sodium, increasing the amount of blood circulating in the heart. As the body tries to compensate, the hearts ability to stretch weakens significantly causing blood to back flow into the arms, legs, ankles, feet, liver, lungs, etc. resulting in CHF.

Heart failure is most often caused by coronary heart disease. Coronary artery disease causes decreased blood flow to the heart muscle. If the arteries become blocked, the heart becomes ischemic which in a short time damages the heart muscle causing the heart not to pump blood proficiently to the body. Other causes of damage to the heart include infection, alcohol / drug abuse, pregnancy, and no apparent cause. Conditions that overwhelm the heart are hypertension, valve disease, thyroid disease, kidney disease, diabetes mellitus, and heart defects. Signs and symptoms include shortness of breath, dizziness, fatigue, rapid or irregular heart beats, lower extremity edema, nausea, palpations, chest pain, etc.

Today, there are many different invasive and non-invasive procedures that can control CHF. Non-invasive procedures include a change in lifestyle, ACE inhibitors, ARB's, Beta-blockers, and Diuretics. Sometimes more invasive procedures are needed which can vary from ultra filtration, coronary artery bypass, coronary angioplasty, implantable cardiac defibrillator, and heart transplant. In the goal of this project of this project is to provide facts between invasive and non-invasive procedures, and the best treatment for specific types of patients.

In mild cases a change in lifestyle can help reduce symptoms like fatigue, shortness of breath, and edema (swelling). A modified diet is an essential start. Limiting the amount of sodium consumed daily is crucial due to its contribution in increasing fluid accumulation in the body's tissue. Abstaining from alcohol and exercising regularly contributes to the strengthening of the heart muscles and lowering the chance of worsening the heart failure.

Angiotensin-converting enzyme (ACE) inhibitors help dilate the arteries allowing the heart to pump blood throughout the body. Usually it is the primary choice for heart failure. They are not used in patients with low blood, and may affect potassium levels and kidney functions. Side effects include chronic non-productive cough, dizziness, increased potassium levels, skin rashes, and sudden swelling of lips, face and cheeks. Some of these drugs include captopril, enalapril, lisinopril, benazepril, and ramipril.

For patients who are unable to tolerate ACE inhibitors, angiotensin receptor blockers (ARBs) are used. They act on the same lines of ACE inhibitors, but instead block the action of anginotensin II directly at the receptor site. Possible side effects of these drugs are the same as ACE inhibitors, but the dry cough is much less common. Some of these drugs include losartan, candesartan, telmisartan, valsartan, irbesartan.

Certain hormones like epinephrine, norepinephrine, etc. produce stimulating effects on beta receptors, causing a more forceful contraction of the heart muscle. Beta blockers are agents that block the actions of