Congestive Heart Failure

Heart failure is a condition in which your heart can’t pump enough blood to meet your body’s needs. Here is how heart failure develops:

• The heart muscle is weakened by conditions or diseases that damage the heart. Heart muscle weakening and damage is often called cardiomyopathy, which literally means “heart muscle disease.”
• Because the heart is weak, its pumping action becomes less efficient.  The body tries to compensate for this in various ways such as sending more hormones to stimulate the heart, making the heart beat faster, and enlarging the heart.
• Sooner or later, these adjustments put extra strain on your heart. Eventually the heart muscle begins to wear out and become even less efficient at pumping blood to your body.

Symptoms

Heart failure symptoms are due to fluid buildup in your system or lack of oxygen to the tissues. Key symptoms of heart failure may include:

• Shortness of breath. This is due to fluid buildup, which makes breathing harder. This tends to occur first during physical activity, and may also happen when you’re trying to lie flat.
• Cough. Some people may have a dry and hacking cough, also a side effect of fluid buildup in your lungs. This most often occurs at night, but may last all day for some.
• Excessive fatigue. You will feel more tired than usual—and may also feel weak—because your muscles and organs aren’t getting the blood they need.
• Weight gain. Because extra fluid is building up in your body, you will gain weight—about 2 pounds for each additional quart of body liquid.
• Swollen ankles, feet, belly, lower back, and fingers. Fluid buildup shows up as swelling in different parts of your body, and is usually worse at the end of the day.
• Poor concentration and memory. Some people experience these symptoms, due to lack of oxygen to the brain.

Causes

The heart muscle is often weakened by other conditions, including atherosclerosis, heart attack, high blood pressure, heart valve problems, and alcohol or drug abuse. Sometimes heart muscle damage occurs for no known reason. This is referred to as idiopathic cardiomyopathy (idiopathic means “no known cause”).

Prevention

Adopting a heart-healthy lifestyle can help you prevent heart failure.

• Eat lots of fruits, vegetables, whole grains, and low-fat sources of protein such as nuts and fish
• Exercise regularly
• Maintain a healthy weight and keep diabetes under control
• Quit smoking

Diagnosis and treatment

Heart failure is a chronic condition that in most cases cannot be cured. However, it can be managed. For most people with heart failure, this means taking medication, making positive lifestyle changes, and self management using MAWDS (Medication, Activity, Weighing yourself, Diet, and monitoring Symptoms). See the links below for diagnosis and treatment procedures.

Diagnostic Tests

• Cardiovascular Diagnostic Testing
  • Blood Tests
  • Chest X-rays
  • Echocardiography
  • Electrocardiogram (EKG,ECG)
  • Medical History & Physical Exam
• Cardiovascular Advanced Imaging
  • Cardiac CT
  • Cardiac Magnetic Resonance Imaging

Treatment Procedures

• Cardiac Cath Lab Rhythm Procedures
  • Electrophysiology Study (EP)
• Cardiovascular Specialized Procedures
  • Heart Transplant
  • Septal Ablation
  • Ventricular Assist Devices

Intermountain Healthcare resources on heart failure

• Living with Heart Failure
• Anticoagulation therapy: what you need to know and do
• Coumadin Dosing Guides
• CAC dosing guide for 2 mg tablets
• CAC dosing guide for 5 mg tablets
• CAC dosing guide for 10 mg tablets
• Spelling out the steps for better health with MAWDS (English/Spanish)
• Heart Failure Self-care Diary: MAWDS
• Heart Failure Self-care Diary: MAWDS (Spanish)

Additional Resources

• American Heart Association (AHA)
• Medline Plus Heart Pages