Congestive heart failure

Chronic heart failure.  Photo from www.sciencephoto.com

The result of the majority of heart disease in the absence of treatment is chronic heart failure (CHF). This condition, wherein heart is unable to pump blood in sufficient amounts, whereby the organs and tissues lack of oxygen and nutrients.

The most obvious signs of heart failure are shortness of breath and swelling. Shortness of breath occurs due to stagnation of blood in the pulmonary vessels and an increased need for oxygen. Edema are due to stagnation of blood in the venous line.

CHF develops gradually, so there are several stages of the disease. There are different principles of division of heart failure at the stage, one of the most convenient and straightforward classifications developed by the New York Heart Association. It is divided into four functional class in patients with chronic heart failure:

I FC — The patient does not experience limitations of physical activity. Conventional load does not provoke the occurrence of weakness (nausea), palpitation, dyspnea or anginal pain.

FC II — Moderate limitation of physical activity. The patient feels comfortable at rest, but the performance of conventional exercise causes weakness (lightheadedness), palpitations, shortness of breath or chest pain.

FC III — A marked limitation of physical activity. The patient feels comfortable only at rest, but less than usual physical activities lead to the development of weakness (nausea), palpitation, dyspnea or anginal pain.

FC IV — Inability to perform any load without causing discomfort. Symptoms of heart failure or angina syndrome may occur alone. When the load increases the minimum discomfort.

What is Chronic heart failure?

State chronic heart failure occurs when the heart is no longer sufficiently provide tissues and organs with blood, and hence of oxygen and nutrients.

Why did this happen?

In the chronic insufficiency of the heart muscle (myocardium) is not able to develop a due diligence on the expulsion of blood from the left ventricle. The reasons for such a violation may be associated with a lesion of the myocardium, aorta (the main artery that goes directly to the heart) and heart valves.

The myocardium is affected by ischemic heart disease, myocarditis (inflammation of the heart muscle), cardiomyopathy, systemic connective tissue diseases. It also occurs in toxic myocardial damage in case of poisoning with poisons, toxins and drugs.

The defeat of the aorta and the arteries occurs in atherosclerosis, hypertension, diabetes and other diseases.

Non-operated heart defects (congenital or acquired) also lead to heart failure.

What's going on?

Slow blood flow causes chronic hypoxia organs and tissues, which causes a characteristic manifestation of heart failure — shortness of breath on exertion, or (in advanced cases) alone. Man complains of fatigue, poor sleep, heart palpitations (tachycardia).

The lack of oxygen in the outermost regions of the heart of the body (fingers, toes, lips) causes the skin to which acquires gray-bluish hue (cyanosis). Insufficient cardiac output leads not only to a decrease in the volume of blood entering the blood stream, but also to stagnation of blood in the venous line. This leads to swelling (in the first place — the legs), as well as pain in the right upper quadrant, associated with the overflow of the veins of the liver.

In the most severe stage of heart failure, all of the above symptoms increase.

Cyanosis and dyspnea concerned person even in a state of complete rest. He had to be carried out in a sitting position all day, as in the supine position increased shortness of breath, and can not even sleep just sitting. Swelling apply to the entire lower part of the body, fluid accumulates in the body cavities and (abdominal, chest).

Diagnosis

Diagnosis is by examination Cardiologist and additional methods of examination, such as the electrocardiogram in different variations: ECG monitoring andtreadmill test. Contractility of the heart and the size, the number of ejected blood into the aorta they can find out by echocardiogram. Perhaps a cardiac catheterization (a thin tube is inserted through a vein or artery directly into the heart, the procedure allows to measure pressure in the heart chambers and to identify the blockage of vessels).

Treatment

Heart failure is much easier to prevent than to cure.

Its prevention involves treatment of hypertension, prevention of atherosclerosis, a healthy lifestyle, exercise, smoking cessation and diet.

If heart failure yet developed, a cardiologist prescribes treatment. Typically it includes diuretics (to reduce the volume of blood pumped) ultraselektivnye beta-blockers (to reduce the oxygen demand of the heart), metabolic therapy and indeed, treatment of the underlying disease.

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