Heart failure

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Heart, section through the middle

Heart, front view

Circulation of blood through the heart

Heart failure

Alternative Names:

CHF; Congestive heart failure
Symptoms:

Weight gain
Swelling of feet and ankles
Swelling of the abdomen
Pronounced neck veins
Loss of appetite, indigestion
Nausea and vomiting
Shortness of breath with activity, or after lying down for a while
Difficulty sleeping
Fatigue, weakness, faintness
Sensation of feeling the heart beat (palpitations)
Irregular or rapid pulse
Decreased alertness or concentration
Cough
Decreased urine production
Need to urinate at night

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Infants may sweat during feeding (or other exertion).

Some patients with heart failure have no symptoms. In these people, the symptoms may develop only with these conditions:

Infections with high fever
Anemia
Abnormal heart rhythm (arrhythmias)
Hyperthyroidism
Kidney disease

Signs and tests:

A physical examination may reveal either an irregular or a rapid heartbeat. There may be distended neck veins, enlarged liver, swelling of the limbs (peripheral edema), and signs of fluid around the lungs (pleural effusion).

Listening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds. Blood pressure may be normal, elevated or low.

An enlargement of the heart or decreased heart functioning may be seen on several tests, including the following:

Echocardiogram
Heart catheterization
Chest x-ray
Chest CT scan
Cardiac MRI
Nuclear heart scans (MUGA, RNV)
ECG, which may also show arrhythmias

This disease may also alter the following test results:

CBC
Blood chemistry
Serum sodium
BUN
Creatinine
Liver function tests
Serum uric acid
Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)
Urinalysis
Urinary sodium
Creatinine clearance
Swan-Ganz measurements (right heart catheterization)

If excessive fluid has accumulated around the sac surrounding the heart (pericardium), you may need to have the fluid removed through a pericardiocentesis.