Congestive Heart Failure: A Patient Guide


Congestive heart failure (CHF) is the result of abnormal and depressed function of the heart for any reason. The most common presentations of this syndrome are the development of shortness of breath during exertion, rest, at night (called paroxysmal nocturnal dyspnea or PND), or upon lying down (called orthopnea). This may be associated with a chronic cough, fatigue or swelling (at the point of the most gravity, feet or the back if lying down) or weight gain. While chest pain may occur with this syndrome it is not a necessary component. These symptoms often develop slowly, but may occur quickly.

The incidence of CHF is on the rise, affecting five million people in the United States. The condition affects mostly older adults. Approximately eight out of 1,000 people over age 70 are diagnosed with CHF. It is one of the most common reasons for hospitalization in this age group. The rise in CHF is due to people living and surviving longer from cardiac problems and conditions that put them at risk for the development of CHF. The condition is treatable and its effects are often reversible.

How the heart works

The heart pumps oxygen and nutrients to the body's tissues and organs. It also helps rid the body of unnecessary waste products. The heart consists of four chambers, the right and left atria and the right and left ventricles. Blood from the body enters the heart through the right atrium to the right ventricle, which brings blood to the lungs. It is here that carbon dioxide is removed from the blood and oxygen is added. Blood then returns to the heart via the left atrium. The heart then pumps the oxygen-rich blood to the rest of the body through the left ventricle. The heart performs this task on an ongoing basis. Should the heart weaken for any reason, the circulation slows and things back up. If the left ventricle is weak (failing), fluid collects in the lungs. This causes a back up of fluid in the right side of the heart and ultimately the development of fluid in the legs.

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