Category: General Health

What is Congestive Heart Failure?

It’s a terrifying moment for many patients: the moment when the doctor enters their hospital room and informs them they are suffering from congestive heart failure. Many people do not know what congestive heart failure is or what it means for their life, and they ask themselves, “Is congestive heart failure the end of my world as I know it?”

Congestive heart failure occurs when for whatever reason the heart is unable to effectively pump the blood through the body. This usually occurs when the heart muscle is weak due to disease or stressed beyond its ability to function. Congestive heart failure is usually a secondary disease following another cardiac condition, primarily either coronary artery disease, cardiomyopathies, myocarditis, valvular disease, or cardiac arrhythmias, with coronary artery disease carrying the poorest prognosis. It may also follow a myocardial infarction, renal failure, sepsis or severe anemia.

Each side of the heart has a different function, and therefore will have a slightly different effect on the body when it is unable to fulfill that function. If it is the left side of the heart that has failed accumulation of fluid in and around the lungs will cause the patient to experience difficulty breathing, and the kidneys will respond to the reduced blood in the circulation by retaining fluid as well. If it is the right side that fails the excess fluid accumulates in the venous system, giving the patient a generalized edema that becomes more severe as their condition deteriorates.

Dyspnea is the prevalent presenting symptom in congestive heart failure, although the severity will vary from patient to patient. Some will possess perfectly normal pulmonary function until under exertion, such as while exercising, walking up stairs or mowing their lawn; others will have so much fluid accumulated that simply rising from bed in the morning will prove difficult. These patients will also usually become easily fatigued due to a lack of oxygen to the tissues. Heart failure will also cause a condition known as pitting edema, in which the body retains fluid to the point that when pressure is applied to specific spot on the body the indentation remains (non-pitting edema is not caused by heart failure).

Treatment of congestive heart failure consists primarily of treating the symptoms. Vital signs should be taken regularly, and often diuretics will be prescribed to facilitate expulsion of accumulated fluid from the body. While in the hospital fluid intake and output will be measured very carefully. Patients will probably be placed in an upright position to assist in moving fluid from around the heart and lungs, given potassium supplements and prescribed bed rest for a period of time. BUN levels and serum creatinine, potassium, sodium, chloride and bicarbonate levels are monitered frequently by a physician.

There are several factors that contribute to congestive heart failure and, if diagnosed, should be treated and maintained. These include hypertension, anemia or poycythemia, endocrine disorders, malnutrition, drug or alcohol use and obesity. Therefore, it is very important that patients suffering from congestive heart failure pay particular attention to maintaining a healthy lifestyle. A doctor can aid in establishing the best diet and exercise plan with each individual to prevent placing undue stress on the heart and lungs.

While no said cure exists for congestive heart failure and the prognosis varies from case to case, by following a strict diet and exercise program, taking all prescribed medications regularly and maintaining a close relationship with their physicians many patients who suffer from heart failure can continue to lead a fairly normal life.

What Evidence of Congestive Heart Failure is a Diagnosis Based

What Evidence of Congestive Heart Failure is a Diagnosis Based on?

While all cardiac conditions carry similar symptoms of chest pain and difficulty breathing, congestive heart failure generally presents with a very specific set of symptoms and lab results, giving doctors a very firm set of clues upon which to base a definite diagnosis.

Dyspnea, or difficulty breathing, coupled with severe pitting edema (when the body retains fluid to the point of holding the imprint of an object that is pressed into the skin for several minutes) are generally the first pieces of evidence pointing to congestive heart failure. Heart failure results in the heart not being able to efficiently pump blood throughout the body; as a result, fluid accumulates rather than being excreted and causes the body to swell as if it were a water balloon. Non-pitting edema, or fluid retention that does not hold an imprint, is not caused by heart failure and indicates that another diagnosis needs to be made. The patient may produce a frothy pink sputum when they cough.

In addition to the symptoms related to the fluid accumulation general weakness and malaise, particularly during times of physical exertion are frequent complaints of patients suffering from congestive heart failure, and should not be ignored. This is caused by a lack of nutrients and oxygen from the blood to the body tissues, and may result in permanent damage to the organs if they are left without these vital elements for a prolonged period of time. Anuria, or a lack of urination, is also evidential of heart failure as fluid accumulates in the tissues rather than being properly excreted. Patients may suffer from a changed mental status due to toxins accumulating in the body.

Once the physician suspects heart failure based on the physical evidence, blood samples will be sent to the laboratory. Beta-natriuretic peptide, or BNP, is an excellent screening tool in suspected cases of heart failure. This hormone is produced in greater quantities by the failing heart muscle as fluid levels rise, with a level between one hundred and five hundred pg/mg suggesting congestive heart failure and greater than five hundred being fairly diagnostic; however, an elevated BNP should not be considered to be sufficient evidence upon which to base a positive diagnosis, as conditions such as renal failure, ventricular strain, tumors or hypoxia can also cause BNP levels to rise. Arterial blood gases may be tested to determine the degree of hypoxemia. A decreased erythrocyte sedimentation rate, proteinuria (protein in the urine), and a mild azotemia (elevated blood urea level) can be seen in early to moderate disease. An increased serum creatinine, hyperbilirubinemia (increased bilirubin in the blood) and dilutional hyponatremia (decreased serum sodium levels) are evidence the patient is suffering from a more advanced case of heart failure.

Radiology will also wish to perform imaging studies to evaluate the condition of the heart. A chest x-ray will generally reveal cardiomegaly (enlargement of the heart) and pleural effusion (fluid around the heart). An echocardiogram may be performed to evaluate the internal structures of the heart to evaluate for any structural abnormalities, as in the case of mitral stenosis. This provides evidence to determine the underlying cause of congestive heart failure, particularly in suspected cases of valvular heart disease.

Physicians are like detectives, if you will. Once these tests have all been run they will gather these pieces of evidence together and put them together to form a fairly accurate picture of the patient’s condition, allowing for an accurate diagnosis leading to proper treatment.

The Top U.S. Hospitals have 28% Lower Mortality Rate

The American Heart Association did a new study concerning hospitals and their mortality rates. We now know that the top 5 percent in the United States have a 28% lower death rate than other hospitals in the nation. Health Grades is an independent health care ratings company released this information January 29th, 2007. They also found that patients who have surgery at the top-rated hospitals are about five percent less likely to suffer complications than patients at other hospitals are.

The Health Grade Company analyzed death and mortality rates for 26 procedures and diagnoses, including bypass surgery, angioplasty, stroke, and heart attack, at all 5,122 nonfederal hospitals. The top hospitals reduced their death rate by an average of 11.7 percent and reduced post-surgical complication rates by 3.4 percent. The study author claimed that if all U.S. hospitals had the same quality of care as the top hospitals, 158,264 lives would have been saved and 12,409 major complications avoided. Unfortunately, there is a gap in the quality of care provided by high quality hospitals and other hospitals in the United States, according to Health Grades.

In order to qualify for the Health Grades list, hospitals were required to meet minimum thresholds in terms of patient volumes, quality ratings and the range of services provided.
In the top 5% of hospitals that deal with heart, patients there are 229 in the nation today. The hospitals are located all around the nation and keep a high standard of performance.
The Christ Hospital located in Cincinnati, Ohio ranked number one in cardiovascular care is affiliated with several other hospitals in the area that are accredited as being in the top 100 of the 5% heart hospitals.

One of the most distinguished top cited heart hospitals and medical centers is the Robert Wood Johnson’s University Hospital. This hospital has earned significant national recognition for clinical quality and patient safety. This hospital is the principal teaching hospital of the University of Medicine in the state of New Jersey. It is a very demanding position to be the one is who teach others how to take care of heart patients.

The Dayton Heart Hospital focus on patient care and fighting any problems that deals with heart problems. Each year heart disease kills more people than any other disease. Patients want new and better ways of healing. The physicians, community leaders, and others want to reduce the impact of heart disease has on society.

Spectrum Hospital in Grand Rapids, Michigan has updated its heart wing, is now one of the leading hospitals for open-heart surgery, and transplants. The staff at Spectrum Hospital is very sensitive to patient needs and stress levels and tries to help in any manner possible. When a patient leaves the hospital, the care does not stop at that point. They provide in home nurses that visit the patient on a daily basis to make sure that they are coming along very well. Therapy is a part of the patient care after a month or so when the patient feels they are ready. The patient then goes to the therapy wing and a professional helps lead in proper therapy techniques. The hospital also provides a dietician who helps with your diet plan. The care provided is necessary for complete recovery.

Public Health

Experts are outraged over the fact that the U.S. Government does not track Heart Diseases. American Heart Association feels that since heart failure is the number one killer amongst men and women that it should concern the government since it does concern the public health. Our government should track national rates of heart disease and stroke to help cut the incidences of these prime causes of death.

Currently data is collected by different sources and then published once a year in the AHA annual Heart Disease and Stroke journal. The Public Health does not keep a record of heart diseases as they do for other illnesses. The doctors of today have to rely on information provided by different sources as journals and magazines. The Public Health is for everybody’s concern and since the government controls this division, it is highly advisable that they start tracking patients with heart problems.

It is true that the American Heart Association has been doing a great job compiling this information from many and various sources. The fact is that there are many missing pieces, and it is not a good idea to have a nongovernmental agency, with no authority to modify data collected. The fact that the Public Health Department has no control over the facts or evaluation means that changes are slowly improved.

The Public Health Department has the capability of being a surveillance unit that can evaluate how data gets collected then make changes as needed. The Public Health Department can make sure that everyone in the medical field has access to all the information concerning the heart.

It is up to the Public Health Department to gather the needed information from the primary physicians, simply have the physicians report heart disease and stroke whenever possible. The information shared with doctors and patients would be much more obtainable. The public is under the false impression that the medical field is well informed about heart diseases. The truth about the situation is that there is no formal method of collecting data. That in reality without the efforts of the AHA doctors would not be as advanced as they are today concerning heart related problems. The current data collected by surveys needs some modification to help with increasing the physician’s capability to treat heart patients.

– National surveys should expand existing questions on risk factors for heart disease, stroke, and other vascular diseases. Include in the survey risk factors such as physical inactivity, unhealthy diet, smoking and obesity.

– The Public Health System should standardize data collection across existing surveys to eliminate duplication and make information easier to compare.

– Laboratory results on cholesterol levels and blood sugar control to information collected from physician visits needs to be compiled for the possibility of discovering any connections to heart problems. The Public Health Department duty should be to maintain these records for our own safety and well-being.

Let us note that heart health is of interest to the U.S. Food and Drug Administration offers advice on how to keep your heart healthy.