Tag: dyspnea

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.

Living With Heart Failure-How Congestive Heart Failure Impacts Your Life

Living With Heart Failure-How Congestive Heart Failure Impacts Your Life

Heart failure, as well as all the risks that accompany it, can be a terrifying prospect for any man, woman or child. The impact of a heart, the body’s central tool for survival, no longer functioning may seem like the beginning of the end. The good news is, by establishing an effective treatment plan with your cardiologist the prognosis, and the chances for you to lead a normal life, increase exponentially.

Heart failure occurs when the heart can no longer efficiently pump blood throughout the body. The blood pools, and while organs are deprived of vital, life giving oxygen and nutrients the excess sodium that would normally be excreted in the urine builds up in the tissues, resulting in fluid retention that leads to organ stress and the dyspnea that is so common in cases of congestive heart failure. Left untreated, the oxygen deprived organs will eventually cease to function and the patient will die.

Fortunately, there are now many ways to combat the mortality factor associated with heart failure. Doctors can prescribe medications to facilitate the flow of blood through the body and take some of the pressure off the heart; blood thinners can decrease the chances of clots forming in the veins. Aside from medicinal means, there are many factors that may be altered in your lifestyle to impact the prognosis of your disease.

It is essential that the body be given sufficient time to rest in a day. While at rest the heart can more easily pump blood throughout the body; just as you would rest an injured leg when it began to pain you, you should rest your heart as well. On the flip side, it is important to establish a daily exercise routine. It doesn’t have to be three hours of aerobics; a half hour walk every day would have a greater impact on your physical being than nothing. Consult with your physician to find the plan that works best for your individual circumstances.

Along with an exercise plan you should work with your doctor to find the best diet plan for you. In most cases a low sodium diet is recommended to help reduce fluid retention. Diuretics can greatly affect the levels of potassium in the body causing hypokalemia, which can lead to muscle weakness, paralysis and a fatal cardiac arrhythmia; therefore, very often if you have been given a diuretic to take daily a potassium supplement will also be prescribed.

Nicotine can create a serious problem for patients with heart failure. It increases the heart rate and blood pressure while having a negative impact on the oxygen level in the blood. All of these things cause the heart to work harder. It is strongly recommended that if you have been diagnosed with heart failure you quit smoking completely.

Hand in hand with smoking are the inherent dangers associated with contracting a case of pneumonia or flu. If you are able you should receive an annual flu shot, as well as the one time dose of pneumococcal vaccine. This will provide some level of protection against pneumococci bacteria, the major cause of bacterial pneumonia. Pneumonia is a problem for the same reasons as smoking; the decreased oxygen levels in the blood cause the heart to work harder in an attempt to compensate and get oxygen to the organs and tissues. If possible, avoid crowded areas during cold and flu season, and stay away from people you know are sick.

Amazingly, something as simple as the clothes you wear can impact your condition if you have suffered heart failure. Tight clothing can cause blood clots and restrict blood flow to the extremities. In addition, in cases of extreme temperature your clothes should be weather appropriate; if the body has to work to maintain its temperature the heart will have to work that much harder.

Sexual relations can usually be continued as before; however, they should occur in as peaceful an environment as possible to prevent undue stress. If your condition is severe it is important that you discuss this with your physician; it may be necessary to forego sexual relations for a time in favor of other, less stressful shows of affection.

Each of these steps will help you continue to live much as you did before being diagnosed. Heart failure will inevitably impact your life; it is entirely up to you how much.

How Doctors are Using Their Skills to Combat Congestive Heart

How Doctors are Using Their Skills to Combat Congestive Heart Failure

Congestive heart failure is an insidious opponent, possessing a slow onset that results in a patient often not even noticing they are having symptoms. Over time the patient will suffer from worsening dyspnea and edema that will eventually drive them to seek treatment, where they will discover that for whatever reason their heart is no longer able to function properly.

Heart failure occurs when the cells of the heart tissue are either destroyed or made non-functional due to another cardiac event, often secondary to ischemic heart disease or coronary artery disease. As a result, the heart is no longer able to pump the blood throughout the body properly; instead the blood pools, resulting in fluids being retained rather than excreted properly and oxygen starved organs being unable to function. The death of these cells is critical because, like brain cells, once the cells of the heart die the body is unable to reproduce them and restore full function to the heart. Congestive heart failure carries with it a high mortality rate, with over fifty percent of its victims dying within five years of being diagnosed. Doctors and researchers are able to use modern advancements in medicine to make the patient more comfortable and, in many cases, to provide them with a more favorable prognosis.

Many patients do not even discover that they have suffered heart failure until they are brought into the Emergency Department of their local hospital complaining of chest pain and difficulty breathing. Doctors will stabilize them there, giving them supplemental oxygen and beginning a course of medicinal treatment that will carry them out of the hospital.

Modern science has provided physicians with a wide array of methods with which to combat the damage done by congestive heart failure. Once oxygen is returned to an acceptable level a physician will usually administer a diuretic to stimulate the renal system to pull fluid out of circulation, relieving the edema and taking a great of stress off of the lungs, heart and other organs. This will also usually be accompanied by supplemental potassium, as the renal system will remove potassium along with the excess fluid and hypokalemia carries with it its own hazards.

A great deal of attention in the field of medicine has been focused on the body’s production of angiotensin II as it aggravates congestive heart failure. Angiotensin II is a substance produced by the body which raises blood pressure and causes the blood vessels to constrict, thereby forcing the heart to work much harder to pump blood throughout the body. An ACE inhibitor will often be administered to prevent the body from making angiotensin II, and an angiotensin receptor blocker is available to those who do not respond as desired to the ACE inhibitor. Many patients with heart problems are given nitroglycerin for this reason.

Along with medicine, research into the field of congestive heart failure is ongoing. The speculated use of stem cells, particularly embryonic stem cells, has opened a whole field of debate for possible treatment of heart failure in the science community. Patients with congestive heart failure were given some of their own stem cells in the heart via injection, and all reacted favorably. Scientists are unsure as to whether this is because the stem cells aid the body in growing new vessels or simply act as a lighthouse for the body’s natural healing mechanisms, drawing other cells to the site of the damage. Whichever the case may be, stem cells present a fascinating opportunity to finally find a means by which to restore heart function to patients who have suffered heart failure.

Modern science is providing a whole new world of treatment options to patients with congestive heart failure, and researchers are making new discoveries all the time. It is the hope of all of those in the medical field that one day heart failure will be another disease medicine has the answer to.