Tag: myocardial infarction

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 New Therapies for Treatment of Congestive Heart Failure?

Heart disease is one of the deadliest killers in the world to date. Congestive heart failure, a condition found secondary to many major cardiac diseases, possesses its own high mortality rate. Fifty percent of those diagnosed with congestive heart failure will die within the five following years. Scientists and researchers are struggling to understand the exact mechanisms of the disease, and to find a cure.

Congestive heart failure results as the cells in the heart die or become non-functioning due to an event such as a myocardial infarction (a heart attack) or ischemic heart disease. Whatever the cause, the heart is subsequently unable to pump blood adequately throughout the body, resulting in the blood pooling in the organs and fluid building up in and around the lungs as sodium is unable to be properly excreted, causing the dyspnea that is the classic symptom of congestive heart failure.

Clinical research is targeted at both the treatment of the disease and the possibility of repairing the damaged cells in the heart. Current research is underway to test new medications that would assist in vasodilation, as well as a calcium inhibitor that would not result in the higher incidence of cardiac arrhythmia seen with the medications currently on the market.

In the age of natural medicine, the power of the mind has been invoked in clinical trials to use meditation and relaxation techniques to combat the stress on the heart that can be the breaking point for patients with heart failure. Stress has been shown to negatively affect the body’s blood pressure, forcing the heart to work harder and placing an undue amount of pressure on an already weakened muscle. The theory lies in the belief that by learning to maintain a low level of mental stress the heart will be less stressed and therefore less likely to fail completely, and the patient can be given a better prognosis.

Alongside the return to natural, holistic methods of treatment is an incredible advancement in clinical technology that was not available twenty or thirty years ago. Scientists claim to have identified a set of altered genes that can make an individual more disposed to suffer from congestive heart failure and are using their current knowledge of genes and the benefits of gene therapy to attempt to reverse the effect. In addition, medications to tamp down on the genes’ activities, such as beta blockers and alpha-2 agonists are already available and being used in treatment programs.

Also being explored is the possibility of using stem cells, the body’s pluripotent progenitors, to assist in reparation of the damaged heart tissue. Clinical trials showed that patients suffering from congestive heart failure responded very favorably to an injection of their own stem cells into the heart, although the exact means by which this causes improvement is as yet unknown. It is suspected that these cells either facilitate the growth of new vessels in the heart or act as beacon, attracting the body’s own healing cells to the site of the damage and stimulating repair.

The possibility of actually growing healthy tissue from embryonic stem cells to be transplanted is also being explored, although the controversial nature of the use of embryonic stem cells due to the necessary destruction of the embryo makes this questionable in the foreseeable future. Scientists have determined that adult stem cells simply cannot provide an adequate number of new cells to meet the needs of patients who have suffered heart failure.

Heart failure is incredibly dangerous because the body cannot reproduce the dead tissue cells in the heart; however, with modern advancements it is the great hope of researchers everywhere to one day find a cure.