Heart Failure Health Article

Definition

"Heart failure" is a broad term—often used inter-changeably with "congestive heart failure" (CHF)—to describe the heart's inability to consistently pump enough blood to the body's organs and tissues. Heart failure occurs either from a structural or a functional abnormality. Since blood carries oxygen and vital nutrients to cells throughout the body, a decrease in blood supply interferes with the ability of organs and other tissues to function properly.

Description

According to the American College of Cardiology, approximately 4.8 million Americans live with CHF. Patients ages 65 and older are hospitalized for complications from CHF more often than for any other medical condition, accounting for about 875,000 hospital admissions each year. Anywhere between 400,000 and 700,000 cases of CHF are discovered annually, bringing the cost of treating patients in the United States between $10 billion and $30 billion. CHF is either a direct or contributing cause of death for as many as 250,000 people per year. As the population ages, the incidence of heart failure increases.

The term "congestive heart failure" describes its course of action. When the heart fails for some reason to deliver adequate blood supply to the body's tissues, edema (swelling, or fluid buildup) develops. Where the edema occurs in the body depends on the part of the heart that is failing in some way. For example, when the left ventricle (lower left chamber of the heart) is damaged, blood fails to get out to other parts of the body as quickly as it returns from the lungs. When blood cannot get back to the heart, it backs up inside blood vessels in the lungs. Some of the fluid in the blood is then forced into the breathing space of the lungs, causing pulmonary edema. Pulmonary edema causes varying degrees of breathing difficulty. The degree of severity depends on the amount of excess fluid in the lungs and can be life-threatening in severe cases. Abnormalities in heart structure or rhythms can also cause left-ventricular CHF. Patients often complain of feeling very tired, due to the lack of circulating oxygen and nutrients caused by an inadequate blood supply.

When the right side of the heart fails, the right ventricle (lower right chamber of the heart) cannot pump blood to the lungs as quickly as blood returns from areas throughout the body, via the veins. The blood then engorges the right side of the heart and veins. Fluid begins to back up in the veins and pushes out into the tissues, causing edema, most often in the feet, ankles, and lower legs. Abnormalities of the heart valves and lung disorders often cause right-ventricular CHF.

The failing heart keeps pumping, but not as efficiently as it should. Sometimes the heart tries to compensate for its lack of pumping ability by becoming hypertrophic (larger). When this happens the heart chamber grows larger and the muscle in the wall of the heart thickens, sometimes helping to improve the pumping ability of the heart. Another way in which the damaged heart tries to compensate for declining pumping ability is by stepping up the frequency of heartbeats to improve blood output and circulation. Eventually the kidneys join the fight to compensate for the failing heart; they hold on to more salt and water in order to increase blood volume. But this extra fluid can also cause edema. This can further complicate the situation and make treatment even more difficult. As the condition worsens over time, these compensatory measures are not enough to keep the heart pumping enough blood to meet the body's demand.

For most people, heart failure is a chronic disease with no real cure. However, depending on the individual circumstances, heart transplantation is considered in some cases when all other treatment options fail. While there is no cure, heart failure can often be managed and treated effectively using medications, proper diet, modified exercise, and other lifestyle changes as needed.