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Alternative Names Return to topCHF; Congestive heart failure
Definition Return to top
Heart failure, also called congestive heart failure, is a life-threatening condition in which the heart can no longer pump enough blood to the rest of the body.
Causes Return to top
Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. This condition may affect the right side, the left side, or both sides of the heart.
As the heart's pumping action is lost, blood may back up into other areas of the body, including the:
Heart failure results in a lack of oxygen and nutrition to organs, which damages them and reduces their ability to function properly. Most areas of the body can be affected when both sides of the heart fail.
The most common causes of heart failure are:
Other structural or functional causes of heart failure include:
Heart failure becomes more common with advancing age. You are also at increased risk for developing heart failure if you are overweight, have diabetes, smoke cigarettes, abuse alcohol, or use cocaine.
Symptoms Return to top
Infants may sweat during feeding (or other activity).
Some patients with heart failure have no symptoms. In these people, the symptoms may develop only with these conditions:
Exams and Tests Return to top
A physical examination may reveal the following:
Listening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds. Blood pressure may be normal, high, or low.
The following tests may reveal heart swelling or decreased heart function:
This disease may also alter the following test results:
Treatment Return to top
If you have heart failure, your doctor will monitor you closely. You will have follow up appointments at least every 3 to 6 months and tests every now and then to check your heart function. For example, an ultrasound of your heart (echocardiogram) will be done once in awhile to see how well your heart pumps blood with each beat.
You will need to carefully monitor yourself and help manage your condition. One important way to do this is to track your weight on a daily basis. Weight gain can be a sign that you are retaining fluid and that the pump function of your heart is worsening. Make sure you weigh yourself at the same time each day and on the same scale, with little to no clothes on.
Other important measures include:
Here are some tips to lower your salt and sodium intake:
Your doctor may consider prescribing the following medications:
If you have sudden (acute) heart failure, you may be admitted to the hospital. Treatment may involve:
Swan-Ganz catheterization may be needed in some cases. If excessive fluid has gathered around the sac surrounding the heart (pericardium), pericardiocentesis will be done.
Severe heart failure may require the following treatments:
These devices can be life-saving, but they are not permanent solutions. Patients who become dependent on circulatory support will need a heart transplant.
Heart failure symptoms may be improved with biventricular pacemaker or cardiac resynchronization therapy. Ask your provider if you are a candidate for this type of treatment.
Outlook (Prognosis) Return to top
Heart failure is a serious disorder. It is usually a chronic illness, which may get worse with infection or other physical stress.
Many forms of heart failure can be controlled with medication, lifestyle changes, and treatment of any underlying disorder.
Possible Complications Return to top
Possible side effects of medications include:
When to Contact a Medical Professional Return to top
Call your health care provider if weakness, increased cough or sputum production, sudden weight gain or swelling, or other new or unexplained symptoms develop.
Go to the emergency room or call the local emergency number (such as 911) if you experience severe crushing chest pain, fainting, or rapid and irregular heartbeat (particularly if other symptoms accompany a rapid and irregular heartbeat).
Prevention Return to top
Follow your health care provider's treatment recommendations and take all medications as directed.
Keep your blood pressure , heart rate, and cholesterol under control as recommended by your doctor. This may involve exercise, a special diet, and medications.
Other important treatment measures:
References Return to top
Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult. J Am Coll Cardiol. 2005;46:1-82.
Mann DL. Management of heart failure patients with reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007: chap 25.
Hess OM and Carroll JD. Clinical assessment of heart failure. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007: chap 23.Update Date: 9/23/2008 Updated by: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.