My mother’s doctor told her she is at risk for congestive heart failure. What is congestive heart failure, and what are the causes and symptoms that we should look out for? What can we do to prevent it?
–Todd from Lexington

Congestive heart failure is a medical condition that occurs when your heart does not effectively pump blood as it should. This condition occurs when the function of the heart’s left ventricle is reduced.

Ejection fraction is the percentage of blood that the left ventricle pumps to the body with each beat. Cardiologists determine this by a number of tests – such as Echocardiography, Nuclear Stress Ejection Fraction, and Cardiac Catheterization. When this percentage is significantly reduced, you are at a risk of congestive heart failure.

Causes of Congestive Heart Failure

So what are some of the causes of congestive heart failure?

One cause is a Myocardial infarction, or rather, a heart attack. If you experience a heart attack, your heart loses some of its ability to pump. The muscle that is damaged by the infarction is permanently scarred and does not contract as it would normally, which can lead to congestive heart failure.

Cardiomyopathy, or cardiac muscle weakness, is one type of viral condition which weakens heart muscle and reduces the heart’s ability to clear an amount of blood that it usually does with each heartbeat. This reduced clearance function can again lead to congestive heart failure.

Another condition that reduces the efficiency of your heart is high blood pressure. High blood pressure leads to a thickening of the muscular wall of the heart, and eventual decreased muscle function can also be a cause for congestive heart failure.

Another cause of congestive heart failure is rheumatic fever. As a result of rheumatic fever, one of the four valves of the heart may be affected by an infection or scarring of the valve.

Symptoms of Congestive Heart Failure

So what are the symptoms of congestive heart failure?

Someone with congestive heart failure is easily short of breath, and as the failure worsens, the shortness of breath worsens as well. People with this symptom have difficulty completing tasks that used to be ordinary. Someone experiencing congestive heart failure may even feel short of breath while lying down. Some people even forgo the bed and sleep only in a chair at night, or sleep with many pillows underneath their heads.

Swelling, also known as edema, is also a common symptom of congestive heart failure. Usually, the first noticeable swelling occurs in the legs (known as peripheral edema), and it may progress to swelling of the stomach as fluid builds in the body.

Treatments for Congestive Heart Failure

The mainstay of treatment for congestive heart failure primarily involves medicine such as beta blockers (which control your heart rate), ACE inhibitors (which control blood pressure), or diuretics (which eliminate extra fluid by encouraging urination). In addition to these options, there is a new medication called Entresto, which has shown significant clinical improvement in many patients. Treatment such as coronary artery revascularization and certain types of pacemaker placement may offer relief. Along with pharmacological treatment, it is also mandatory to restrict salt in your diet and avoid all prepared foods with high sodium amounts. If a single food has over 400mg of sodium, you should avoid it and make the food with fresh or frozen vegetables. Usually canned vegetables, canned soups, canned meats, packaged lunch meats, or snack foods do not contain less than 400mg of sodium per serving. Your total daily sodium intake should be less than 2g of sodium.

To treat congestive heart failure, we need to first identify the cause. If you are experiencing any swelling in the feet, ankles, and legs, along with a sudden shortness of breath, you should visit a doctor immediately. Before the next day, you should have your symptoms evaluated as this could be a serious and dangerous problem. There are many therapeutic interventions that can improve your symptoms and extend your life.

If you want to learn more about congestive health failure or discuss your heart health, call the Cardiovascular Institute of the Shoals at 256-766-2310 to schedule an appointment.