I’ve been diagnosed with… congestive heart failure?

Congestive heart failure (CHF) is a common condition among the elderly and is usually described as the inability of the heart to pump out enough blood to supply the body (professionals may describe this phenomenon as “low cardiac output” or “low ejection fraction”).

What symptoms might I develop?

Symptoms will depend on the type of CHF (there are quite a few methods of classification) you have been diagnosed with. Some classic symptoms include lower leg swelling (on both legs), shortness of breath (especially when lying down flat), and dizziness. In very severe cases a person may develop yellowing of the skin (jaundice) and bleeding disorders due to liver damage.

What caused this?

There are several causes of CHF, the most common being ischemic heart disease (meaning there was not enough blood flow to heart tissue at some point in time, which caused permanent damage). Other causes include smoking, uncontrolled high blood pressure, and damage to heart valves.

How was this diagnosed?

An echocardiogram (an ultrasound of the heart) can measure the blood flow pumped out of the heart. Doctors typically use echocardiograms to measure an “ejection fraction”; a way of comparing how much blood is pumped out of the chambers of the heart to how much is left inside during a contraction. A low ejection fraction can indicated CHF. There are also blood tests and signs on physical exam that help point to the diagnosis of CHF.

What can be done?

Immediate treatment usually involves diuretics (medications that make you urinate). This helps reduce the amount of fluid in the body which tends to build up in the legs and lungs in CHF. Other medications may be used, such as anti-hypertensives (drugs that help decrease blood pressure) and inotropes (drugs that help your heart contract).

What will happen in the future?

CHF is a progressive disease, meaning heart muscles will continue to weaken and thus decrease the amount of blood flow to the rest of the body. How quickly this happens will vary from person to person and can be better evaluated by a physician.  

How do I prevent this from happening to me?

The basics to prevent heart failure include practicing heart healthy activities. This includes daily exercise for at least 1 hour (as tolerated) and eating right. Reducing the cholesterol and salt in your diet can help prevent some of the predisposing factors to CHF (including ischemic heart disease and high blood pressure). If you smoke, try to quit with a method that works for you. Speak with your physician for more ideas on keeping your heart healthy.