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Congestive heart failure.

Congestive heart failure is a condition that occurs because the heart muscle is damaged or overworked. Damage can result from high blood pressure, a heart attack, atherosclerosis, a congenital heart defect, heart muscle disease, heart valve disease resulting from past rheumatic fever or other causes, infection of the heart valves and/or heart muscle itself (endocarditis and/or myocarditis), or high blood pressure in the lungs resulting from lung disease. Because it is damaged, the heart lacks the strength to keep blood circulating normally throughout the body. The failing" heart keeps working, but not as efficiently as it should. Next, as blood flow out of the heart slows, blood returning to it through the veins backs up, causing congestion in the tissues. Swelling (edema) often results, most commonly in the legs and ankles, but in other parts of the body as well. Sometimes, fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down. Heart failure affects the ability of the kidneys to dispose of sodium and water. The retained water increases edema.

The most common signs of congestive heart failure are swollen legs or ankles, difficulty in breathing, and weight gain because of accumulating fluid. Congestive heart failure usually requires a treatment program of rest, proper diet, modified daily activities, and drugs such as digitalis, diuretics, and vasodilators. Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water. Vasodilators expand blood vessels and decrease resistance, allowing blood to flow more smoothly and making the heart's work easier.

In some Gases, congestive heart failure can be treated by controlling high blood pressure or surgically replacing abnormal heart valves. Most cases of oongestive heart failure are treatable. With proper medical supervision, people with heart failure don't have to become invalids.

Coping with congestive heart failure. An estimated 2-3,000,000 Americans have congestive heart failure (CHF), and approximately 400,000 new cases are diagnosed annually. The prevalence of CHF is increasing, with 11% of Americans over the age of 65 having been diagnosed with heart failure.

"Heart failure is the most costly disease in managed care," notes Mandeep Mehra, director of the Heart Failure Clinic, Ochsner Heart and Vascular Institute, New Orleans, which focuses on individualized care plans for patients in the outpatient selling. Services include cohesive evaluation of heart failure patients, with emphasis on optimal medical management, risk factor modification, and prognosis assessment.

Congestive heart disease is a chronic illness that varies from mild to severe. Early symptoms are weakness and fatigue. When the left side of the heart fails, increased pressures in the heart trigger fluid congestion. The most frequent symptom of left-sided heart failure is breathing difficulty, caused by fluid in the lungs. initially, breathiessness may occur only during or after exercise, but as the disease progresses, the patient may be able to breathe easily only when propped up in bed. If the right side of the heart fails, congestion occurs in the legs and the liver. Right-sided heart failure is associated with edema (swelling) of the ankles. Often, both the right and left sides of the heart fail.

Immediate treatment for congestive heart failure consists of bed rest with the patient sitting up, along with diuretic drugs to rid the body of excess fluid. Long-term treatment includes correcting the underlying cause, if possible, which might include surgery. Medical treatment may include vasodilator drugs that ease the workload of the heart or digitalis, which strengthens contractions.

Important considerations for those with congestive heart failure include:

* Maintaining one's correct weight. Patients may weigh themselves daily to monitor any fluid retention that might indicate that the heart is compromised.

* Following doctors' orders about diet. Look for unexpected sources of sodium, such as certain toothpastes. Just by removing the salt shaker from the table, it is possible to reduce sodium intake to the recommended one to two grams per day.

* Exercising according to your own limits, even if it means walking half a block. If you experience shortness of breath, fatigue, or a cough, take a rest from the activity. Consult your physician about exercise that is appropriate for you.
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Article Details
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Title Annotation:causes, symptoms, and treatment recommendations
Publication:USA Today (Magazine)
Article Type:Brief Article
Date:Feb 1, 1997
Previous Article:Cardiovascular disease: a look at the numbers.
Next Article:Arrhythmias.

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