CONGESTIVE HEART FAILURE (CHF) and Its PREVENTION

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CONGESTIVE HEART FAILURE (CHF) and Its PREVENTION

WHAT IS HEART FAILURE? The term "heart failure" makes it sound like the heart is no longer working at all and there's nothing that can be done. Actually, heart failure means that the heart isn't pumping as well as it should be.

What is Heart Failure? contd Your body depends on the heart's pumping action to deliver oxygen- and nutrient-rich blood to the body's cells. When the cells are nourished properly, the body can function normally. When this doesn t happen, it results in fatigue and shortness of breath. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.

HOW THE HEALTHY HEART WORKS The normal healthy heart is a strong, muscular pump a little larger than a fist. It pumps blood continuously through the circulatory system.

NORMAL HEALTHY HEART The heart has four chambers, two on the right and two on the left: Two upper chambers called atria (one is an atrium) Two lower chambers called ventricles Oxygen-rich blood travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body. The right atria takes in oxygen-depleted blood from the rest of the body and sends it back out to the lungs through the right ventricle. The heart pumps blood to the lungs and to all the body's tissues by a sequence of highly organized contractions of the four chambers. For the heart to function properly, the four chambers must beat in an organized way.

What is Heart Failure? Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body's needs for blood and oxygen. With heart failure, the weakened heart can't supply the cells with enough blood.

Body s Response to Heart Failure At first the heart tries to make up for this by: Enlarging. When the heart chamber enlarges, it stretches more and can contract more strongly, so it pumps more blood. Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially. Pumping faster. This helps to increase the heart's output.

Body s Compensation to HF The blood vessels narrow to keep blood pressure up, trying to make up for the heart's loss of power. The body diverts blood away from less important tissues and organs to maintain flow to the most vital organs, the heart and brain.

Body s Response con t : These temporary measures mask the problem of heart failure, but they don't solve it. Eventually the heart and body just can't keep up, and the person experiences symptoms of heart failure.

View Animation of Heart Failure

Common Causes of Heart Failure Coronary (ischemic) heart disease (predisposing factors, Diabetes, High Blood pressure, obesity, smoking) Hypertension Idiopathic dilated cardiomyopathy (DCM) Primary valvular heart disease Other ( Severe lung disease, substance abuse, infections, anemia, Sleep apnea, etc)

Signs and Symptoms of HF Sign or Symptom People with Heart Failure May Experience... Why It Happens Shortness of breath (also called dyspnea)...breathlessness during activity (most Blood "backs up" in the pulmonary commonly), at rest, or while sleeping, which veins (the vessels that return blood from may come on suddenly and wake you up. the lungs to the heart) because the heart You often have difficulty breathing while can't keep up with the supply. This lying flat and may need to prop up the causes fluid to leak into the lungs. upper body and head on two pillows. You often complain of waking up tired or feeling anxious and restless. Persistent coughing or wheezing...coughing that produces white or pink blood-tinged mucus. Fluid builds up in the lungs (see above). Buildup of excess fluid in body tissues (edema)...swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight. As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing fluid to build up in the tissues. The kidneys are less able to dispose of sodium and water, also causing fluid retention in the tissues.

Signs and Symptoms of HF Sign or Symptom People with Heart Failure May Experience... Why It Happens Tiredness, fatigue...a tired feeling all the time and difficulty with everyday activities, such as shopping, climbing stairs, carrying groceries or walking. The heart can't pump enough blood to meet the needs of body tissues. The body diverts blood away from less vital organs, particularly muscles in the limbs, and sends it to the heart and brain. Lack of appetite, nausea Confusion, impaired thinking Increased heart rate...a feeling of being full or sick to your stomach....memory loss and feelings of disorientation. A caregiver or relative may notice this first....heart palpitations, which feel like your heart is racing or throbbing. The digestive system receives less blood, causing problems with digestion. Changing levels of certain substances in the blood, such as sodium, can cause confusion. To "make up for" the loss in pumping capacity, the heart beats faster.

Signs & Symptoms of HF This is the heart This is you

Systolic And Diastolic HF Systolic Heart Failure When the heart muscles are enlarged, flabby and pump ineffectively. Diastolic Heart Failure When heart muscles are thickened and stiff and relax poorly. Therefore does not allow blood to fill up fully in the heart chambers. Most common causes are high blood pressure, diabetes and ischemic heart disease.

Diagnosis of Congestive Heart Failure History and Physical Examination Blood Test Chest X ray EKG Echocardiogram Stress test/nuclear scan (MUGA) Cardiac catheterization

(NYHA) Classification of CHF Class I symptoms of HF only at activity levels that would limit normal individuals Class II symptoms of HF with ordinary exertion Class III symptoms of HF with less than ordinary exertion Class IV symptoms of HF at rest

Prevention And Treatment of HF Treatment of underlying cause ( high blood pressure, diabetes, high cholesterol, anemia ) Medications compliance Lifestyle Modifications Surgical procedures Implantable devices, transplant etc.

Lifestyle Changes for Heart Failure Quitting Smoking Losing or maintaining your weight Tracking your fluid intake Managing Stress Eating a heart-healthy diet (low in trans, saturated fat, low in sodium/salt) Being physically active Managing stress and taking adequate rest

Lifestyle Changes for Heart Failure Monitoring your blood pressure Limiting your caffeine and alcohol intake Keeping track ( of your symptoms ) and developing support. Vaccinations for flu and pneumonia Appropriate clothing ( tight stockings can slow blood flow and cause clots, avoid extreme temperature).

JAZAKALLAH!