* Heart Failure

Heart failure also called congestive heart failure.

Heart failure becomes more common with advancing age. Heart failure is a condition in which the heart can't pump enough blood throughout the body. Heart failure develops over time as the pumping action of the heart grows weaker. Heart failure is a serious condition. It contributes to or causes about 300,000 deaths each year. About 5 million people in the U.S. have heart failure. It contributes to 300,000 deaths each year. It can affect the left side, the right side, or both sides of the heart.

Most cases involve the left side where the heart can't pump enough oxygen-rich blood to the rest of the body. The most common causes of heart failure are hypertension (high blood pressure) and coronary artery disease (for example, you have had a heart attack). Arterial plaque lines the inside of the arteries that supply the heart and the rest of the body, meaning less blood gets to the heart itself, as well as the heart having to work harder to push blood through the thinner systemic arteries.

Heart failure may result from disorders that cause the heart's walls to stiffen, such as infiltrations and infections.

Heart failure due to systolic dysfunction usually develops because the heart cannot contract normally. Heart failure has two main forms: systolic dysfunction (which is more common) and diastolic dysfunction. In systolic dysfunction, the heart contracts less forcefully and cannot pump out as much of the blood that is returned to it as it normally does. Heart valve disorders - narrowing (stenosis) of a valve, which hinders blood flow through the heart, or leakage of blood backward (regurgitation) through a valve - can cause heart failure.

Some heart valve disorders, such as aortic valve stenosis, hinder blood flow out of the heart. Other causes may include diseases of the heart valves and weakened heart muscle due to viral infections or their poisonous products (called toxins). Individuals with heart failure are sensitive to small shifts in their intravascular volume status (the amount of fluid in their circulatory system). Often left heart failure leads to right heart failure and then both sides are affected.

Left-sided heart failure leads to fluid accumulation in the lungs, which causes shortness of breath.

Heart failure is a major cause of sudden death due to production of arrhythmias. Persons with diabetes have a much greater risk of developing heart failure than those without because diabetes is associated with other heart failure risk factors such as high blood pressure, obesity and high cholesterol levels. Weight reduction - through physical activity and dietary modification, as obesity is a risk factor for heart failure and ventricular hypertrophy. Fluid restriction - patients with CHF have a diminished ability to excrete free water load. Sodium restriction - excessive sodium intake may precipitate or exacerbate heart failure.

Moderate physical activity, when symptoms are mild or moderate; or bed rest when symptoms are severe. Another current treatment involves the use of left ventricular assist devices (LVADs). Smoking and drinking alcohol can worsen heart failure and should be stopped. Exercise, weight loss, and stopping smoking help reduce the risk of coronary artery disease, as do good control of diabetes and lowering of cholesterol levels.

Treatment for Heart Failure

• Angiotensin-converting enzyme (ACE) inhibitors drugs help people with heart failure live longer and feel better.
• Diuretics are often called "water pills" because they make you urinate more often and help keep fluid from building up in your body.
• Diuretics, or water tablets, which work on the kidneys to remove the extra fluid and salt from the body and lower blood pressure.
• ACE (angiotensin converting enzyme) inhibitors, which lower blood pressure and help the heart to pump more easily.
• Digoxin helps the heart by making it beat more strongly and pump more blood.
• Nitrates help with shortness of breath because they reduce the blood pressure in the lungs by widening (dilating) blood vessels and allow the heart to work more efficiently.
• Warfarin stops blood clots from forming and aspirin also stops blood clots from forming.