What is congestive heart failure?

  Congestive heart failure (CHF) is a condition where your heart suddenly stops being able to pump blood effectively.  The heart is basically a pump.  If the pump fails, or weakens, blood cannot be pumped to the rest of the body and signs and symptoms of heart failure occur:

- shortness of breath (dyspnea)

- unable to lie flat (orthopnea)

- swelling in the feet and legs (edema)

- confusion

- fatigue

More than 500,000 people are diagnosed with congestive heart failure each year in the United States. Some patients benefit from drug therapy. But others may require a heart transplant or other intervention.

The term "heart failure" can be very alarming. While it does not mean the heart has "failed" or stopped working, it is a serious condition. Congestive heart failure (CHF) implies the heart does not pump as well as it should to meet the body's oxygen demands, often due to heart diseases (like cardiomyopathy or cardiovascular disease).

CHF can result from either a reduced ability of the heart muscle to contract or from a mechanical problem that limits the ability of the heart's chambers to fill with blood. When weakened, the heart is unable to keep up with the demands placed upon it; blood returns to the heart faster than it can be pumped out so that it gets backed up or congested.

CHF occurs when the heart attempts to compensate for the congestion, or backup, of blood in a number of ways. It beats faster and expands somewhat more than usual as it fills with blood, so that when it contracts, more blood is forced out to the body. In addition, the decreased volume of blood reaching the kidneys causes them to start a hormonal cascade, which causes them to retain sodium and water. These efforts help meet the body's demands in the short term, but they ultimately have very harmful long-term effects. Faster beating allows less time for the heart to refill after contraction, so less blood ends up being circulated. The increased effort means the heart muscle needs more oxygen, and if this need isn't met, it can be fatal.

CHF occurs most frequently in those over age 60 and is the leading cause of hospitalization and death in that age group. In over 50 percent of cases, sudden death occurs due to a cardiac arrhythmia, or irregular heartbeat.

Patients with CHF can enjoy better health if they treat the underlying cause, if possible. For many patients the outlook is uncertain and depends on the extent of the disease and the patient's response to therapy. However, in other cases, restricted salt intake and medication are used to ease the strain on the heart and to relieve symptoms. While CHF is a serious health risk, it is possible for patients to live with CHF and manage many symptoms effectively with proper treatment if they adhere to prescribed regimens.