Congestive Heart Failure Symptoms, Causes, Risk Factors, and Treatment
Statistics of CHF
Approximately 5 million Americans living with congestive heart failure (CHF). There are 600,000 new cases diagnosed every year. Congestive heart failure affects everyone from children to the elderly.
As a cardiac nurse, CHF is one of the most frequent causes of admissions and re-admissions. Today, the lifespan of people diagnosed with CHF has greatly increased because of groundbreaking medications and improved technology.
Once the patient is admitted, we start the standard treatment. The gold standard diagnostic test is a chest X-ray. This X-ray will show if the lungs are congested. The first-line drug is Lasix. With CHF, the body is not able to push the fluids through the body. Therefore, the fluid will stagnant in the legs, arms, heart, and abdomen.
Next, the physician will most likely order an Ace Inhibitor and/or a Beta-blocker. These medications have been shown to strengthen the left ventricle.
Risk Factors for CHF
Diseases that damage your heart also increase your risk of CHF. Some of these diseases and lifestyle choices include:
Coronary artery disease
Coronary heart disease is a condition in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.
Plaque narrows the arteries and reduces blood flow to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. Coronary heart disease can lead to chest pain or discomfort called angina, a heart attack, and heart damage.
CHF occurs in coronary artery disease because once the arteries get clogged up, it makes the blood have to work harder to go through the muscle of the heart. After a while, the heart muscle will become stiff and it will not be able to sufficiently contract. Therefore, the person will develop CHF.
High blood pressure is the silent killer. There are hundreds of millions of people around the world who have high blood pressure. There are also millions who are not diagnosed. In fact, high blood pressure is the highest risk factor of all in contracting CHF. This is because after years of uncontrolled high blood pressure, the heart muscle becomes very weak and it can no longer contract normally.
Blood pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over time, it can weaken your heart and lead to plaque buildup. Blood pressure is considered high if it stays at or above 130/90 mmHg over time. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher.
Unhealthy behaviors can also increase your risk of CHF, especially for people who have one of the diseases listed above. Diabetes is now an epidemic. People with diabetes usually go on to have high blood pressure and coronary artery disease. The American diet is full of processed food. This is certainly not helpful to the heart.
We have all been told to avoid tobacco and tobacco products. Although there has been a significant decrease in the people who smoke, there are still too many people developing diseases directly from smoking. Smoking causes plaque in the arteries. If the blood cannot flow smoothly through the arteries, the heart muscle will be stiff. Again, CHF will develop.
The world has an obesity problem. I don’t even think it is related to overeating. The food now is so processed and toxic. This has created an epidemic of insulin resistance. We know that insulin is the fat hormone. We have also had an epidemic of gall bladder removals. Gall bladder removal predisposes you to gain weight because you know have the enzymes to properly digest food in the proper amount.
Weight gain contributes to high blood pressure, and high blood pressure is a direct risk factor for CHF. It is imperative that people limit the number of bad fats, cholesterol, and excess sodium in their diet.
Lack of Exercise
Exercise is great! What can I say! Your whole body loves exercise. Your heart is a muscle which means it loves exercise. Exercise can help prevent CHF by doing the following:
- Maintaining weight
- Maintain blood glucose
- Maintain blood pressure
- Exercise helps the muscle and bones, and the heart is a muscle
- Exercises improve brain health
Obesity is the cause of many diseases and disorders including CHF. Obesity is related to diet and lack of exercise. Obesity can also prevent CHF from getting better because the excess weight causes a strain on the heart.
Signs and Symptoms of Congestive Heart Failure
- Shortness of breath during daily activities.
- Having trouble breathing when lying down.
- Weight gain with swelling in the feet, legs, ankles, or stomach.
- Generally feeling tired or weak.
Stages of Congestive Heart Failure
The American College of Cardiology/American Heart Association (ACC/AHA) staging system is defined by the following four stages:
Stage A: High risk of heart failure, but no structural heart disease or symptoms of heart failure
Stage B: Structural heart disease, but no symptoms of heart failure
Stage C: Structural heart disease and symptoms of heart failure
Stage D: Refractory heart failure requiring specialized interventions
Classes of Congestive Heart Failure:
The New York Heart Association (NYHA) functional classification defines four functional classes as:
- Class I: HF does not cause limitations to physical activity; ordinary physical activity does not cause symptoms.
- Class II: HF causes slight limitations to physical activity; the patients are comfortable at rest, but ordinary physical activity results in CHF symptoms.
- Class III: HF causes marked limitations of physical activity; the patients are comfortable at rest, but less than ordinary activity causes symptoms of CHF.
- Class IV: HF patients are unable to carry on any physical activity without HF symptoms or have symptoms when at rest.
(Resourced From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961993/)
Treating Congestive Heart Failure
Early diagnosis and treatment can improve the quality and length of life for people who have heart failure. Treatment usually involves taking medications, reducing sodium in the diet, and getting daily physical activity. People with heart failure also track their symptoms each day so that they can discuss these symptoms with their healthcare team.
Medications For CHF
The medications are given for congestive heart failure are usually diuretics, beta-blockers, and ace-inhibitors.
We are hearing about advances in CHF daily. If you do a search, you will see the average lifespan of CHF patients are 5 years. This data is so old. Most of the sites talk about hospice. We are not going to discuss hospice because this article is not about dying or hospice.
This article is about supporting people living with CHF and giving you encouragement that you can live a full and productive life. I know when you search about CHF, you read about hospice and palliative care,
Congestive heart failure does not have to be a death sentence. I know Google says the life expectancy is 5 years. However, those statistics are from years ago. The health industry has made leaps and bounds in the treatment of heart failure.
These are drugs such as Coreg and Metoprolol. In fact, Coreg is considered the gold standard medication for CHF. These drugs have so many side effects. there are many people who cant take them.
Ace inhibitors are drugs like Lisinopril, Captopril, and Accupril. These are good drugs forCHF but patients have to be careful because ace inhibitors can cause angioedema. Angioedema is a life threatening disorder. African Americans have a high rate of angioedema.
These are drugs like Valsartan, Cozaar, and Benicar. There are many people who cannot take Ace Inhibitors, therefore ARB’S are the second choice.
Diuretics are drugs like Lasix, Bumex and HCTZ. While these drugs are wonderful because they get the fluid off. However, diuretics can be a challenge because they also deplete the body’s vitamins and minerals. As you know, B vitamins are water soluble which means that they are depleted by the kidneys. The irony is that a deficiency of B vitamins is linked to CHF.
People at high risk for atrial fibrillation and certain congenital disorders These new generation blood thinners are Zarelto, Eliquis and Pradaxa.
People are living great lives with CHF. The key to having a productive live with CHF is to be compliant with your medications and treatment.
How are you coping with CHF? Leave me a comment below
In some cases, congestive heart failure can be reversed. With the advancements in technology, medications, and lifestyle changes people are living with congestive heart failure for 15 or more years.