Cardiovascular Disease: Congestive Heart Failure

Congestive heart failure means your heart is not pumping blood as well as it should. It does not mean that the heart has stopped working. The word "congestive" refers to the building up of fluids in your body as result of the heart not pumping correctly. The underlying causes of this problem must include any disease that effects the heart and interferes with its circulation. This would include any coronary heart disease, heart attack, congenital heart disease, high blood pressure, abnormal heart rhythm, problems with heart valves and/or abuse of alcohol.

Symptoms of congestive heart failure include the following:

• Shortness of breath when walking or climbing stairs.
• Waking up breathless.
• Shortness of breath when lying flat.
• Feeling tired or weak.
• Swelling of legs (usually feet or ankles).
• Swelling of neck veins.
• Chronic cough.
• Rapid weight gain (1 or 2 pounds a day for three days in a row).
• Enlarged muscle on the left side of the heart

Your physician should check out these symptoms.

Heart failure is a chronic condition. Because of modern medicine's ability to help prolong life more people are surviving heart attacks than ever. Although they survive their heart may be in a weakened or damaged condition. Medications may be the first line of defense in this disease but there needs to be life style changes for decreasing the chances of morbidity. These changes include eating a healthy diet (reduce salt intake), avoid alcohol, loss of weight, exercise and stop smoking. When corrective steps are taken, the quality of life of the individual with congestive heart failure will improve exponentially with maintenance of a wellness program. Unfortunately over half of those diagnosed with heart failure will die within 5 years of the diagnosis.

Medications which are used to treat heart failure include:

• ACE Inhibitors which open your arteries, dilate blood vessels and lower blood pressure;
• Diuretuics ("water pills") which help keep fluid from building up in your body;
• Digoxin which helps the heart pump better;
• Nitrates which improve blood flow to the heart;
• Beta Blockers (See our article Beta Blockers and Aldosterone vs. Ace Inhibitors-Reducing The Risk of Dying From Heart Disease)
• Calcium Channel Blockers.

Cardiovascular disease is the leading cause of morbidity and mortality in the United States. More than 13.5 million Americans have a history of myocardial infarction or angina pectoris. Each year there are approximately 1 million survivors of myocardial infarction in the United States. Each year more than 1 million Americans undergo coronary revascularization by either bypass surgery or coronary angioplasty. Approximately 5 million Americans have chronic congestive heart failure, and 400,000 cases arise yearly.

The US Public Health Service has a free publication (US Department of Health and Human Services Clinical Practice Guideline Number 17: Cardiac Rehabilitation 1995) which describes treatment guidelines. It states "These programs are designed to limit the physiologic and psychological effects of cardiac illness, reduce the risk of sudden death or reinfarction, control cardiac symptoms, stabilize or reverse the arthereosclerotic process, and enhance the psychosocial and vocational status of selected patients." Yet today, only 11% to 38% of eligible patients participate in cardiac rehabilitation programs.

See related articles about strokes
See: Congestive Heart Failure-Part II

FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "HOW TO SELECT A NURSING HOME".

By Harold Rubin, MS, ABD, CRC. Guest Lecturer
Updated November 3, 1999
http://www.therubins.com

To e-mail: RehabStrat@aol.com or rubin@brainlink.com

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