Congestive heart failure (CHF) is a condition in which the heart can't pump enough blood to the body's other organs. The failing heart keeps working but not as efficiently as it should. As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues generally resulting in swelling (edema) in the legs and ankles and shortness of breath.
Congestive heart failure can affect many organs of the body. For example, the weakened heart muscles may not be able to supply enough blood to the kidneys, which then begin to lose their normal ability to excrete salt (sodium) and water. This diminished kidney function can cause the body to retain more fluid. The lungs may become congested with fluid (pulmonary edema) and the person's ability to exercise is decreased. Fluid may likewise accumulate in the liver, thereby impairing its ability to rid the body of toxins and produce essential proteins. The intestines may become less efficient in absorbing nutrients and medicines. Over time, untreated, worsening congestive heart failure will affect virtually every organ in the body.
Congestive heart failure (CHF) can result from:
- narrowed arteries that supply blood to the heart muscle — coronary artery disease
- past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work
- high blood pressure
- heart valve disease due to past rheumatic fever or other causes
- primary disease of the heart muscle itself, called cardiomyopathy
- congenital heart defects
- infection of the heart valves and/or heart muscle itself — endocarditis or myocarditis
The diagnosis of congestive heart failure is most often a clinical one that is based on knowledge of the patient's pertinent medical history, a careful physical examination, and selected laboratory tests. The treatment of congestive heart failure can include lifestyle modifications, addressing potentially reversible factors, medications, heart transplant, and mechanical therapies. The course of congestive heart failure in any given patient is extremely variable.
