Heart Failure

Heart Failure is a condition in which the heart does not effectively pump enough blood through the body. Heart Failure develops slowly over time, as the pumping action of the heart grows weaker. It does not mean that your heart has stopped or is about to stop. You have heart failure when excess fluid starts to leak into the lungs and/or the peripheral parts of the body.

Normally the pumping actions of the left and right sides of the heart compliment each other, producing a continuous flow of blood. Heart Failure may occur with both ventricles failing, although one ventricle may precede the other in dysfunction.

Heart Failure is usually chronic and long term. It is some times referred to as congestive. The most common form of all initial heart failure is left-sided failure, which occurs when the left ventricle is not working properly. This causes blood to back up through the left atrium and into the pulmonary veins, resulting in pulmonary congestion and edema because the fluid is backed up into the lungs. The most common causes of left sided failure are disease of the coronary arteries, hypertension (high blood pressure), cardiomyopathy (enlarged heart), and rheumatic heart disease.

Right-sided failure can occur as a result of damage to the right ventricle, such as a heart attack or enlargement of the right ventricle. Right-sided heart failure from a weakened right ventricle causes fluid to back into the body, resulting in swollen ankles and weight gain.

Causes

There are numerous causes of congestive heart failure:

• Valvular Heart Disease — Incompetency (leakage or blockage) of the heart valves leads to an ineffective flow of blood through the heart. Over time, the heart will attempt to compensate for the problem by “enlarging,” eventually leading to congestive heart failure, heart attack, cardiac arrhythmias, or cardiac arrest (heart stops beating). Valve replacements have improved the survival rate in these patients.
• Cardiomyopathy — This medical term describes a weakness in the heart muscle’s ability to contract. This may result from the effects of long standing hypertension, diabetes, alcohol abuse, or multiple heart attacks, all of which can damage the heart muscle to a point that its pumping function has been compromised.
• Viral Myocarditis — In addition to irregularities (arrhythmia) of the heart beat, this viral infection of the heart can result in poor cardiac muscle function. Viral myocarditis is one of few causes for heart failure seen in young people.
• Severe anemia — This condition can precipitate heart failure in the patient with a very low red blood cell count. The heart will go into congestive failure as it attempts to compensate for the inadequate number of circulating red blood cells. Red blood cells are necessary for adequate oxygenation of the tissues.
• Myocardial infarction (heart attack) — This can cause sudden (acute) congestive heart failure in cases where a substantial portion of the heart muscle has become severely damaged. The lack of oxygen to the cardiac muscle results in poor contraction.