Heart Failure/CHF/CCF

It means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened.This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. As a result, the kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

Types of Heart failure

Type of heart failure / Description
Left-sided heart failure /
  • Fluid may back up in your lungs, causing shortness of breath.

Right-sided heart failure /
  • Fluid may back up into your abdomen, legs and feet, causing swelling.

Systolic heart failure /
  • The left ventricle can't contract vigorously, indicating a pumping problem.

Diastolic heart failure
(also called heart failure with normal ejection fraction) /
  • The left ventricle can't relax or fill fully, indicating a filling problem.

Causes

Heart failure is caused by many conditions that damage the heart muscle, including:

  • Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.
  • Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly.
  • Cardiomyopathy (cardio=heart + myo=muscle = path=abnormality). Damage to the heart muscle that loses its ability to squeeze efficiently from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.Dilated cardiomyopathy describes an enlarged heart where heart muscle fibers are damaged and stretched and cannot contract efficiently.Hypertrophic cardiomyopathy describes abnormally thick heart muscle that cannot squeeze effectively.
  • Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can occur when several diseases or conditions are present at once.

Rarer causes of heart failure include:

  • Viral myocarditis (an infection of the heart muscle)
  • Infiltrations of the muscle such as amyloidosis
  • HIV cardiomyopathy (caused by human immunodeficiency virus)
  • Connective tissue diseases such as systemic lupus erythematosus
  • Arrhythmias

Pathophysiology

Heart failure is caused by number of conditions like myocardial infraction, hypertension, amyloidosis. Over time these increases in workload will produce changes to the heart itself:

  • Reduced force of contraction, due to overloading of the ventricle.
  • A reduced stroke volume, as a result of a failure of systole, diastole or both.
  • Reduced spare capacity.
  • Increased heart rate, stimulated by increased sympathetic activity. In order to maintain CO.
  • Hypertrophy (an increase in physical size) of the myocardium.
  • Enlargement of the ventricles, contributing to the enlargement and spherical shape of the failing heart.

The general effect is one of reduced cardiac output and increased strain on the heart.

Symptoms

  • Shortness of breath (dyspnea) when you exert yourself or when you lie down
  • Fatigue and weakness
  • Swelling (edema) in your legs, ankles and feet
  • Rapid or irregular heartbeat
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood-tinged phlegm
  • Increased need to urinate at night
  • Swelling of your abdomen (ascites)
  • Sudden weight gain from fluid retention
  • Lack of appetite and nausea
  • Difficulty concentrating or decreased alertness
  • Sudden, severe shortness of breath and coughing up pink, foamy mucus
  • Elevated blood pressure
  • Chest pain, if your heart failure is caused by a heart attack

Stages of Heart failure