Congestive Heart Failure

What is Congestive Heart Failure?

Congestive Heart Failure (CHF) is a highly prevalent heart condition in which the heart is unable to pump blood properly. Heart failure is chronic and has a high mortality rate. Additionally, CHF greatly affects the daily lives of those who have it, making everyday tasks difficult. Over 26 million people worldwide have CHF, and the number of cases are continuously increasing. (Savarese, 2017)

Heart Failure is caused by other diseases or conditions that weaken the heart. When the heart is unable to properly pump blood, it often backs up in parts of the body like the lower legs and major organs like the lungs. There are many scenarios that cause this failure, which is part of why it is so common. This public service announcement will go over the different symptoms of CHF, how it affects the body, its different stages, and treatment.

Causes

There are many conditions that lead to the development of CHF. Anything that can inhibit the heart's ability to function can cause heart failure. Below is a list of common causes:

• Coronary artery disease
• High blood pressure
• Diabetes
• Obesity
• Renal failure
• Metabolic syndrome
• Forms of heart disease

Along with this list, there are many groups that are predisposed to heart failure. This includes people aged 65+, those who are overweight, smokers, African Americans, and men ("Congestive Heart Failure," 2020). Physical activity also plays a role, as well as less educated groups (Tripoliti, 2017).

Types of Heart Failure

Heart failure can either be due to systolic or diastolic failure. Each type of failure has to do with how much blood the heart can take in or output. Systolic Heart Failure is when the heart is unable to pump out enough blood. This could be due to the heart muscle being too weak to pump out the normal amount. Diastolic Heart Failure is when the heart is unable to fill completely with blood. This could be due to stiff muscle not being able to relax, or thicker tissue in that ventricle. Heart failure is also classified by the left and right sides to indicate where the failure is being caused. Oftentimes, failure of one side will lead to problems with both.

Symptoms

Irregular heartbeat

Shortness of breath

Fatigue & weakness

Swelling of lower legs

Wheezing and cough

Stages

CHF is split into stages based on the severity of the case.
Stage A - This stage indicates that a patient is at high risk for heart failure. They may have one of the conditions that leads to CHF, or have a family history.
Stage B - In this stage, a patient has a heart dysfunction but has yet to experience symptoms of CHF.
Stage C - Patients begin to experience symptoms of CHF in stage C. This can include fatigue, weakness, and shortness of breath.
Stage D - The last stage of heart failure is when patients are experiencing extreme symptoms that do not improve. Surgery or transplant are the only treatments for this stage.

How Does CHF Affect the Body?

In the early stages, congestive heart failure affects the sympathetic nervous system by causing it to go into overdrive, increasing the amount of adrenaline produced causing increased heart rate and stress levels.

Increased stress on the heart causes the inner lining to fail. The lining of the heart thickens due to this increased stress on the tissues (Figure 2). As the tissue thickens, the heart may not be able to take in as much blood (diastolic failure) or push out as much blood (systolic failure). This causes an irregular heart beat.

Many other side effects may occur like atherosclerosis, which is the buildup of substances in arteries that restrict flow. Additionally, the lack of adequate blood flow to other parts of the body or even tissues in the heart can lead to cell death (necrosis). The main symptom of CHF is the buildup of blood that is no longer being pumped properly through the body. This buildup can occur in any organs like the lungs or even the lower body. Because the heart is a central part of the body, any failure in its ability to function will be associated with many other failures and problems throughout the body.

Treatment

The first step to getting treated for heart failure is to visit a doctor. When treating, they will take into account any medical history of heart conditions that may increase risk of CHF. The doctor will also begin with a physical examination, taking blood pressure and pulse. This will detect any immediate irregularities. X-Rays can be used to look at the state of the heart and lungs, checking for physical issues there or fluid buildup ("Heart failure," 2013).

Electrocardiograms can also check if your heart is beating properly and has the correct rhythm (Figure 3). All of these methods are checking that the heart is functioning as it should be. Tests for other underlying heart issues can also be used to check a patient's risk for heart failure.

Once diagnosed, steps can be taken to improve the symptoms of heart failure, however it is chronic so cannot be completely healed. Depending on the cause for heart failure, different treatments are used. Medications can be given to slow heart rate, lower blood pressure, and improve the overall function of the heart. Transplants and other surgeries are also an option for worse cases of CHF. Implants and heart assistants can also help the heart beat or strengthen it. Lifestyle changes can also be used to generally strengthen the heart. These changes are also used alongside other treatments ("Heart failure," 2013).

These treatments can improve and lengthen the lives of patients with CHF but are not able to cure it.

Current research

Because Congestive Heart Failure cannot be cured, it is important to always improve the methods being used to detect it in early stages and treat it as soon as possible. Technology is evolving fast in the medical field and is being used to improve treatment techniques. Some fascinating research is also being conducted to detect CHF in its early stages through machine learning. Studies like Heart Failure: Diagnosis, Severity Estimation and Prediction of Adverse Events Through Machine Learning Techniques, are using machine learning models to detect heart abnormalities and use patient data to determine the type of heart failure that they have and classify it. Along with catching it in its early stages, technology can be used to improve and elongate the lives of people with chf. Implanted devices to assist the heart may be used, and new therapies are also being explored.

CHF may never be cured, but it is being extensively studied and techniques of treatment are being improved upon. Research strives to decrease the risk of chf and improve the lives of those who do have it.

Works Cited

Congestive Heart Failure | Heart Failure | CHF. (2020, March 16). Retrieved from https://medlineplus.gov/heartfailure.html

Grassi, G., Quarti-Trevano, F., & Esler, M. D. (2019). Sympathetic activation in congestive heart failure: an updated overview. Heart Failure Reviews. doi: 10.1007/s10741-019-09901-2

He, J., Ogden, L. G., Bazzano, L. A., Vupputuri, S., Loria, C., & Whelton, P. K. (2001). Risk Factors for Congestive Heart Failure in US Men and Women. Archives of Internal Medicine, 161(7). doi: 10.1001/archinte.161.7.996

Heart failure. (2017, December 23). Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-failure/diagnosis-treatment/drc-20373148

Heart Failure: Understanding Heart Failure Management and Treatment. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heart-failure/management-and-treatment

Left Ventricular Hypertrophy (Enlarged Heart). (2018). Retrieved April 19, 2020, from https://www.vascularhealthclinics.org/institutes-divisions/cardiology/left-ventricular-hypertrophy-enlarged-heart/

Savarese, G., & Lund, L. H. (2017). Global Public Health Burden of Heart Failure. Cardiac failure review, 3(1), 7–11. https://doi.org/10.15420/cfr.2016:25:2

Tripoliti, E. E., Papadopoulos, T. G., Karanasiou, G. S., Naka, K. K., & Fotiadis, D. I. (2017). Heart Failure: Diagnosis, Severity Estimation and Prediction of Adverse Events Through Machine Learning Techniques. Computational and Structural Biotechnology Journal, 15, 26–47. doi: 10.1016/j.csbj.2016.11.001

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