Your heart beats over 100,000 times a day and approximately 37 million times a year. By the time you reach the age of 70, your heart would have beaten more than 2.5 billion times.
The human heart is a highly efficient pump that combines muscles and electrical conduction to deliver life sustaining, oxygen rich blood throughout the body. Unfortunately, there are certain disease that can weaken or cause stiffening of the heart muscles. These include heart attack, disorders of the heart’s valves, and myocarditis (inflammation of the heart muscles due to a viral infection). Chronic alcohol abuse can also weaken the heart muscles. Other diseases increase oxygen demand by the body tissues beyond the capability of the heart to deliver. These include longstanding high blood pressure and thyroid disorders.
When the heart is affected by any of these diseases, its pumping efficiency is compromised and a life threatening condition called congestive heart failure (CHF) develops. The symptoms of CHF vary depending on the particular organ systems involved and the degree to which the rest of the body has “compensated” for the heart muscle weakness. An early CHF symptom is fatigue. Because the heart is unable to efficiently pump blood, the body becomes overloaded with fluid and swelling (edema) of the ankles and legs or abdomen may occur. Fluid may accumulate in the lungs, causing shortness of breath, particularly during exercise and when lying flat. Some patients are weakened at night, gasping for air; others may be unable to sleep unless they sit upright. The extra fluid in the body may also cause frequent urination, particularly at night. Fluid build-up in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.
A cardiologist diagnoses CHF through a thorough investigation of the patient’s medical history and physical examination, as well as ordering selected laboratory tests, such as chest x-ray, electrocardiogram (ECG), and echocardiogram (ECG), and echocardiogram. Upon confirmation of diagnosis, treatment is started immediately. One of the most important CHF treatments is lifestyle modification, particularly salt and fluid intake restriction, and weight management. A medically supervised aerobic exercise regimen is now recommended for CHF patients as this has been shown to help maintain overall functional capacity and quality of life.
Surgical procedures may be considered in patients whose CHF is caused by inadequate blood flow to the heart muscle. Heart valve surgery may be recommended for patients whose CHF is caused by severe valve disease. Aggressive blood pressure control will often alleviate the condition of patients whose heart failure is caused by uncontrolled hypertension. Likewise, abstinence from drinking can significantly improve the condition of patients with alcohol abuse-related CHF.
Several classes of blood pressure lowering medications are available to both improve CHF symptoms and prolong survival. These include angiotensim-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, and diuretics. With increasing medical knowledge and more effective surgical and pharmacologic treatments, CHF patients today have a better chance of recovering and living a relatively normal life.
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