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Heart failure, also referred to as congestive heart failure, is a condition in which the heart’s pumping ability is not sufficient to meet the body’s need for oxygen-rich blood. As a result, arm and leg muscles may tire more quickly, and the kidneys may not function normally.
The kidneys filter fluid and waste products from the blood into the urine, but when the heart cannot pump adequately, the kidneys malfunction and cannot remove excess fluid from the blood. As the amount of fluid in the blood stream increases, blood pressure rises, forcing the failing heart to work harder. This creates a vicious circle.
The term congestive heart failure is technically reserved for situations in which heart failure has led to edema or fluid build-up in the body. Although not all heart failure is congestive, the terms are often used interchangeably.
Heart failure may either be left-sided, in which pulmonary edema is the main symptom, or right-sided, in which hepatomegaly or liver enlargement and systemic edema are the main symptoms. In many instances, both sides of the heart are involved. Any disorder that directly affects the heart can lead to heart failure, as can some disorders that indirectly affect the heart.
In the United States, the most common causes of heart failure are ischemic heart disease and hypertension. Arrhythmias and valve diseases are also common causes. Less common causes include illicit drugs, vitamin deficiency, and hyperthyroidism.
Therapy usually requires a combination of multiple drugs and lifestyle changes. There are many different drugs used to treat heart failure. The choice of therapy is influenced by the patient’s age, renal function, serum potassium levels, racial background, blood pressure, volume status, and clinical condition. Surgical therapy, including transplantation in severe cases, may be required.
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