Congestive Heart Failure

Congestive heart failure (CHF) occurs when the heart muscle is not able to pump enough blood to satisfy the metabolic needs of the tissues. Heart failure may be due to a primary disease of the heart muscle which is called cardiomyopathy, or may be secondary to diseases which affect the heart muscle such as hypertension, coronary heart disease, or various diseases of the heart valves.

Heart failure is divided into various types:

• Left-sided heart failure is failure of the left ventricle (larger chamber that pumps blood to the body). This may result in fluid accumulating in the lungs and the patient complaining of shortness of breath.

• Right-sided heart failure is failure of the right ventricle (chamber that pumps blood to the lungs) and may result in fluid accumulating in the abdomen and in the ankles.

Heart failure is further subdivided into systolic dysfunction and diastolic dysfunction:

• Systolic dysfunction is an abnormality of contraction of the pumping chambers of the heart.

• Diastolic dysfunction occurs when the pumping chamber may be contracting normally but does not relax properly (i.e., they are stiff).

Congestive heart failure is estimated to affect about 5 million people in the United States or about 1.7% of the overall population. Approximately 550,000 new cases of CHF are diagnosed in the United States each year. Congestive heart failure is a disease that primarily affects older individuals with an estimated prevalence of about 10% in people age 80 or older. It is rarely observed in individuals younger than age 50. Congestive heart failure is a leading cause of hospitalization in people over the age of 65 and is estimated to be a contributing factor to nearly 250,000 deaths annually.

Goals of therapy for patients with congestive heart failure include improvement in the quality of life, reduction in the occurrence of acute episodes, decreased mortality and improved length of survival. Another goal is to decrease the likelihood of arrhythmia, which may be a cause of sudden death in persons with heart failure.

In general, the treatment options for congestive heart failure include:

• Drug therapy
• Implantable device therapy
• Surgery

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• What are the risk factors of Congestive Heart Failure?
• What standard and alternative treatment options are available?
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• What are the results of the latest clinical trials?
• Where are the support groups and additional resources in my area?
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