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The facts on congestive heart failure

September 11, 2006|Hilary E. MacGregor | Times Staff Writer

What is congestive heart failure?

Congestive heart failure -- or heart failure -- means that the heart can't pump as much blood as the body needs. (In contrast, cardiac arrest means the heart has stopped beating.) As either or both of the heart's ventricles fail, blood backs up and congests into the liver, abdomen, lower extremities and lungs.

What causes it?

It can be caused by heart damage due to a heart attack, high blood pressure, coronary artery disease, viral infections, a genetic abnormality, certain chemotherapy treatments or excessive alcohol or drug use. Sometimes, the cause is unknown. About half of the 5 million people with heart failure in the U.S. are 65 and older.

What are the symptoms?

Typically, heart failure develops slowly. Symptoms may include shortness of breath, swelling of feet and legs, chronic lack of energy, difficulty sleeping at night due to breathing problems, a swollen abdomen with loss of appetite, persistent cough with frothy sputum, increased urination at night and confusion or impaired memory.

How is it treated?

Heart failure can be treated, but not cured. Medications -- often used in combination -- include angiotensin-converting enzyme (ACE) inhibitors, to widen the blood vessels and decrease the load on the heart; beta blockers, to slow the heart and reduce blood pressure; digoxin, to increase the force of heart muscle contractions; and diuretics, to help the kidneys eliminate extra fluid.

Doctors may sometimes recommend replacement of a damaged heart valve or coronary bypass surgery. Exercising, reducing salt intake, managing stress and dealing with depression can also strengthen the heart and help reduce strain on it.

In certain cases, doctors may recommend ventricular devices. These include implantable cardioverter defibrillators, which monitor the heart's rhythm and shock it back to normal if it starts beating wildly; cardiac resynchronization therapy, which sends electronic impulses to the heart's chambers to keep them pumping in time; and heart pumps, attached to the heart to keep it pumping.

For more information, contact the American Heart Assn., www.americanheart.org, or the Mayo Clinic, www.mayoclinic.com.

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