Congestive heart failure.

Congestive heart failure is a condition that occurs because the heart muscle is damaged or overworked. Damage can result from high blood pressure, a heart attack, atherosclerosis, a congenital heart defect, heart muscle disease, heart valve disease resulting from past rheumatic fever or other causes, infection of the heart valves and/or heart muscle itself (endocarditis and/or myocarditis), or high blood pressure in the lungs resulting from lung disease. Because it is damaged, the heart lacks the strength to keep blood circulating normally throughout the body. The failing" heart keeps working, but not as efficiently as it should. Next, as blood flow out of the heart slows, blood returning to it through the veins backs up, causing congestion in the tissues. Swelling (edema) often results, most commonly in the legs and ankles, but in other parts of the body as well. Sometimes, fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down. Heart failure affects the ability of the kidneys to dispose of sodium and water. The retained water increases edema.

The most common signs of congestive heart failure are swollen legs or ankles, difficulty in breathing, and weight gain because of accumulating fluid. Congestive heart failure usually requires a treatment program of rest, proper diet, modified daily activities, and drugs such as digitalis, diuretics, and vasodilators. Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water. Vasodilators expand blood vessels and decrease resistance, allowing blood to flow more smoothly and making the heart's work easier.

In some Gases, congestive heart failure can be treated by controlling high blood pressure or surgically replacing abnormal heart valves. Most cases of oongestive heart failure are treatable. With proper medical supervision, people with heart failure don't have to become invalids.

Coping with congestive heart failure. An estimated 2-3,000,000 Americans have congestive heart failure (CHF), and approximately 400,000 new cases are diagnosed annually. The prevalence of CHF is increasing, with 11% of Americans over the age of 65 having been diagnosed with heart failure.

"Heart failure is the most costly disease in managed care," notes Mandeep Mehra, director of the Heart Failure Clinic, Ochsner Heart and Vascular Institute, New...