Congestive heart failure is explained in lay terms and exacerbations of congestive heart failure are explained as well.
How our heart works
The heart is the mighty pump which with each beat renews the life in our body. By the power of each pumping, blood flows from the chambers of the heart to our entire body, bringing much-needed oxygen and nutrients to every cell. With every contraction, the left side of the heart must overcome the resistance of all the blood vessels of the body and push forward a full volume of blood to the periphery. Another part of the heart, the right part – is busy pushing blood to the lungs and from there to the left side of the heart. The right side ensures that the rest of the body is supplied with blood rich in oxygen.
What happens in congestive heart failure?
In congestive heart failure – or CHF, the left side of the heart is incapable (for any of a variety of reasons) of pushing sufficient blood forward. This creates an excess of blood waiting its turn to be pushed forward. The result is an increase in blood volume in the blood vessels ranging from the lungs to the left heart. As a result, these blood vessels be dilated and “congested”. When this happens – fluid is forced out of the blood vessels of the lungs into the surrounding airspace of the lungs. As a consequence, the primary presentation of CHF will often be shortness of breath and “water” in the lungs. Water in the lungs is termed pulmonary edema.
Exacerbation of congestive heart failure
Usually, even a sick heart in a patient with congestive heart failure manages to reach a state of equilibrium despite the increased difficulty in propelling the blood. This holds until something happens to disrupt the equilibrium. This could be a fever which increases the heart rate and thus more strain on the heart, anemia which means that there is less hemoglobin available for transporting oxygen, a heart attack with further damage to the heart, or a variety of other problems. Even a significant increase in salt intake can sometimes lead to increased blood volume and consequent dysequilibrium. Once equilibrium is disturbed, the heart can’t keep up with the volumes being loaded on it and fluid accumulates in the lungs in greater and greater amounts. This usually accompanies difficulty breathing, chest pain, and being a very stressful situation for the body may involve other signs of extreme stress such as profuse sweating and anxiety.
Right-sided heart failure
If the above situation occurs and there is damage to the right heart as well, blood pools also in the periphery, and thus some of the fluid will get pushed out of blood vessels and into the periphery. This typically manifests with swelling of the lower limbs and abdomen or, edema as it is technically termed. Right heart failure is rarely seen in isolation without accompanying left heart failure.
Treatment of congestive heart failure
Treatment of exacerbations of congestive heart failure reflects all we have previously written.
- Identifying and treating the underlying cause are primary concerns.
- Helping the heart with medications that improve contractions of the heart.
- Reducing fluid overload with diuretics or other methods of fluid volume reduction, in some cases, this may include blood pressure-lowering medications which expand the periphery and give more room for fluids to pool there safely.
- In certain cases mechanical devices can help push fluids in the right direction – if the edema is in the legs – stockings can help, if the edema is in the lungs – devices that compress air into the lungs can help.
- In extreme cases, devices that push blood through the blood vessels can be used as a temporary replacement for the heart.
Regardless, the goal is to relieve the extra load on the heart until the body can once more achieve equilibrium.