Congestive Heart Failure

Congestive Heart Failure: Overview

Congestive heart failure (CHF) is a serious condition in which the heart is not pumping well enough to meet the body's demand for oxygen.  This condition has its name due to the heart failing to pump efficiently, which often results in congestion of the lungs.  As a result, the heart tries to overcompensate for the problem, which only makes the problem worse.

Incidence; Causes and Development

According to statistics from the American Heart Association, 550,000 new cases of CHF are diagnosed in the United States every year, including 1% of people over the age of 65.  Of all newly diagnosed patients, 50% of CHF patients die within 5 years of diagnosis.  Males and females appear to be affected about equally, but somewhat more women die from the condition.

Conditions that can lead to CHF include coronary artery disease, hypertension, heart attacks, cardiomyopathy, heart valve disease and infections, congenital heart disease and pulmonary hypertension.

Signs and Symptoms

The initial symptoms of CHF, such as swelling of the ankles, seems so minor that patients may not seek treatment until significant heart damage has already been done.

Treatment and Prevention

A number of different conventional treatments may be prescribed.  These include medications such as diuretics and invasive procedures such as a balloon angioplasty with coronary stenting.  Severe cases may require surgery.

Congestive Heart Failure

Information On This Page

Signs, symptoms & indicators of Congestive Heart Failure:

Symptoms - Abdomen

Frequent/occasional abdominal discomfort may be a sign or symptom of Congestive Heart FailureFrequent/occasional abdominal discomfort
Accumulation of fluid (due to congestive heart failure) in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.

Symptoms - Food - General

Loss of/weak appetite may be a sign or symptom of Congestive Heart FailureLoss of/weak appetite
Accumulation of fluid (due to congestive heart failure) in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.

Symptoms - Gas-Int - General

Regular unexplained nausea may be a sign or symptom of Congestive Heart FailureFrequent/occasional/regular unexplained nausea
Accumulation of fluid (due to congestive heart failure) in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.

Symptoms - General

Counter-indicators:
No/past history of being fatigued often contraindicates Congestive Heart FailureNo/past history of being fatigued
Fatigue is a sensitive indicator of possible underlying congestive heart failure.

Symptoms - Metabolic

Edema of the ankles/lower legs is often a sign or symptom of Congestive Heart FailureEdema of the ankles/lower legs
Edema of the ankles is a common manifestation of failure of the right ventricle related to both venous congestion and salt and water retention.
Edema of the feet may be a sign or symptom of Congestive Heart FailureEdema of the feet
Due to weakened heart muscles, blood supply to the kidneys may be reduced, which in turn impairs their ability to excrete salt and water.  As a result the body retains more fluid, some of which may accumulate in the extremities, resulting in edema of the ankles and/or feet.
Edema of the abdomen may be a sign or symptom of Congestive Heart FailureEdema of the abdomen
The weakened heart muscles may not be able to supply enough blood to the kidneys, which then begin to lose their normal ability to excrete salt (sodium) and water.  This diminished kidney function can cause the body to retain more fluid.

Symptoms - Nails

Symptoms - Respiratory

Shortness of breath when at rest may be a sign or symptom of Congestive Heart FailureShortness of breath when at rest
Congestive heart failure leads to reduced blood supply to the kidneys, which leads in turn reduced kidney function, and in turn excess fluid retention (edema).  The lungs may become congested with fluid (pulmonary edema) and thus the ability to exercise is decreased.

Symptoms - Sleep

Waking up with choking sensation is often a sign or symptom of Congestive Heart FailureWaking up with choking sensation
Fluid may accumulate in the lungs, causing shortness of breath particularly during exercise and when lying flat.  In some instances, patients are awakened at night, gasping for air.

Conditions that suggest Congestive Heart Failure:

Metabolic

Organ Health

Enlarged Spleen may suggest Congestive Heart FailureEnlarged Spleen
In severe failure of the right ventricle, elevated venous pressures are transmitted to the portal system, leading to congestion of the spleen and splenomegaly.
Kidney Disease may suggest Congestive Heart FailureKidney Disease
Renal insufficiency due to underperfusion from a failing heart is more widespread than commonly thought.

Respiratory

Pneumonia may suggest Congestive Heart FailurePneumonia
Heart failure is a risk factor for the development of pneumonia.

Symptoms - Cardiovascular

Uro-Genital

Nocturia may suggest Congestive Heart FailureNocturia
Edema fluid that collects in tissues during the day due to heart failure can result in increased night time urination.

Risk factors for Congestive Heart Failure:

Lab Values - Scans

Counter-indicators:
Normal chest X-ray often decreases risk of Congestive Heart FailureRecently-normalized chest X-rays or normal chest X-ray
A chest X-ray of a patient with congestive heart failure may show an enlarged heart and/or fluid buildup in the lungs (pulmonary edema).

Metabolic

Hemochromatosis (Iron overload) may increase risk of Congestive Heart FailureHemochromatosis (Iron overload)
Congestive heart failure occurs in about 7% of symptomatic patients with hemochromatosis.  If untreated, patients may develop an acute onset of severe congestive heart failure with rapid progression to death.

Symptoms - Food - Beverages

Counter-indicators:
Moderate/low alcohol consumption often decreases risk of Congestive Heart FailureModerate/low alcohol consumption
A study found that elderly people who drank at least 1.5 drinks per day had a risk of heart failure 47% lower than abstainers, regardless of age, race, blood pressure, history of diabetes, smoking and other factors.

Studies do not justify advising lifelong nondrinkers to start drinking for health, especially because most have good reasons for abstaining.  People with liver disease or a history of alcohol abuse should not drink at all, while those with diabetes and hypertension may partake in light alcohol consumption.

Tumors, Malignant

Carcinoid Cancer may increase risk of Congestive Heart FailureCarcinoid Cancer
Metastatic carcinoid disease can result in congestive heart failure by causing progressive fibrosis of the right-sided chambers and valves.

Congestive Heart Failure can lead to:

Organ Health

Congestive Heart Failure often leads to Kidney DiseaseKidney Disease
Renal insufficiency due to underperfusion from a failing heart is more widespread than commonly thought.

Recommendations for Congestive Heart Failure:

Amino Acid / Protein

Botanical

Hawthorn Berry Extract often helps with Congestive Heart FailureHawthorn Berry Extract
In a sample of 1,011 patients with stage II cardiac insufficiency, a standardized hawthorn extract containing 84mg of oligomeric procyanidins improved ejection fraction and resting pulse rate, and produced a reduction in cardiac arrhythmias.  Duration of the study was 24 weeks.  [Eur J Heart Fail 2000;2(4): pp.431-7]

Clinical trials with an extract (WS 1442) have successfully demonstrated improved cardiac function and improved quality of life primarily in patients with early stage CHF.  For the treatment of early stage CHF, the effective daily dosage of WS 1442 (standardized to 18.75% oligomeric procyanidins) has ranged from 160-900mg per day, divided into 2-3 doses.  Benefit has been shown in the 160-480mg per day range.  [Fortschr Med 1996;114: pp.291-6]

Diet

Increased Fruit/Vegetable Consumption may help with Congestive Heart FailureIncreased Fruit/Vegetable Consumption
Whole fruit and fruit and vegetable juice, both high in potassium, are recommended by some doctors for congestive heart failure (CHF).  This dietary change should, however, be discussed with a healthcare provider because several drugs given to people with CHF can actually cause retention of potassium, making dietary potassium, even from fruit, dangerous.  Bananas are a rich source of potassium and need to be avoided in persons taking potassium-sparing diuretics.

Drug

Diuretics is highly recommended for Congestive Heart FailureDiuretics
Potassium-sparing diuretics such as Aldactone or Dyrenium help the body to retain potassium and are often used in congestive heart failure patients, often along with the other two types of diuretics.  They do not significantly lower blood pressure.

Loop diuretics such as Lasix or Bumex are often used to counter congestive heart failure symptoms and are especially useful in emergencies.  They do not, however, significantly lower blood pressure.  Thiazide diuretics, such as Esidrix or Zaroxolyn, can be used to treat edema in heart failure.

Nutrient

CoQ10 (Ubiquinone) is highly recommended for Congestive Heart FailureCoQ10 (Ubiquinone)
CoQ10 is known to be highly concentrated in heart muscle cells due to the high energy requirements of this cell type.  The great bulk of clinical work with CoQ10 has focused on heart disease.  Specifically, congestive heart failure (from a wide variety of causes) has been strongly correlated with significantly low blood and tissue levels of CoQ10 [Proc.  Natl.  Acad.  Sci., U.S.A., vol.  82(3), pp.  901-4].

The severity of heart failure correlates with the severity of CoQ10 deficiency [Drugs Exptl.  Clin.  Res.  X(7) pp.497-502].  This CoQ10 deficiency may well be a primary causative factor in some types of heart muscle dysfunction while in others it may be a secondary phenomenon.  Whether primary, secondary or both, this deficiency of CoQ10 appears to be a major treatable factor in the otherwise inexorable progression of heart failure.

The efficacy and safety of CoQ10 in the treatment of congestive heart failure, whether related to primary cardiomyopathies or secondary forms of heart failure, appears to be well-established.

KEY

Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk of
Weak or unproven link:
may be a sign or symptom of; may suggest; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often leads to
Strong or generally accepted link:
is often a sign or symptom of; often leads to
Definite or direct link: strongly suggests
Definite or direct link:
strongly suggests
Strong counter-indication: often contraindicates; often decreases risk of
Strong counter-indication:
often contraindicates; often decreases risk of
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Very useful: is highly recommended for
Very useful:
is highly recommended for