Congestive heart failure (CHF) (also called congestive cardiac failure and heart failure) is the inability of the heart to pump a sufficient amount of blood throughout the body, or requiring elevated filling pressures in order to pump effectively. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The heart and lungs (from an older edition of Grays Anatomy) The heart (Latin cor) is a hollow, muscular organ that pumps blood through the blood vessels by repeated, rhythmic contractions. ... Red blood cells (erythrocytes) are present in the blood and help carry oxygen to the rest of the cells in the body Blood is a circulating tissue composed of fluid plasma and cells (red blood cells, white blood cells, platelets). ...

The term heart failure is frequently misused, especially when given as cause of death: it is not synonymous with "cessation of heartbeat".

There are many different ways to categorize heart failure, including the side of the heart involved (left heart failure vs. right heart failure) or whether the abnormality is due to contraction or relaxation of the heart (systolic heart failure vs. diastolic heart failure).

Individuals with heart failure are sensitive to small shifts in their intravascular volume status (the amount of fluid in their circulatory system). Increasing the volume in their circulatory system can cause symptoms and signs of decompensated heart failure, while decreasing the volume in the circulatory system can cause hypotension. The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ...

Signs of decompensated heart failure include pulmonary edema (fluid accumulation in the lungs), peripheral edema (fluid build-up in dependent portions of the body). In medicine, a sign is a feature of disease as detected by the doctor. ... Pulmonary edema is swelling and/or fluid accumulation in the lungs. ... Peripheral edema ...

Symptoms of decompensated heart failure include dyspnea (shortness of breath) on exertion, fatigue, paroxysmal nocturnal dyspnea (shortness of breath that occurs hours or minutes after lying down). The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: A symptom may loosely be said to be a physical condition which shows that one has a particular illness or disorder (see... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ...

The NYHA functional class is a commonly used way to gauge the progression of CHF in a particular patient. This classification is used to determine how much CHF limits their lifestyle, and does not apply to a particular decompensated episode. The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying the extent of heart failure. ...

Treatment

The treatment of CHF focuses on treating the symptoms and signs of CHF and preventing the progression of disease. If there is a reversible cause of the heart failure (e.g. infection, alcohol ingestion, anemia, thyrotoxicosis, arrhythmia, or hypertension), that should be addressed as well.

Treating the signs and symptoms of CHF involves maintaining a euvolemic state (normal fluid level in the circulatory system). This is done with the judicious use of diuretic agents, vasodilator agents, and positive inotropes. Certain subgroups may benefit from Bi-ventricular pacemaker placement or surgical remodelling of the heart. While these treatment modalities may make the patient symptomatically better, either they have not been shown to improve survival in large clinical studies or those studies have not been performed. A diuretic is any drug that tends to increase the flow of urine from the body (diuresis). ... A vasodilator is a substance that causes blood vessels in the body to become wider by relaxing the smooth muscle in the vessel wall. ... An inotrope is an agent which increases or decreases the force or energy of muscular contractions. ... This article is about a medical device which electrically stimulates the heart. ...

In the recently completed COMPANION trial, cardiac resynchronization therapy (pacing both the left ventricle as well as the right ventricle) has been shown to improve survival in individuals with NYHA class III or IV heart failure with a widened QRS complex on EKG.² ECG may also refer to the East Coast Greenway Lead II An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ...

Delaying the progression of heart failure involves the use of ACE inhibitors, beta blockers, and aldosterone inhibitors. These agents have been proven to improve survival in individuals with CHF. While the mechanism of improving is not entirely clear, it appears that these agents prevent remodelling of the heart and therefore prevent progression of dilatation of the left ventricle. ACE inhibitors, or inhibitors of Angiotensin-Converting Enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in most cases as the drugs of first choice. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ...

The ultimate treatment is cardiac transplant surgery (heart transplant) or implantation of an artificial heart. An artificial heart is a device that is implanted into the body to replace the original biological heart. ...

References

1. ACC / AHA guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult (PDF Copy)

2. Bristow MR, Saxon LA, Boehmer J, et al for the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004; 350:2140-2150.

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