Congestive Heart Failure (CHF)

Congestive Heart Failure (CHF)

Symptoms, Causes & Treatment

By: Dr (Hakeem) Aslam Javed

Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as "heart failure," CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.

In early Arab world, paralysis and heart diseases emerged more prominently than infectious diseases. According to various reports in recent years, the cardiovascular diseases are spreading fast in India due to our sedentary lifestyle. According to a Tibb study, western experts are associating lifestyle changes as the main reasons behind heart diseases in the country. A consortium of Tibb experts has researched in 22 nations of the Arab League. For this massive health study, they visited Tibb centres built during 1990-2010. The report was named as "2010 Global Burden of Diseases".

In 1990, respiratory diseases were very common and known as primary diseases in Tibb system. 11 per cent deaths were caused by these infections. In the similar manner, birth of dead babies was also reported highly. According to Tibb researchers, these diseases are still prevalent in poor Arab and African countries such as Somalia and Yemen. Barring HIV, the rate of spread in other diseases has come down in these countries, while these diseases are spreading very fast in India. According to this study, the biggest cause of deaths in the Arab countries was heart-related diseases in 2010, which stood at 14.3 percent. In 1990, this cause of death was at second position. In 2010, the second biggest killer disease was paralysis, followed by respiratory infections, diabetes and road accidents.

According to this Tibb report, depression, stress, house conflicts and neck and back pain are other leading diseases in this Arab region. The report indicates that this part of the world is witnessing a transformation in terms of diseases in recent times. It was mentioned in the report that the disease scenario of this region is akin to what we see in EU, US and Canada. It was clearly said in the research that indulgences like drinking and smoking are the main reasons behind such diseases and deaths in this region; the same was very low in this part of the world two decades back.

Indian Scenario:

Now if we look at the cardiovascular disease scenario in our own country, the situation is worse. According to the World Health Organization (WHO), the deaths caused by heart diseases have increased double-fold in recent times. A decade ago, the deaths caused by heart diseases were not so high, but with time, the situation has turned worse. The condition is similar in almost every country which is economically rising. In India, one fourth deaths are caused by heart-related diseases, followed by respiratory infections (13 %), cancer (7%), diabetes (2%) and other causes (12%). The cancer is spreading fast in the country, and Bangalore is witnessing the most number of cancer cases. The national average of cancer patients in the country is 81 per 1 lakh people, while it is 126 per 1 lakh people in Bangalore which is becoming the cancer capital of India. In developed nations like the US, three fourth deaths are caused by non-infectious diseases like heart failure.

According to a WHO representative, it takes one century to notice a change in diseases which eventually become primary causes of deaths. In India, the most number of deaths are caused by heart-related diseases. Cardiovascular diseases are spreading very fast, thanks to our sedentary lifestyle and bad food habits.

CHF: the silent killer

When we take a stock of the current situation, we come to know that babies and children are getting affected more than the adults by the heart-related disease. Congestive heart failure (CHF) occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the body's needs. Signs and symptoms commonly include shortness of breath, excessive tiredness, and leg swelling.

Specialists first try to know the affected side of the heart to reach the exact causes. The normal issues arising from CHF include: the right side of the heart receives blood supply from blood vessels or arteries. If this part becomes non-functional or defected, the blood returns to the arteries. In this condition, fluid gets deposited in the arteries. In babies and children, you can notice this fluid in the form of swollen hands, stomach, feet and eyes.

The left side of heart gets blood supply from the lungs. When this side of the heart does not function properly, fluid enters the lungs and gets deposited there. In such a condition, you will notice that your child breathes fastand with great difficulty. This can create difficulty in taking breaths and may hinder natural growth in body weight and even diet intake of your child.

The two parts of the heart can be connected by a hole which helps in easy movement of the blood. CHF or failure of the heart is due to some congenital heart defect. This is very common amongst the babies and children. Congenital means a problem occurring before birth.

Causes of CHF:

• Cardiomyopathy (When the heart muscle becomes enlarged, thick, or rigid)
• Angiocarditis(inflammation of the heart and blood vessels)
• Myocarditis(inflammation of the heart muscle)

Symptoms of CHF:

If your child is suffering from CHF, you will notice some changes in him. In such a case, immediately consult a doctor. These indicatory changes are listed below:

• Difficulty in eating and drinking
• Lack of hunger, vomiting, difficulty in increasing weight, feeling tired after a small meal and sleeping more than average

Emergency Signs:
• Extreme tiredness, frustration and crankiness
Physical signs:

• Sweating more than normal, usually around the head, fast breathing pattern and discolouring of nails, hands and legs, especially bluish Decrease in frequency of urine or less diaper change
• Swollen stomach, dry cough, coldness of hands, legs and arms

Please note that these symptoms can also be due to presence of some virus. So it is advised that you immediately consult a doctor.

CHF is treated with medicines, especially those medications which remove extra fluid from the lungs and arteries. These are urine stimulating medications. Angiotensin-converting enzymes (ACE) are different types of medicines which are used to treat CHF. ACE inhibitors such as enalapril (Vasotec) and lisinopril (Prinivil, Zestril)are the cornerstone of drug treatment for CHF. ACE inhibitors promote dilation of the blood vessels and thus improve blood flow. They can also reduce blood pressure and lighten the workload on the heart.Angiotensin-converting enzymes (ACE) treat this condition by dilating blood vessels and help the heart in pumping blood to the whole body. To know details about these medicines and how they work, you can talk to your doctor.

When the heart fails to pump enough blood to the body, the condition is known as CHF. This condition is called congenital defect as it starts before birth. If you notice symptoms mentioned above, do not delay and immediately visit a specialist. CHF can be treated by medications. As a matter of fact, the heart related diseases are emerging more prominently in the Arab world also than infectious diseases.