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Congestive Heart Failure (CHF) in Seniors

Congestive heart failure (CHF) is a condition in which the heart cannot pump enough blood to meet the body’s needs. It is more likely to be seen in seniors who may have other heart and blood vessel problems, which has, over the long term, compromised the heart function. Congestive heart failure may involve the right side of the heart, which sends blood to the lungs, or the left side, which circulates blood to the entire body. Failure of blood circulation leads to accumulation of fluid (congestion) in various parts of the body like the lungs, abdomen, legs and feet.

CHF Symptoms

Initially, mild CHF may present with obvious symptoms unless a person strains themselves. Over time the symptoms become persistent even when a person is resting. The symptoms of chronic CHF are:

  • Shortness of breath during physical activities
  • Generalized weakness
  • Swelling in legs, ankles, feet or abdomen
  • Irregular or fast heartbeat
  • Persistent cough with bloody phlegm
  • Sudden weight gain from fluid retention

Congestive heart failure (CHF) can be acute or chronic. The symptoms of acute CHF are similar to those of chronic CHF but are more severe and have a rapid onset or progression. If CHF is caused by a heart attack, chest pain is also reported.

Causes of Congestive Heart Failure

The following conditions can damage or weaken the heart, precipitating a CHF:

  • Coronary artery disease is the most common cause of CHF. This condition is characterized by narrowing of blood vessels with plaques formed by fatty deposits.
  • High blood pressure (hypertension) results in the thickening of heart muscles.
  • A heart infection, coronary artery disease or heart defect can damage the heart valves, leading to CHF.
  • Infections, medical conditions like thyroid abnormalities, drug or alcohol abuse, and chemotherapeutic drugs can damage heart muscles.
  • Inflammation of the heart muscles (myocarditis) caused by a virus can result in left-sided CHF.
  • Birth defects in the heart chambers or valves may lead to CHF.
  • Secondary causes are diseases and conditions like severe anemia, diabetes, lung diseases, iron build-ups, protein build-ups, allergic reactions, virus infections, blood clots in the lungs, and use of certain drugs may also lead to CHF as a secondary complication.

Treatment of Congestive Heart Failure

Treatment for CHF aims at improving the heart functions and treating the underlying causes.

Medication

  • Drugs called angiotensin-converting enzyme (ACE) inhibitors (enalapril, lisinopril, and captopril) dilate the blood vessels to lower the blood pressure and improve blood flow.
  • Angiotensin II receptor blockers (losartan and valsartan) are recommended for patients reactive to ACE inhibitors.
  • Digoxin or digitalis increases the strength of heart muscles.
  • Medicines known as beta blockers (carvedilol, metoprolol, and bisoprolol) slow the heart rate, reduce blood pressure, limit or reverse the heart damage, and improve heart function.
  • Diuretics (bumetanide, furosemide) and aldosterone antagonists (spironolactone and eplerenone) clear up water retention in the body.

Surgery

  • Coronary bypass surgery includes bypassing a blocked artery in the heart to allow blood flow.
  • Heart valve surgery is often recommended to repair or replace defective valves.
  • Implantable cardioverter de-fibrillators work like pacemakers and monitor heart rhythm.
  • Bi-ventricular pacing or cardiac re-synchronization therapy helps in restoring proper heart functioning.
  • Mechanical heart pumps implanted into the abdomen or chest aid the heart in pumping.
  • Heart transplants are recommended in severe CHF cases.

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