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Congestive heart failure (CHF) is a condition in which the heart cannot pump enough blood to meet the needs of the body. The term “heart failure” should not be confused with “heart attack.” Heart failure occurs after the heart muscle has been damaged or weakened by another primary cause, such as high blood pressure , coronary artery disease , or certain kinds of infections. Depending on the cause, heart failure can occur gradually, over many years, while the heart tries to compensate for its loss of function, or it may occur more quickly if a lot of the heart muscle is damaged at once.
Blood Flow Through the Heart |
It is estimated that 5 million Americans are currently living with CHF. As the US population ages, and baby boomers are getting older, that number is expected to climb.
Types of CHF
CHF occurs when the heart muscle cannot pump adequate amounts of blood to meet the body’s needs. When the heart fails to keep up with demand, fluid can accumulate behind the failing heart chambers. In order to understand the types of CHF, you should first understand how the heart—the center of the circulatory systems—works.
The heart has two sides (right and left), and each side has two chambers. The four chambers of the heart have specific functions:
Two upper chambers (atria / atrium)—Receive blood from the body and empty the blood to the lower chambers
Two lower chambers (ventricles)—Receive blood from the upper chambers and pump blood back out to the body
The right atrium receives blood from the body and empties it into the right ventricle. The right ventricle pumps the blood out to the lungs where carbon dioxide is exchanged for needed oxygen. The left atrium receives blood rich in oxygen from the lungs and empties that blood into the left ventricle. The left ventricle is the strongest muscle/chamber in the heart and is responsible for pumping the blood back out to the body.
Heart failure can occur on either side of the heart and is classified as:
- Left-sided failure:There are two main ways that the left ventricle can fail to keep up with the demands of the body. When the left ventricular muscle is damaged, it fails to contract/pump with sufficient force. That is called systolic failure. If the muscle is damaged in such a way that it becomes stiff and cannot accept all the blood it needs from the left atrium, then it is called diastolic failure. The difference between these two types of failure is important because the treatment approach for each type may be different. In either type, when the left ventricle fails to circulate the blood, the blood can “back up” into the lungs. Accumulation of fluid in the lungs causes one of the main symptoms of CHF, shortness of breath. Doctors use the term pulmonary edema to describe severe fluid build-up in the lungs.
- Right-sided failure:This occurs when the right ventricle fails to pump out enough blood to meet the body’s demand. In this case, the right ventricle and atrium cannot accept all the blood returning to the heart, and the blood “backs-up” into the veins and capillaries. The “overflow” of this fluid leaks out of the capillaries to the tissue, causing edema. Edema, or fluid accumulation, usually shows up as swelling, particularly in the legs. Right-sided failure usually occurs as a secondary result of left-sided failure, but it may also be caused by primary conditions that increase the pressure in the lungs.
Pulmonary Edema |
Causes of CHF
There are several conditions that can cause CHF. It is important to accurately diagnose the underlying cause, as it will guide the course of treatment.
The two most common causes of CHF are:
- Hypertension (high blood pressure):If your arteries have become narrowed from fatty deposits or are less flexible due to aging or other causes, then your heart will have to pump much harder to get the blood through the arteries. This pumping effort is reflected in your “blood pressure.” If your heart muscle has to continually pump much harder than normal, then eventually, this may lead to heart muscle damage, and finally may cause heart failure.
- Coronary artery disease (CAD): Cholesterol and fat can build up in the arteries that supply the heart with blood. This build-up narrows the blood vessels, causing reduced blood flow (ischemia) to the heart muscle, and an inability to meet increased blood flow demands (like from exercise). If the blood flow is completely cut off, a heart attack can occur. Heart attack means that an area of heart muscle has been deprived of blood and nutrients long enough that the area of heart muscle dies. If enough heart muscle is damaged in this way and the muscle cannot pump enough blood to meet the body’s needs, then heart failure occurs.
Other conditions that cause CHF include:
- Valvular heart disease:The four valves of the heart keep blood flowing efficiently and in the correct direction. If these valves become damaged or infected ( endocarditis ), the heart is forced to work harder. Over time, this can weaken the heart muscle.
- Cardiomyopathy:The heart may become damaged due to infection, chronic alcohol abuse, use of certain chemotherapy drugs, cocaine, or scarring from diseases. The damage results in inadequate contraction of the heart muscle, which can lead to CHF.
- Congenital heart defects:When there is a malformation of the heart muscle or valves at birth, the heart is forced to work harder to produce the same output. Over time, this may cause CHF.
- Diabetes :People who have diabetes are at increased risk of developing heart disease. They often have other conditions that increase their risk of heart disease, like high cholesterol and increased weight.
- Abnormal heart rhythms (arrhythmia):If a heart beats too slowly (bradycardia), the heart may not be able to pump out an adequate supply of blood. If the heart beats too quickly (tachycardia), there may not be enough time for the heart to fill with blood. Both of these conditions produce strain and may lead to CHF.
- Hyperthyroidism :This condition, caused by an overactive thyroid gland, increases the metabolic rate in the body. The increased levels of thyroid hormone signal the heart to pump faster and harder to supply the body with blood, causing strain, which (if uncorrected) may lead to CHF.
- Anemia :Red blood cells carry oxygen throughout the body. When the number of red blood cells is reduced ( anemia ), the heart must circulate blood more frequently to supply enough oxygen to the tissues. This is another type of strain that may lead to CHF.
What are the risk factors for congestive heart failure?
[What are the symptoms of congestive heart failure?
[How is congestive heart failure diagnosed?
[What are the treatments for congestive heart failure?][16]
Are there screening tests for congestive heart failure?
[How can I reduce my risk of congestive heart failure?
[What questions should I ask my doctor?
[Where can I get more information about congestive heart failure?
Congestive heart failure (CHF) is a condition that is usually the result of other underlying conditions. It is important to diagnose the underlying cause, so that the proper treatment can be given.
Swollen Feet |
There are not always noticeable symptoms for CHF as it develops. When symptoms do occur, they may include:
- Shortness of breath, especially with activity, or when lying down
- Swelling of feet and ankles
- Fatigue and weakness
- Persistent cough or wheezing cough that may be accompanied by white or blood-tinged phlegm
- Rapid weight gain
- Irregular or rapid heartbeat
- Change in urine production (increase or decrease, need to urinate at night)
- Nausea
- Loss of appetite
- Decreased alertness
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Felker CM, Thompson RE, Hare JM, et al. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med.2000;342:1077.
He, J, Ogden, LG, Bazzano, LA, et al. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med.2001;161:996.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Mayo Clinic Heart Center http://www.mayoclinic.com/health/heart-failure/HB00061 Last accessed at January 30, 2007
Congestive heart failure (CHF) is a condition in which the heart cannot pump enough blood to meet the needs of the body. The term “heart failure” should not be confused with “heart attack.” Heart failure occurs after the heart muscle has been damaged or weakened by another primary cause, such as high blood pressure , coronary artery disease , or certain kinds of infections. Depending on the cause, heart failure can occur gradually, over many years, while the heart tries to compensate for its loss of function, or it may occur more quickly if a lot of the heart muscle is damaged at once.
Blood Flow Through the Heart |
It is estimated that 5 million Americans are currently living with CHF. As the US population ages, and baby boomers are getting older, that number is expected to climb.
Types of CHF
CHF occurs when the heart muscle cannot pump adequate amounts of blood to meet the body’s needs. When the heart fails to keep up with demand, fluid can accumulate behind the failing heart chambers. In order to understand the types of CHF, you should first understand how the heart—the center of the circulatory systems—works.
The heart has two sides (right and left), and each side has two chambers. The four chambers of the heart have specific functions:
Two upper chambers (atria / atrium)—Receive blood from the body and empty the blood to the lower chambers
Two lower chambers (ventricles)—Receive blood from the upper chambers and pump blood back out to the body
The right atrium receives blood from the body and empties it into the right ventricle. The right ventricle pumps the blood out to the lungs where carbon dioxide is exchanged for needed oxygen. The left atrium receives blood rich in oxygen from the lungs and empties that blood into the left ventricle. The left ventricle is the strongest muscle/chamber in the heart and is responsible for pumping the blood back out to the body.
Heart failure can occur on either side of the heart and is classified as:
- Left-sided failure:There are two main ways that the left ventricle can fail to keep up with the demands of the body. When the left ventricular muscle is damaged, it fails to contract/pump with sufficient force. That is called systolic failure. If the muscle is damaged in such a way that it becomes stiff and cannot accept all the blood it needs from the left atrium, then it is called diastolic failure. The difference between these two types of failure is important because the treatment approach for each type may be different. In either type, when the left ventricle fails to circulate the blood, the blood can “back up” into the lungs. Accumulation of fluid in the lungs causes one of the main symptoms of CHF, shortness of breath. Doctors use the term pulmonary edema to describe severe fluid build-up in the lungs.
- Right-sided failure:This occurs when the right ventricle fails to pump out enough blood to meet the body’s demand. In this case, the right ventricle and atrium cannot accept all the blood returning to the heart, and the blood “backs-up” into the veins and capillaries. The “overflow” of this fluid leaks out of the capillaries to the tissue, causing edema. Edema, or fluid accumulation, usually shows up as swelling, particularly in the legs. Right-sided failure usually occurs as a secondary result of left-sided failure, but it may also be caused by primary conditions that increase the pressure in the lungs.
Pulmonary Edema |
Causes of CHF
There are several conditions that can cause CHF. It is important to accurately diagnose the underlying cause, as it will guide the course of treatment.
The two most common causes of CHF are:
- Hypertension (high blood pressure):If your arteries have become narrowed from fatty deposits or are less flexible due to aging or other causes, then your heart will have to pump much harder to get the blood through the arteries. This pumping effort is reflected in your “blood pressure.” If your heart muscle has to continually pump much harder than normal, then eventually, this may lead to heart muscle damage, and finally may cause heart failure.
- Coronary artery disease (CAD): Cholesterol and fat can build up in the arteries that supply the heart with blood. This build-up narrows the blood vessels, causing reduced blood flow (ischemia) to the heart muscle, and an inability to meet increased blood flow demands (like from exercise). If the blood flow is completely cut off, a heart attack can occur. Heart attack means that an area of heart muscle has been deprived of blood and nutrients long enough that the area of heart muscle dies. If enough heart muscle is damaged in this way and the muscle cannot pump enough blood to meet the body’s needs, then heart failure occurs.
Other conditions that cause CHF include:
- Valvular heart disease:The four valves of the heart keep blood flowing efficiently and in the correct direction. If these valves become damaged or infected ( endocarditis ), the heart is forced to work harder. Over time, this can weaken the heart muscle.
- Cardiomyopathy:The heart may become damaged due to infection, chronic alcohol abuse, use of certain chemotherapy drugs, cocaine, or scarring from diseases. The damage results in inadequate contraction of the heart muscle, which can lead to CHF.
- Congenital heart defects:When there is a malformation of the heart muscle or valves at birth, the heart is forced to work harder to produce the same output. Over time, this may cause CHF.
- Diabetes :People who have diabetes are at increased risk of developing heart disease. They often have other conditions that increase their risk of heart disease, like high cholesterol and increased weight.
- Abnormal heart rhythms (arrhythmia):If a heart beats too slowly (bradycardia), the heart may not be able to pump out an adequate supply of blood. If the heart beats too quickly (tachycardia), there may not be enough time for the heart to fill with blood. Both of these conditions produce strain and may lead to CHF.
- Hyperthyroidism :This condition, caused by an overactive thyroid gland, increases the metabolic rate in the body. The increased levels of thyroid hormone signal the heart to pump faster and harder to supply the body with blood, causing strain, which (if uncorrected) may lead to CHF.
- Anemia :Red blood cells carry oxygen throughout the body. When the number of red blood cells is reduced ( anemia ), the heart must circulate blood more frequently to supply enough oxygen to the tissues. This is another type of strain that may lead to CHF.
What are the risk factors for congestive heart failure?
What are the symptoms of congestive heart failure?
How is congestive heart failure diagnosed?
What are the treatments for congestive heart failure?
Are there screening tests for congestive heart failure?
How can I reduce my risk of congestive heart failure?
What questions should I ask my doctor?
Where can I get more information about congestive heart failure?
References:
Harrison’s Principles of Internal Medicine. 15th ed. McGraw-Hill; 2001.
Heart Failure Online website. Available at: http://www.heartfailure.org . Accessed January 30, 2007.
Mayo Clinic heart Center website. Available at: http://www.mayoclinic.com/health/heart-failure/HB00061 . Accessed January 30, 2007.
A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop congestive heart failure with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing congestive heart failure. If you have a number of risk factors, ask your healthcare provider what you can do to reduce your risk.
Risk factors for congestive heart failure (CHF) include:
Medical Condition
The following medical conditions put you at increased risk for developing CHF:
- Hypertension (high blood pressure)
- Coronary artery disease
- Diabetes
- Obesity
- Hyperthyroidism
- Severe emphysema
- Previous history of heart disease
- Valvular heart disease
Specific Lifestyle Factor
These lifestyle factors can increase your risk of developing CHF:
- Excessive alcohol consumption
- Smoking
- Long-term use of anabolic steroids
Age
CHF is most common in people who are older; most people who have CHF are age 65 or older. CHF is the leading cause of hospital admission in patients older than 65.
Gender
Both men and women can develop CHF. However, men are at a slightly higher risk of developing CHF.
The first step your doctor will take to assess whether you have CHF is to discuss your medical history and conduct a complete physical exam. Afterwards, your doctor may recommend some or all of the following tests to help make the diagnosis and assess the degree of damage:
Chest X-ray—An x-ray image will show whether the heart is enlarged, or congestion is present in the lungs.
Blood Tests—To check for anemia, thyroid disease, elevated cholesterol and blood lipids, and to evaluate kidney and liver function, electrolytes, and calcium and magnesium levels. In addition, your doctor will check plasma levels of BNP (brain natriuretic peptide) as those are elevated in patients with heart failure.
Electrocardiogram (EKG or ECG)—Records the electrical activity of your heart through electrodes attached to the skin. This test will help diagnose heart rhythm problems, muscle abnormalities, and damage to the heart from a heart attack .
Echocardiogram—Uses sound waves to produce an image of the working heart. This test helps evaluate the function of the valves and chambers of the heart and determines the amount of blood ejected from the heart with each heartbeat (ejection fraction). An echocardiogram also can detect structural damage, tumors, or excess fluid around the heart.
Exercise Stress Test—Records the heart's electrical activity during increased physical activity. It may be coupled with an echocardiogram or nuclear heart scan. Patients who cannot exercise may be given medication intravenously that simulates the effects of physical exertion.
Nuclear Scanning—Radioactive material is injected into a vein and observed as it is absorbed by the heart muscle. Areas with diminished flow (and uptake of the radioactive material) show up as dark spots on the scan.
Coronary Angiographyand Coronary Catheterization—Contrast dye is injected via a thin, flexible tube (catheter) that is threaded into the aorta or heart. X-rays are then taken to view blood flow and highlight the arterial blood vessels. This test helps to detect obstruction in the arteries and assess heart function. Testing to check for blockage in the coronary arteries is recommended for some individuals with heart failure, especially younger patients and patients with symptoms of chest pain and angina .
Electron-beam CT Scan (EBCT) and CT Angiography (CTA)—EBCT and CTA are used to find blockages in the arteries. With CTA, a small amount of dye is injected into the blood vessels. As the dye passes through the heart, a type of x-ray machine that uses computers helps show any blood flow blockage. EBCT is similar but it takes multiple pictures even faster than the CTA.
Cardiac Magnetic Resonance Imaging—This test uses high intensity magnetic fields to generate high resolution images. It can help evaluate large blood vessels, coronary arteries, heart walls, and pericardium. It is also helpful in measuring ejection fraction and evaluating patients for the presence of cardiomyopathy.
Diagnostic Indicators
As your doctor examines you, he or she will be looking for some characteristic signs of CHF on the physical exam, including:
- Sound of fluid in the lungs (rales)
- Enlargement of the jugular vein in the neck (jugular venous distention)
- Enlargement of the liver (hepatomegaly)
- High blood pressure (hypertension)
- Low blood pressure (hypotension)
- Fast heart rate (tachycardia)
- Edema (swelling of the ankles, legs, feet)
- Fluid in the abdominal cavity ( ascites )
- Fluid in the space between the lungs and ribs ( pleural effusion )
References
McMurray JJ, Ostergren J, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet.2003;362:767.
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Harrison’s Principles of Internal Medicine. 14th ed. McGraw-Hill; 2001.
Heart Failure Online website. Available at: http://www.heartfailure.org .
Mayo Clinic Heart Center website. Available at: http://www.mayoclinic.com/health/heart-disease/HB00057 .
Vasan RS, Benjamin EJ, Levy D. Prevalence, clinical features and prognosis of diastolic heart failure; an epidemiologic perspective. J Am Coll Cardiol.1995;26:1565.
Congestive heart failure (CHF) is a condition that is usually the result of other underlying conditions. It is important to diagnose the underlying cause, so that the proper treatment can be given.
Swollen Feet |
There are not always noticeable symptoms for CHF as it develops. When symptoms do occur, they may include:
- Shortness of breath, especially with activity, or when lying down
- Swelling of feet and ankles
- Fatigue and weakness
- Persistent cough or wheezing cough that may be accompanied by white or blood-tinged phlegm
- Rapid weight gain
- Irregular or rapid heartbeat
- Change in urine production (increase or decrease, need to urinate at night)
- Nausea
- Loss of appetite
- Decreased alertness
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Hunt SA, Abraham WT, Chin MH, et al. For: American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult. Circulation.2005;112:e154.
Lima JA, Desai MY. Cardiovascular magnetic resonance imaging: current and emerging applications. J Am Coll Cardiol.2004;44:1164.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Redfield MM, Rodeheffer RJ, Jacobsen SJ, et al. Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study. Circulation.2004;109:3176.
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Levitan EB, Wolk A, Mittleman MA. Consistency with the DASH diet and incidence of heart failure. Arch Intern Med.2009;169:851-857.
8/31/2009 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Djoussé L, Driver JA, Gaziano JM. Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA.2009;302:394-400.
American Heart Association
Address:
American Heart Association
National Center
7272 Greenville Avenue
Dallas, TX 75231
Phone:
1-800-AHA-USA-1
Internet Address:
http://www.americanheart.org
Description of Services Provided:
On this site, you will find general information about heart disease, including educational information, news, research, health programs, and dietary information.
Centers for Disease Control (CDC) Cardiovascular Health Program
Address:
Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333
Phone:
1-800-311-3435
Internet Address:
http://www.cdc.gov/nccdphp/cvd
Description of Services Provided:
This site provides educational and statistical information about cardiovascular health, as well as information.
National Heart, Lung and Blood Institute (NHLBI)
Address:
NHLBI Health Information Center
Attention: Website
PO Box 30105
Bethesda, MD 20824-0105
Phone:
1-301-592-8573
Internet Address:
http://www.nhlbi.nih.gov
Description of Services Provided:
This government site provides information about all types of cardiovascular conditions, including educational fact sheets, dietary information, research news, scientific resources, and clinical guidelines.
Heart Failure Online
Internet address:
http://www.heartfailure.org
Description of services provided:
Also available in Spanish, Heart Failure Online offers an overview of the cardiovascular system, updated information on studies and medications, a thorough section on heart failure, as well as a "frequently asked questions" page.
If you are at risk of developing congestive heart failure (CHF), you can take steps to prevent it by adhering to the following recommended lifestyle guidelines:
- Lose Excess Weight
- Discontinue or Avoid Smoking
- Eat a Healthy Diet
- Maintain Normal Blood Pressure
- Decrease or Discontinue Alcohol Consumption
- Exercise Regularly
Lose Excess Weight
Excess weight can put a strain on the heart muscle, which can eventually lead to CHF. If you are overweight, adopt a sensible eating plan that will enable you to lose weight gradually and maintain your weight at the desired level.
Discontinue or Avoid Smoking
Smoking damages your blood vessels, reduces the amount of oxygen in your blood, and forces your heart to work harder. Discuss with your doctor the best way to help you quit .
Eat a Healthy Diet
Making dietary changes can help to lower your risk of CHF.
Foods that are high in sodium (salt) cause your body to retain fluids. This results in an increased workload for your heart and can worsen symptoms of shortness of breath and swelling in the ankles, legs, and feet. Try to restrict your sodium intake to 2,000 mg daily. You may also want to consult with a dietitian to learn about “hidden” sources of sodium in food.
In addition, try to avoid foods that contain fat and cholesterol, such as:
- High-fat processed meats, such as bologna, sausage, hot dogs
- Solid fats, such as shortening, stick butter, or lard
- Whole milk, cream, ice cream, and cheese
- Baked goods that contain egg yolks and butter
- Fried foods such as fried chicken, french fries, and potato chips
- Fatty red meats or organ meats (such as liver)
- Saturated oils like coconut oil, palm oil, and palm kernel oil
Research suggests that following the DASH diet may reduce the risk of heart failure. The DASH diet is rich in fruits, vegetables, and low-fat dairy foods, and low in saturated fat, total fat, and cholesterol. Eating whole-grain breakfast cereal may lower your risk, as well.
Maintain Normal Blood Pressure
High blood pressure (hypertension) is a critical risk factor for CHF. Patients with poorly controlled blood pressure run twice the risk of developing heart failure compared with those who have normal blood pressure. Hypertension causes the heart muscle to work harder than normal. In response to this increased workload, the heart muscle may thicken, and eventually dilate. The increased strain on the heart, and the changes in the muscle in response to the strain, may eventually result in a weakened heart muscle, and finally heart failure. Discuss with your doctor the best way to reach and maintain a healthy blood pressure.
Decrease or Discontinue Alcohol Consumption
Excessive use of alcohol can weaken the heart, and predispose it to abnormal rhythms. Alcohol also may react with certain heart medications. You should reduce alcohol intake if you are at risk of developing CHF; you will definitely need to discontinue alcohol consumption if you develop CHF. Talk with your physician as to how best accomplish this goal.
Exercise Regularly
For people who have not yet developed CHF, regular aerobic exercise—such as brisk walking or using a stationary bike or treadmill—is recommended. Exercise will strengthen the heart muscle and lower blood pressure, and is recommended in moderation (at least 3-4 times a week for 30 minutes). People with CHF should discuss exercise with their physician. Depending on your symptoms, the severity of your CHF, and the degree of exercise you want to do, your doctor will decide whether or not you need an exercise test before embarking on an exercise program. Your doctor may give you an exercise “prescription.” In general, heavy lifting and over exertion are not recommended for people with severe CHF.
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
Screening Tests or Guidelines
There are no guidelines for screening for congestive heart failure in the absence of symptoms. If you have symptoms or risk factors for heart disease see your doctor.
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Heart Failure Online website. Available at: http://www.heartfailure.org .
Konstam M, Dracup K, Baker D, et al. Heart failure: evaluation and care of patients with left ventricular systolic dysfunction. Clinical practice guideline No. 11. AHCPR publication No. 94-0612. Rockville MD: Agency for Health Care Policy and Research; 1994.
Mayo Clinic Heart Center website. Available at: http://www.mayoclinic.com/health/heart-disease/HB00057 . Accessed January 30, 2007
You have a unique medical history. Therefore, it is essential to talk with your doctor about your personal risk factors and/or experience with congestive heart failure (CHF). By talking openly and regularly with your doctor, you can take an active role in your care.
General Tips for Gathering Information
Here are some tips that will make it easier for you to talk to your doctor:
- Bring someone else with you. It helps to have another person hear what is said and think of questions to ask.
- Write out your questions ahead of time, so you don't forget them.
- Write down the answers you get, and make sure you understand what you are hearing. Ask for clarification, if necessary.
- Don't be afraid to ask your questions or ask where you can find more information about what you are discussing. You have a right to know.
Specific Questions to Ask Your Doctor
The following are some suggested questions to discuss with your doctor, recommended by the American Heart Association:
About Congestive Heart Failure:
- What is my diagnosis?
- Is the heart failure mild, moderate, or severe?
About Your Risk of Developing Congestive Heart Failure
- Am I or is anyone in my family at risk for developing CHF?
- What can I do to prevent CHF?
About Treatment Options
- What are the treatment options for my condition?
- What side effects are caused by this treatment?
- What is likely to happen without treatment?
- Are there any alternative or complementary therapies that will help me?
About Medication
- What medications are available to me?
- Are there any medications, in particular, that would be of benefit to me?
- What are the side effects of these medications?
- What should be done if these side effects occur?
- Will these medications interact with other medications, over-the-counter products, or dietary or herbal supplements that I am already taking?
- What is the name of the medicine? Is this the brand or generic name? Does it matter which one is used?
- What is the medicine supposed to do?
- How and when should it be taken—and for how long?
- What foods, drinks, and other medicines should be avoided while taking this medicine?
- Is any written information available about the medicine?
- A certain medication is causing side effects that are difficult to deal with. Is there some way to minimize those side effects? Is there another equally good medication available?
About Lifestyle Changes
- What are some specific ways that daily life will change?
- Can I still work, play golf, have sex, do the laundry, (fill in whatever activity you're wondering about)?
- What strategies have other patients found useful for motivating themselves to:
- Eat better?
- Exercise?
- Stop smoking?
About Outlook
- What should we expect within the next few weeks, months, and years?
- Can you recommend a support group?
- What is the likely progression of the condition?
- What are the most important things we can do to manage this condition?
