Congestive Heart Failure (cont.)
What causes congestive heart failure?
Many disease processes can impair the pumping efficiency of the heart to cause
congestive heart failure. In the
United States, the most common causes of congestive heart failure are:
Less common causes
include viral infections of the stiffening of the heart muscle, thyroid disorders,
disorders of the heart
rhythm, and many others.
It should also be noted that in patients with underlying heart disease, taking certain
medications can lead to the development or worsening of congestive heart failure. This is especially true for
those drugs that can cause sodium retention or affect the power of the heart muscle.
Examples of such medications are the commonly used nonsteroidal antiinflammatory drugs (NSAIDs),
which include ibuprofen (Motrin and others)
and naproxen (Aleve and
others) as well as certain steroids, some diabetic medication, and some calcium
channel blockers.
What are the symptoms of congestive heart
failure?
The symptoms of congestive heart failure vary among individuals according to the particular
organ systems involved and depending on the degree to which the rest of the body
has "compensated" for the heart muscle weakness.
- An early symptom of congestive
heart failure is fatigue.
While fatigue is a sensitive indicator of possible underlying congestive heart
failure, it is obviously a
nonspecific symptom that may be caused by many other conditions. The person's ability
to exercise may also diminish. Patients may not even sense this decrease and they may
subconsciously reduce their activities to accommodate this limitation.
- As the body
becomes overloaded with fluid from congestive heart failure, swelling (edema) of the ankles and legs or abdomen
may be noticed.
- In addition, fluid may accumulate in the lungs, thereby causing
shortness of breath, particularly during exercise and when lying flat. In some
instances, patients are awakened at night, gasping for air.
- Some may be unable
to sleep unless sitting upright.
- The extra fluid in the body may cause increased
urination, particularly at night.
- Accumulation of fluid in the liver and intestines
may cause nausea,
abdominal pain, and decreased appetite.
Next: How is congestive heart failure diagnosed? »
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