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Friday, September 12, 2008

Recognizing Congestive Heart Failure Symptoms

Congestive heart failure symptoms, or simply heart failure symptoms, is a condition that occurs when the heart is unable to pump enough blood to meet the normal needs of the body's tissues. It interferes with the kidney's usual function of eliminating excess sodium and other waste from the body. Congestive heart failure can affect either the right side, left side or both sides of the heart. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise, shortness of breath, and swelling. Today, however, there are many effective measures that can be utilized to improve the symptoms, and the survival, of patients with congestive heart failure.

While all cardiac conditions carry similar symptoms of chest pain and difficulty breathing, congestive heart failure has a very specific set of symptoms and lab results, giving doctors a firm set of clues upon which to base a definite diagnosis.

Dyspnea, or difficulty breathing, coupled with severe edema (when the body retains fluid to the point of holding the imprint of an object that is pressed into the skin for several minutes) are generally the first symptoms pointing to congestive heart failure. It results in the heart not being able to efficiently pump blood throughout the body; as a result, fluid accumulates rather than being removed and causes the body to swell as if it were a water balloon. Non-pitting edema, or fluid retention that does not hold an imprint, is not caused by heart failure and indicates that another diagnosis should be made. The patient may also produce a frothy pink sputum when they cough.

In addition to the symptoms related to the fluid accumulation, general weakness and malaise, particularly during times of physical exertion are frequent symptoms of patients suffering from congestive heart failure, and should not be ignored. This is caused by a lack of nutrients and oxygen from the blood to the body tissues, and can result in permanent damage to the internal organs if they are left without these vital elements for a prolonged period of time. Anuria, or a lack of urination, is also evidential of heart failure as fluid accumulates in the tissues rather than being excreted as normal. Patients may suffer from an altered mental status due to toxins accumulating in the body.

As soon as the physician suspects heart failure based on the physical evidence, blood samples will be sent to the laboratory. BNP, or Beta-natriuretic peptide, is excellent for screening in suspected cases of heart failure. This hormone is produced in greater quantities by the failing heart muscle as fluid levels rise, with a level between one hundred and five hundred pg/mg suggesting congestive heart failure and greater than five hundred being fairly diagnostic; however, an elevated BNP should not be considered to be sufficient evidence upon which to base a decisive diagnosis, as conditions like renal failure, ventricular strain, tumors or hypoxia can also cause BNP levels to rise too. Arterial blood gases may be tested to determine the degree of hypoxemia. A decreased erythrocyte sedimentation rate, proteinuria (protein in the urine), and a mild azotemia (elevated blood urea level) becomes evident in early to moderate disease. An increased serum creatinine, hyperbilirubinemia (increased bilirubin in the blood) and dilutional hyponatremia (decreased serum sodium levels) are also evidence that the patient is suffering from a more advanced case of heart failure.

Radiology can also perform imaging studies to evaluate the condition of the heart. A chest x-ray will usually reveal cardiomegaly (enlargement of the heart) and pleural effusion (fluid around the heart). An echocardiogram is performed to study the internal structures of the heart to evaluate for any structural abnormalities, as in the case of mitral stenosis. This provides confirmation to determine the underlying cause of congestive heart failure, particularly in suspected cases of valvular heart disease.

Physicians are very like detectives, in that once these tests have all been run they will gather these pieces of evidence together to form a fairly accurate picture of the patient's condition, allowing for an accurate diagnosis leading to proper treatment.

Today there are many effective measures that can be used to improve the symptoms, and the survival, of patients with congestive heart failure.

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