Research Paper: Congestive Heart Failure

Throughout our life, there are many fears; the fear of life, the fear of death, the fear of failure. All are realistic fears that sit in the back of our head whispering to us through our lives. However, it is only when an incident brings to light the reality of how real these fears really are. One of the easiest fears to be reminded of the fear of health and dying. So easily can the complex system that is our body make a tiny mistake that can severely mess up the way we function. One of the most common medical heart issues among people is Congestive Heart Failure which effects more than five million Americans. (“Congestive Heart Failure” 1)

    So as everyone knows, blood is necessary for every human’s survival and understanding that the heart controls all of the blood regulation that means that it would be extraordinarily bad if something were to happen to it. In this the case of congestive heart failure (CHF), it simply means that the heart for some reason is unable to sufficiently pump blood the way it is needed to. The two know types of CHF are when the heart muscle is weak and therefore struggles to pump enough blood to the rest of the body or the other is when the heart cannot pump enough blood through the body even though the heart is squeezing normally. (“Congestive Heart Failure” 1)

    Congestive heart failure can be caused by many things including genetics, weight, age, sex, and preexisting conditions. People who are sixty-five years or older have a higher rate of developing CHF. Also, African Americans are more likely to get it genetically than other ethnicities as well as people who are overweight. Men also have been found to have a higher rate of CHF than women. (“Congestive Heart Failure | Heart Failure | CHF.” 23) Many pre-existing conditions can contribute to congestive heart failure including cardiac

arrhythmia, cardiomyopathy, congenital defects, heart valve disease, high blood pressure, coronary artery disease, diabetes, and people who have had a heart attack. (“Congestive Heart Failure” 1)

    So to predict this major health issue, many signs and symptom have been recorded for the benefit of the public. The signs of congestive heart failure include having shortness of breath, an ongoing cough or wheezing, an irregular or increased heart rate, and a buildup of excess fluids in the tissue which can lead to swelling of the legs, feet, and abdomen. The symptoms of congestive heart failure include fatigue, chest pain, lack of appetite or nausea, and confusion or impaired thinking. It is also important to note that in the case of more severe heart failure, these symptoms can continue even when the person is asleep. (“Warning Signs of Heart Failure.” 1) Some tests can be done to help medical professionals better diagnose CHF. These test can include intravascular ultrasounds (IVUS), Cardiac Angiograph, Electrocardiogram (EKG), Cardiac MRI, Cardiac Computed Tomography, and Cardiac Echocardiogram (ECHO). Some more invasive techniques to get a better look at what is happening with the heart includes heart biopsies and cardiac catheterization. (“Diagnostic Procedures.” 1)

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    Doctors are human too and on many occasions will get it wrong when attempting to diagnose an illness. It can be common to have multiple diseases with the same signs and symptoms. In this case, some of the signs of CHF like wheezing, coughing, and shortness of breath overlap with the signs of cardiac asthma. (“What Is Cardiac Asthma?” 1) Another disease with similar signs to CHF is a pulmonary edema. It has signs of difficulty breathing, persistent coughing and wheezing, and leg or abdominal swelling. (“Pulmonary Edema.” 1) Even cancer has certain symptoms that are the same as in CHF like fatigue, nausea, and chest pain. (“Signs and Symptoms of Cancer | Do I Have Cancer?” 1)

Depending on what type of heart failure you have and what some of the causes of it where, there are various ways including medication, device therapy, lifestyle changes, and surgery to help treat CHF. Once diagnosed with CHF, it is highly suggested that the patient changes their lifestyle to ensure the best results from whatever treatment that they are receiving. They are advised to always take the medications that have been prescribed, change to a low sodium diet, keep active, and make sure to track the symptoms. (“Living with Heart Failure.” 1) 

It is important to note that for medication, it will not cure a person’s heart failure, however, it can help to improve your symptoms and prevent your condition from becoming worse. Medications that are angiotensin receptor blockers (ARB), Isosorbide Dinitrates, Hydralazines and angiotensin-converting enzyme inhibitors (ACE-I) can help to improve the pumping of your heart over time by dilating the blood vessels to help allow more blood flow to the rest of the body. Beta-blocker medications are used to also improve heart function over time by controlling blood pressure and helping the heart to keep a more normal rhythm. Diuretic medications can be used to help pump your heart more easily and can help decrease swelling in the feet, legs, and abdomen by allowing the kidneys to remove extra fluids. Aldosterone Antagonists can help to regulate stress hormones so it does not worsen the heart failure and it can help to increase the potassium levels in the blood. Digoxins and Ivabradine can help to slow the heart rate and allow for a more regular heartbeat. (“Heart Failure Medications.” 1)

Devices that can be used to help the congestive heart failure include an implantable cardiac defibrillator, cardiac resynchronization therapy (biventricular pacing), and ventricular assist devices (VADs) that all are used to help keep more regular pump action within the heart. (“Cardiac Devices for Patients with Heart Failure.” 1) Of course, when the medications, therapy, and lifestyle changes are not enough to resolve the issue, surgery is the last resort. Surgeries to help fix heart failure depending on the issue include coronary artery bypass graft (CABG) surgery, valve surgery, aneurysm repair surgery, and if all else fails, a heart transplant. (“Heart Failure Surgery.” 1)

Patients with a class I (no limitations on life and no apparent symptoms) or class II (few limitations on life and mild symptoms) congestive heart failure have a significantly high survival rate. However, patients with class III (many limitations on life and significant symptoms) or class IV (severe limitations on life and crippling symptoms) congestive heart failure have a significantly low survival rate. In an overall study of the survival rate of people with varying classes of CHF, it was reported that in the first year the survival rate was 78.5%, the third year survival rate was 59.8%, the fifth year survival rate was 50.4%, and the tenth year survival rate was 14.7%. If left untreated, a person with congestive heart failure will die. (Matoba 1)

Having congestive heart failure is not cheap. With just the cost of doctors and hospital appointments averaging $62,509 and medications averaging $942. That’s not even considering the cost of surgery which can range anywhere from 30,000 to 200,000 dollars depending on the type of heart surgery, where it is done at, and who was performing the operation. Not to mention that not everyone is privy to the same medical help as others. A person could require a heart transplant but live in a small town far from a facility authorized to do that procedure. After all of that expense, there still is a 2.94% chance of death after the surgery which might not seem that high but there is little guarantee that the patient will fully recover. It is even harder when the patient has to provide for themselves or the family but is unable to for the duration of the surgery and recovery time. (Xuan 1)

When all is said and done, health is usually the number one priority for most people. It is important to take care of our bodies and make sure everything in our bodies is working properly. If a person was to find out that something was wrong with the way their body was functioning, they should do everything in their power to fix that problem. Unfortunately, not everyone is able to get better after developing congestive heart failure but there are many solutions including medication, therapy, lifestyle changes, and surgeries to help solve the problem. And with more and more solutions being developed every year, we should be hopeful that if any one of us were unfortunate enough to develop CHF, we too could hopefully recover from it and continue to productively live our lives.

Works Cited:

• “Cardiac Devices for Patients with Heart Failure.” Cleveland Clinic, my.clevelandclinic.org/health/treatments/16835-cardiac-devices-for-patients-with-heart-failure.
• “Congestive Heart Failure.” MedStar Heart & Vascular Institute, www.medstarheartinstitute.org/conditions/congestive-heart-failure/.
• “Congestive Heart Failure | Heart Failure | CHF.” MedlinePlus, U.S. National Library of Medicine, 6 Sept. 2018, medlineplus.gov/heartfailure.html.
• “Diagnostic Procedures.” MedStar Heart & Vascular Institute, www.medstarheartinstitute.org/treatments/diagnosis/diagnostic-procedures/#q={}.
• “Heart Failure Medications.” Cleveland Clinic, my.clevelandclinic.org/departments/heart/patient-education/recovery-care/heart-failure/medications#medications-tab.
• “Heart Failure Surgery.” Cleveland Clinic, my.clevelandclinic.org/health/treatments/12905-heart-failure-surgery.
• “Living with Heart Failure.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/17181-heart-failure-living-with-heart-failure.
• Matoba, M, et al. “Long-Term Prognosis of Patients with Congestive Heart Failure.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 1990, www.ncbi.nlm.nih.gov/pubmed/2332933.
• “Pulmonary Edema.” University of Maryland Medical Center, www.umms.org/ummc/patients-visitors/health-library/medical-encyclopedia/articles/pulmonary-edema.
• “Signs and Symptoms of Cancer | Do I Have Cancer?” American Cancer Society, www.cancer.org/cancer/cancer-basics/signs-and-symptoms-of-cancer.html.
• “Warning Signs of Heart Failure.” About Heart Attacks, 31 May 2017, www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure.
• “What Is Cardiac Asthma?” Ice Packs vs. Warm Compresses For Pain – Health Encyclopedia – University of Rochester Medical Center, www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=56&ContentID=DM164.
• Xuan, J, et al. “The Economic Burden of Congestive Heart Failure in a Managed Care Population.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, June 2000, www.ncbi.nlm.nih.gov/pubmed/10977478.