Heart failure:Inability of the heart to keep up with the demands on it and, specifically, failure of the heart to pumpbloodwith normal efficiency. When this occurs, the heart is unable to provide adequate blood flow to other organs such as thebrain, liver and kidneys. Heart failure may be due to failure of the right or left or bothventricles. The signs and symptoms depend upon which side of the heart is failing. They can includeshortness of breath(dyspnea), asthma due to the heart (cardiacasthma), pooling of blood (stasis)inthe general body (systemic)circulationor in the liver's (portal) circulation, swelling (edema), blueness or duskiness (cyanosis), and enlargement (hypertrophy) of the heart.
There are many causes of congestive heart failure including: (1) coronaryarterydiseaseleading to heart attacks andheart muscleweakness, (2)primaryheartmuscleweakness fromviralinfections or toxins such as prolongedalcoholexposure, (3) heart valve disease causing heart muscle weakness due to too much leaking of blood or heart muscle stiffness from a blocked valve, and (4) hypertension (high blood pressure). Rarer causes include hyperthyroidism (highthyroid hormone), vitamin deficiency, and excessamphetamine("speed") use.
The aim oftherapyis to improve the pumping function of the heart. General treatment includessaltrestriction,diuretics(to get rid of excess fluid),digoxin(to strengthen the heart), and other medications. A drug calledspironolactonehas been found to be amajorhelp in treating congestive heart failure Its beneficial effects are additive to those fromACE inhibitors, another class of drugs commonly relied on in treating heart failure. A pacemaker-like device is also now available to treat heart failure. The implantable device delivers synchronized electrical stimulation to three chambers of the heart, enabling the heart to pump blood more efficiently throughout the body.
