Overview
Congestive heart failure (CHF) or congestive cardiac failure (CCF) occurs when the heart can no longer pump blood well enough. It is common in older people as the heart may become less efficient with ageing. It causes fluid to build up mainly in the liver, lungs, hands, and feet. The legs and ankles may develop swelling which becomes worse when the person stands and improves when they lie down. If the lungs are involved, fluid accumulation can cause shortness of breath and coughing. This may happen during exercise such as walking up stairs or when lying down flat in bed.
CHF may occur in those who have had a previous heart attack or have high blood pressure, narrowed arteries to the heart or other types of heart disease.
A combination of tests may be used to diagnose the condition, including a physical examination, echocardiogram (ECG), and chest x-ray.
Laboratory tests may include urine testing (urinalysis) and blood tests to check on salt balance and kidney function.
Symptoms of kidney disease are similar to those of CHF. A new blood test is available for use in helping to diagnose CHF called BNP or brain natriuretic peptide. BNP is a substance produced, not by the brain, but by the left main pumping chamber of the heart. Levels of BNP are raised in CHF, and this test may be used to decide which patients should have further investigations.
CHF is usually a progressive disease.
Treatment is aimed at stabilising the condition and treating the symptoms. This usually includes controlling salt intake and water balance and eliminating smoking and alcohol. Regulating these external problems will also help control blood pressure.