Congestive heart failure (CHF) is a syndrome, not a disease, that can be brought about by several causes.

CHF is a weakening of the heart brought on by an underlying heart or blood vessel problem, often a combination of several different problems, including the following:

Weakened heart muscle Damaged heart valves Blocked blood vessels supplying the heart muscle (coronary arteries), leading to a heart attack Toxic exposures, like alcohol or cocaine Infections High blood pressure that results in thickening of the heart muscle (left ventricular hypertrophy) Pericardial disease, such as pericardial effusion (a large collection of fluid around the heart in the space between the heart muscle and the thick layer of pericardium surrounding the heart) and/or a thickened pericardium, which does not allow the heart to fill properly Congenital heart diseases Prolonged, serious arrhythmias

CHF is often a result of the following lifestyle habits:

Unhealthy habits, such as smoking and excessive use of alcohol, are often to blame. Obesity and lack of activity may contribute to CHF, either directly or indirectly through accompanying high blood pressure, diabetes, and coronary artery disease. Years of uncontrolled high blood pressure damages both heart and blood vessels.

Whether through disease or lifestyle choices, the pumping action of the heart can be impaired by several mechanisms:

Heart muscle damage (cardiomyopathy): The heart muscle can become weak because of damage or disease and thus does not contract or squeeze as forcefully as it should. This damage to the muscle can occur from coronary heart disease (coronary artery disease) leading to a heart attack, or long-standing high blood pressure, viral infection, alcohol abuse, diabetes, or many other less common causes. Sometimes, the cause is not known.

Heart attack (myocardial infarction): A heart attack commonly causes severe pain in the chest, shortness of breath, nausea, sweating, and/or a feeling of impending doom. Heart attack may rapidly lead to either cardiac arrest (no heartbeat) or permanent damage of the left ventricle. If this damage is bad enough, that part of the heart will not work properly, which leads to heart failure. High blood pressure (hypertension): Abnormally high blood pressure increases the amount of work the left ventricle has to do to pump blood out into the circulatory system. Over time, this greater workload can damage and weaken the heart. This can lead to heart failure if this damage is allowed to go on unchecked. Proper treatment of high blood pressure can prevent left ventricular hypertrophy and heart failure. Heart valve problems: The valves of the heart normally keep the blood flowing in the right direction through the heart. Abnormal heart valves impede this forward flow in 1 of 2 ways.
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An incompetent valve is a valve that does not close properly when it should and allows blood to flow backward in the heart, "against the current." When blood flows the wrong way across a valve, the heart has to work harder to keep up its output. Eventually, this backed up blood accumulates in the lungs and the body. A stenotic valve is a valve that does not open properly when it should. Blood flow through the narrowed opening is blocked, creating an increased workload on the heart.

Abnormal rhythm or irregular heartbeat: Abnormal heart rhythms lower the heart's effectiveness as a pump. The rhythm may be too slow or too fast, or irregular. The heart has to pump harder to overcome these rhythm disorders. If this excessively slow or fast heartbeat is sustained over hours, days, or weeks, the heart can weaken, which can cause heart failure. Other conditions may have injured the heart such as thyroid disorders (too much or too little thyroid hormone) or treatments for cancer (radiation or certain chemotherapy drugs).

Congestive Heart Failure Symptoms

People with congestive heart failure (CHF) sometimes do not suspect a problem with their heart.

The early symptoms are often shortness of breath, cough, or a feeling of not being able to get a deep breath. If you have a known breathing problem, such as asthma, chronic obstructive pulmonary disease (COPD), or emphysema, you may think you are having an "attack" or worsening of that condition.

If you usually do not have breathing problems, you may think you have a cold, flu, or bronchitis. To make matters worse, any or several of these conditions may coexist along with congestive heart failure.

Congestive heart failure has the following 3 major symptoms:

Exercise intolerance
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A person may be unable to tolerate exercise or even mild physical exertion that he or she may have been able to do in the past. The body needs oxygen and other nutrients during physical activity. A failing heart cannot pump enough blood to provide these nutrients to the body. The ability to exercise, even to walk at a normal pace, may be limited by feeling tired (fatigue) and having shortness of breath. Ordinary activities, such as sweeping, vacuuming, pushing a lawnmower, or even walking about the house, may be difficult or impossible.

The shortness of breath that accompanies these activities usually gets better with rest.

Shortness of breath
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If a person has CHF, he or she may have difficulty breathing (dyspnea), especially when he or she is active. When CHF worsens, fluid backs up into the lungs and interferes with oxygen getting into the blood, causing dyspnea at rest and at night (orthopnea). If a person has CHF, he or she may awaken at night short of breath and have to sit or stand up to get relief. This is called paroxysmal nocturnal dyspnea. Several pillows may help with a more comfortable sleep. A person may also prefer sleeping in a recliner rather than in a bed. As the buildup of fluid in the lungs becomes very severe, a frothy, pink liquid may be coughed up.

Fluid retention and swelling

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Puffy swelling (edema) in the legs, the feet, and the ankles may occur, particularly at the end of the day or after prolonged sitting or standing. Often, the swelling is more noticeable in the ankles or on the lower leg in the front where the bone is close to the skin.

Press down on the skin in the puffy areas; the indentation where the finger pressed may be visible for a few minutes. This is called pitting edema. Nonpitting edema is not caused by heart failure. Pitting edema is not synonymous with heart failure; it can have other causes, including liver and kidney failure. Swelling may be so severe as to reach up to the hips, scrotum, abdominal wall, and eventually the abdominal cavity (ascites). Daily weight checks are mandatory in persons with heart failure because the amount of fluid retention is usually reflected by the amount of increasing shortness of breath and weight gain. Persons with heart failure should know what their dry weight is or what they weigh when they feel good with no pitting edema.

Congestive heart failure usually does not cause chest pain. Remember, though, that other serious conditions that do cause chest pain, such as angina and myocardial infarction, can coexist with heart failure.

Mekanisme edema dan fatigue

a. EFFECT OF SMOKING CIGARETTES 10pcs/day Kandungan Rokok CO Pengaruh Bagi Tubuh Menimbulkan desaturasi Hb Mengganggu pelepasan O2 ke jaringan sehingga mengurangi persediaan O2 jaringan (termasuk pada miokardium) kurangnya kemampuan hemoglobin untuk mengikat oksigen. Mempercepat terjadinya aterosklerosis. Nikotin Menyebabkan ketagihan merokok Merangsang pelepasan adrenalin Mengganggu sistem saraf simpatis akibat meningkatnya kebutuhan O2 Meningkatkan frekuensi denyut jantung Mneingkatkan tekanan darah Meningkatkan kebutuhan O2 jantung Meningkatkan irama jantung TAR Menyebabkan gangguan jalan nafas, seperti batuk dan sesak nafas Menempel pada lidah, bibir, dan jalan napas Cadmium Ketika diisap, cenderung tertahan di ginjal sehingga memperparah level hipertensi.

 Diuretics sometimes called water pills; diuretics remove excess fluid from the body. Diuretics are often the first line of treatment. A significant side effect is the loss of potassium in the urine, which may result in electrolyte abnormalities. Angiotensin-converting enzyme (ACE) inhibitors These drugs have been shown to improve survival among patients with CHF by lowering blood pressure. Side effects include dangerously low blood pressure, dizziness, coughing, and birth defects. Beta blockers These drugs slow the heart rate by making it less sensitive to adrenaline (epinephrine). This medication may be given after a patient's condition has been made stable on ACE inhibitors. Side effects may include weight gain, tiredness, dizziness, and sensitivity to cold. Patients who have a slow heart rate, elevated systolic blood pressure, peripheral vascular disease, asthma, or chronic obstructive pulmonary disease, or who have had certain heart rhythm abnormalities should not take beta blockers.

Digoxin Digoxin is used to control the symptoms of some forms of CHF and to control heart rate irregularities. Side effects include abdominal pain, nausea or vomiting, diarrhea, and, rarely, dangerous heart rhythm abnormalities

Working with a knowledgeable physician, patients with CHF may consider adding any of these supplements to their program: Hawthorn relaxing blood vessels to lower blood pressure, increasing blood flow to the heart, and controlling heart rate in a way that is similar to digoxin. helps improve exercise tolerance and has shown promise in the treatment of left ventricular dysfunction.

Magnesium and potassium magnesium supplementation may normalize potassium and magnesium levels within the heart. Blood tests can help determine if magnesium or potassium levels are low in response to diuretic therapy

DISEASE

Shortness of breath

Fatique

Nausea

Chest pain

Fever

Cough

Palpitation

Aortic stenosis

yes

Yes

No

Yes

No

No

Yes

Endocarditis Pericarditis Mitral valve prolapse

Yes Yes Yes

Yes Yes Yes

No No No

No No Yes

Yes Yes No

Yes Yes No

No No No

Myocarditis Congestive heart failure

Yes Yes

Yes Yes

No No

Yes Yes

Yes Yes

No Yes

No No

Rhuematic heart diseases

Yes

Yes

Yes

No

Yes

Yes

Yes

Antioxidant vitamins antioxidants such as vitamins C and E have been shown to have a lower incidence of heart disease