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Krista Scott

Dr. Cassel

English 101

14 November 2018

Congestive Heart Failure

Congestive heart failure, three words yet such a complex topic. Heart failure has

impacted millions not just in the United States but all around the globe. It’s a topic researcher

have studied for years at a time that dates back through generation and generations of scientists

and doctors. It’s a disease that many know so little about. Personally, it’s affected my family in

more ways than I can count. My grandfather and both my grandmothers have been affected by

heart failure and it ultimately was fatal to them. It’s an awful disease that needs more attention

and should be more aware of by others. If people knew more about this disease prevention and

survival could increase so tremendously, I know it would have made a difference in my family if

we knew more about heart failure. So why is congestive heart failure such a critical and

important condition in the human body?

So, what is congestive heart failure? CHF is a progressive, life threatening disease that

worsens over time if left untreated. Heart failure isn't just our nation's problem but a worldwide

issue. Heart failure occurs when the heart cannot pump enough blood and oxygen to other

organs, but it doesn't necessarily mean that the heart has stopped beating. Approximately 5.7

million adults have heart failure in the United States alone, around 550,000 people come down
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with heart failure every year. It’s one of the leading causes of death in the USA. About half of

those diagnosed have a five-year mortality rate. The number of those having to be hospitalized

has skyrocketed from 50-80% and among these statistics it is also proven that 10-50% of those

who have been admitted in the hospital will be admitted again at some point after discharge.

After hospitalization statistics show at least a one-year survival rate after that. Some conditions

can cause this condition to progress faster, and weaken the heart such as, coronary heart disease,

high blood pressure, inflammation or damage to the heart muscle, some medications, kidney

disease even diabetes. The disease is common in both men and women though women tend to

develop it later in life. Congestive heart failure is not a curable disease and is ultimately fatal to

those who have it. Congestive heart failure is a deadly disease that attacks the body but the lack

of knowledge people has of CHF is possibly responsible.

There are four different stages of heart failure, all four stages change the way one

changes their lives and treatment. Stage one or also known as stage A, is when the doctors

consider you in pre-heart failure, the patient is at high risk of developing the disease, due to

family or medical conditions such as, hypertension, diabetes, metabolic syndrome, alcohol abuse,

taking drugs that can damage to heart muscles. Stage two (B), this stage is also when doctors
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consider the patient to be pre-heart failure. This is when the doctors have diagnosed the patient

with Systolic left ventricular dysfunction, but the patient hasn't actually had any symptoms of

heart failure. Most people in this stage have an ejection fraction of 40% or less. Stage 3 (C), this

stage is when doctors have been diagnosed with heart failure and have had or are having

symptoms of CHF. Stage 4 (D), This is the final stage of CHF, this is when you have been

diagnosed with advanced symptoms that will not get better with any treatments. This stage is

usually always fatal. As the disease progresses in stages you cannot go backwards, you can only

prevent yourselves from progressing in the stages.

There’re as well two different types of CHF, heart failure with reduced left ventricular

function and heart failure with preserved left ventricular function. HF-rEF is when “the lower

left chamber of the heart (left ventricle) gets bigger (enlarges) and cannot squeeze (contract) hard

enough to pump the right amount of oxygen-rich blood to the rest of the body.”( Cleveland

clinic, 2). HF-pEF is when “the heart contracts and pumps normally, but the bottom chambers of

the heart (ventricles) are thicker and stiffer than normal. Because of this, the ventricles can't relax

properly and cannot fill up all the way. Because there is less blood in the ventricles, less blood is

pumped out to the rest of the body when the heart contracts.” (Cleveland Clinic, 2).

When it comes to congestive heart failure it’s important to know the symptoms and your

Ejection fraction, for this could make a huge difference in your survival rate with CHF. When it

comes to the symptoms of this disease some may not even have them, some may only be mild or

severe, some can even come and go and won't remain constant. This is why it's important to

know them and identify them if you have factors or family history of CHF, so you know when
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it's time to see a doctor. Some sign of Congestive heart failure includes, Shortness of breath or

trouble breathing, this may occur when you are exercising or simply laying in bed. This occur in

people with CHF because the fluid backs up into the lungs and the body isn't getting enough

oxygen in the blood or heart. This tend to be one of the most severe symptoms. Fatigue and

weakness in everyday activities , occurs when the heart cannot pump enough oxygen rich blood

to major organs and muscles causing one to feel weak. Swelling in the ankles, legs, and

abdomen, sometimes even weight gain. When the kidneys in someone with heart failure dont

filter enough blood the body hold extra fluids and water causing the swelling and weight gain.

Constant need to urinate. Dizziness, confusion, fainting are all also severe symptoms, because

you're not getting the oxygen rich blood to your brain. Rapid or irregular heartbeats, dry

coughing, and loss of appetite or nausea are all symptoms as well. Ejection Fraction also known

as EF makes a huge difference when detecting CHF, it allows doctors to determine the best

treatment for you. EF “refers to how well your left ventricle or right ventricle pumps blood with

each heartbeat. Most times, EF refers to the amount of blood being pumped out of the left

ventricle each time it contracts. The left ventricle is the heart's main pumping chamber.” EF is

measured most commonly by an echocardiogram, other ways include, magnetic resonance

imaging, nuclear medicine scan. EF is expressed as a percentages, anything below normal can be

the first sign of heart failure. Depending on how low your percentage is determines how severe

the patient's condition is. A normal EF is anything between 55% and 70%. EF of 40%-54% is

slightly below normal. This means less blood is available so there is less oxygen rich blood

available in the rest of the body, this is wear you may not develop any symptoms yet. EF of 35%

to 39% is moderately below normal , which means you have mild heart failure. EF of anything
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below 35% is severely below normal and means the ventricles in your heart are not pumping in

unison. This level of ejection fraction is usually life threatening.

Throughout time there has been experiments and studies based on congestive heart

failure. A couple studies such as ones conducted by Nobuyuki Kagiyama, and Yuya Matsue and

Thi Thu Hương Pham, Jintana Yunibhand, and Chanokporn Jitpanya, medical professionals and

students have determined the following relating to CHF. Most clinical trials have failed even

with the introduction of new drugs, some treatments have remained the same for years and years

and continue to have neutral rate of mortality and the cases are not decreasing or continuing to

get better. The REALITY-AHF study shows how time and the furosemide administration are

crucial to future clinical trials and decreasing mortality rates. However time remains to be the

most crucial factor in AHS detection and treatment and as well play a important factor in future

studies. As well as that one major factor was barriers to sodium restrictions. It also showed that

those who knew about heart failure and the self-care requirements recieved more social support,

and this helped them carry out the self-care requirements more frequently. Those with more

knowledge about heart failure and heart failure self care, have a greater chance of survival, and a

decreased hospital admission rate.

So is there a way to prevent and or treat Congestive heart failure? The answer is a solid

yes. Some treatments vary depending on what stage of CHF the patient is in. In stage A and B

treatment includes the following, regular exercise, being active, walking every day

Quitting smoking, treatment for high blood pressure ,medication, low-sodium diet, active

lifestyle. Treatment for high cholesterol, not drinking alcohol or using recreational drugs.
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Medications such as, Angiotensin converting enzyme inhibitor or an angiotensin II receptor

blocker if you have coronary artery disease, diabetes, high blood pressure, or other vascular or

cardiac conditions. Beta-blocker if you have high blood pressure. For more severe stages of

CHF, some doctors will recommend surgery, such as valve repairs or replacements or more

intense surgerys such as a heart transplant. This treatments occurs when you have been

diagnosed with CHF but it’s even easier to just prevent getting it all together by living a healthy

lifestyle and behaviors.

Congestive heart failure is a life threatening disease which if half of the fatal to those who

develop it and destroys the body as a whole. Having an early diagnosis and treatment can

improve those with heart failure tremendously. When treating heart failure those involved need

to be taking their medication, reducing sodium, participle frequently in self care and getting daily

exercise. These can help patients from progressing through the stages of CHF. When you have

family history of CHF it’s important to take precaution and take the steps to improve your health

and lead a healthy lifestyle to prevent developing this disease. It’s all about timing and early

detection as well as livng a good lifestyle and then congestive heart failure isn't as critical as it

should be. When people are informed about CHF and all the facts that go into it, people may not

develop it as much and can control it reducing the number who die from the disease and reduced

the new amount of cases of heart failure that arise.

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Works Cited

“Division for Heart Disease and Stroke Prevention.” Centers for Disease Control and

Prevention, Centers for Disease Control and Prevention, 16 June 2016,

www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm. Accessed 29

October 2018

Nobuyuki Kagiyama, and Yuya Matsue. “The Time-to-Treatment Concept in Acute

Heart Failure: Lessons and Implications from REALITY-AHF.” Anatolian Journal of

Cardiology / Anadolu Kardiyoloji Dergisi, vol. 20, no. 2, Aug. 2018, pp. 125–129.

EBSCOhost, doi:10.14744/AnatolJCardiol.2018.88935.

Jaarsma, Tiny, et al. “Management of Heart Failure in The Netherlands.” European

Journal of Heart Failure, vol. 7, no. 3, Mar. 2005, pp. 371–375. EBSCOhost,

doi:10.1016/j.ejheart.2005.01.007.

“Heart Failure: Understanding Heart Failure Stages.” Cleveland Clinic,

https://my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heart-

failure/stages
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