Congestive heart failure

Congestive heart failure (CHF) (also called congestive cardiac failure and heart failure) is the inability of the heart to pump a sufficient amount of blood throughout the body, or requiring elevated filling pressures in order to pump effectively.

Treatment

The treatment of CHF focuses on treating the symptoms and signs of CHF and preventing the progression of disease. If there is a reversible cause of the heart failure (e.g. infection, alcohol ingestion, anemia, thyrotoxicosis, arrhythmia, or hypertension), that should be addressed as well.

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Treating the signs and symptoms of CHF involves maintaining a euvolemic state (normal fluid level in the circulatory system). This is done with the judicious use of diuretic agents, vasodilator agents, and positive inotropes. Certain subgroups may benefit from Bi-ventricular pacemaker placement or surgical remodelling of the heart. While these treatment modalities may make the patient symptomatically better, either they have not been shown to improve survival in large clinical studies or those studies have not been performed.

Related Topics:
Diuretic - Vasodilator - Inotrope - Bi-ventricular pacemaker

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In the recently completed COMPANION trial, cardiac resynchronization therapy (pacing both the left ventricle as well as the right ventricle) has been shown to improve survival in individuals with NYHA class III or IV heart failure with a widened QRS complex on EKG.2

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Delaying the progression of heart failure involves the use of ACE inhibitors, beta blockers, and aldosterone inhibitors. These agents have been proven to improve survival in individuals with CHF. While the mechanism of improving is not entirely clear, it appears that these agents prevent remodelling of the heart and therefore prevent progression of dilatation of the left ventricle.

Related Topics:
ACE inhibitor - Beta blocker - Aldosterone inhibitor

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The ultimate treatment is cardiac transplant surgery (heart transplant) or implantation of an artificial heart.

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