Congestive heart failure occurs when the heart muscle doesn't pump blood as well as it should. Stephanie Yenter, cardiac and pulmonary rehab coordinator with ThedaCare said certain conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump efficiently. “The heart does not need to be weakened to cause heart failure,” she said. “It can become stiff.”
In heart failure, the ventricles may become stiff and not fill properly between beats. In some cases of heart failure, the heart muscle may become damaged and weakened, and the ventricles stretch to the point that the heart can't pump blood efficiently throughout the body. Over time, the heart can no longer keep up with the normal demands placed on it to pump blood to the rest of the body. “One way to prevent heart failure is to control conditions that cause heart failure, such as coronary artery disease, high blood pressure, diabetes or obesity,” said Yenter.
Heart failure can be chronic or may start suddenly. Heart failure signs and symptoms may include:
- Shortness of breath (dyspnea) when exerting the body or laying down
- Fatigue and weakness
- Swelling (edema) in legs, ankles and feet
- Rapid or irregular heartbeat
- Reduced ability to exercise
- Persistent cough or wheezing with white or pink blood-tinged phlegm
- Increased need to urinate at night
- Swelling of your abdomen (ascites)
- Sudden weight gain from fluid retention
- Lack of appetite and nausea
- Difficulty concentrating or decreased alertness
- Sudden, severe shortness of breath and coughing up pink, foamy mucus
- Chest pain if the heart failure is caused by a heart attack
An ejection fraction is an important measurement of how well the heart is pumping and is used to help classify heart failure and guide treatment. In a healthy heart, the ejection fraction is 50 percent or higher, meaning that more than half of the blood that fills the ventricle is pumped out with each beat. But heart failure can occur even with a normal ejection fraction. This happens if the heart muscle becomes stiff from conditions such as high blood pressure.
The term congestive heart failure comes from blood backing up into, or congesting, the liver, abdomen, lower extremities and lungs. “However, not all heart failure is congestive,” said Yenter. “One might have shortness of breath or weakness due to heart failure and not have any fluid building up.”
Medicare and insurances are paying for those individuals diagnosed with congestive heart failure if their ejection fraction is less than 35 percent. Patients attend cardiac rehab up to three days per week. “The cardiac rehab program at Riverside Medical Center in Waupaca provides education and exercise to help heart patients increase physical fitness, reduce cardiac symptoms, improve health and reduce the risk of future heart problems,” said Yenter, noting the program meets in the 900 Building on the Riverside Medical Center campus.
