Congestive Heart Failure

Congestive heart failure (CHF) refers to the heart being unable to perform as effectively as it should. During this time there is fluid that builds up around the heart which effects how the heart muscles pump blood throughout your body.

When blood cannot be fully circulated to other organs, CHF causes fluid to be retained in the lungs, abdomen, and lower extremities. When you have fluid on your lungs, you will likely experience shortness of breath. At any point, if you notice you’re having shortness of breath (especially worse than normal) you need to be evaluated by your physician.

Also if you notice you’re carrying a lot of what feels like fluid or water weight in your abdomen, this can indicate complications with your CHF.

Not everyone who has lower leg swelling has CHF, it could be a potential side effect of medication. Commonly we see patients that have been on Amlodipine (blood pressure medication) that have experienced leg swelling after the dosage is increased from 5 mg to 10 mg. If this happens, let your doctor know so he/she can make adjustments as needed.

Causes

Those at risk for Congestive Heart Failure have one or more of the following conditions:

  • Hypertension (high blood pressure)
  • Coronary Artery Disease
  • Heart valve problems
  • Diabetes
  • Thyroid disease
  • Obesity
  • Severe allergic reactions & infections

Testing

There are a few ways that patients are diagnosed with Congestive Heart Failure, most routinely any heart testing starts off with an EKG. The EKG is a non-invasive procedure where you lay down on a table and are hooked up to a machine that measures your heart rhythm as it looks for any irregularities. The results for this test print out within 20 seconds or so and the doctor will review the results with you.

I haven’t seen any doctor that is looking for that diagnosis use that as a confirmatory test and do nothing else. The next step would be an Echocardiogram which is an ultrasound of your heart. I’ve had this done a few times, it’s also an easy procedure. You just lay down and they take some cold jelly and an ultrasound wand and take a look at your chest. The pictures taken of your heart will be reviewed by a cardiologist and the doctor will notify you of the results within 2-3 business days.

Baseline testing also includes some blood work to check your cardiac enzymes and your electrolyte levels. These types of tests don’t require that you are fasting so they are normally done the same day you go into see your doctor. Unless he/she is not concerned that this is an emergent situation and you happen to be due for your fasting cholesterol tests. If that’s the case you may be asked to return to the lab when you haven’t ate or drank anything in 10-12 hours.

An MRI can also be performed, but isn’t really a routine test. For any patients that have metal in the body, an MRI is not allowed as it is a huge magnet.

In addition to the Echocardiogram, a stress test can be ordered to see how well your heart performs under “stress”. If you’re someone that is unable to stand or walk/run on a treadmill, the doctor will order a nuclear medicine stress test. This test involves getting a substance injected into your blood which simulates exercise without actually having to perform it.

A regular stress test is done hooked up to a treadmill and a few wires as you jog/run. The doctor will increase the speed you’re going in order to get your heart rate up to a desired range. If you cannot reach the desired range for your heart rate, the test will be inconclusive. It is important to follow all instructions given for the prep for any of these tests.

Invasive Procedure

Although minimally invasive, if the doctor finds an abnormality on the screening tests, he/she may want to schedule you for a cardiac cath. Most of the time this is a small incision in the groin or wrist and the recovery time is fairly quick.

The cardiac cath involves a camera taking a look at the inner part of your coronary arteries to rule out any sort of blockages that can lead to a heart attack. If there’s anything significant, the doctor may place a cardiac stent that allows the blood to flow as it should.

Treatment

There are several different types of medications that are used to treat Congestive Heart Failure. Some are specific to reducing the fluid around the heart or legs which is called a diuretic. Other medications are for heart rhythm and blood pressure.

Monitoring

If you are someone who is newly diagnosed with CHF, your primary care doctor will refer you to a cardiologist for complete workup and evaluation. Once you are considered stable, your Cardiologist may release you to be managed through your primary care provider.

Some people are more comfortable with seeing a cardiologist for heart related issues, which isn’t a bad idea. Depending on how well you’re doing as far as your symptoms, lab results, blood pressure readings, and physical exam, your Cardiologist may want to see you every 3-6 months for an appointment in the office. If you’re an all-star patient, it may just be annually.

Gadgets

For someone with congestive heart failure, it’s a good idea to have on hand a digital scale to weigh yourself and an at home blood pressure monitor. The scale is so that you weigh yourself every morning and that way you can keep an eye on how much fluid retention you’re having.

If you notice an increase in your weight of more than 2-3 lbs (or whatever your doctor dictates) within a day- your doctor may want to hear about this because it’s an indication that your medication may need to be adjusted. It’s just a good way to stay ahead of the troublesome issues that comes along with having this condition.

For anyone looking to get a blood pressure monitor, make sure you take it (after purchase) to your primary care or cardiologist office so you can check the accuracy of the machine. Not all blood pressure machines are created equal.

I will say when buying a new machine, I would avoid he wrist cuffs as they are the least accurate form of blood pressure monitoring. It always fluctuates way more than it should and a slight twist of the wrist can throw a reading off by 20 points in either direction.

The automatic arm cuff is ideal, make sure you measure the top part of your arm (where the cuff goes) to ensure you’re getting the right size. If you have a cuff that is too small or too big, your readings won’t be correct.

You can also see if your doctor can write you a prescription for a blood pressure monitor and you can take that to a Durable Medical Supply company to see if your insurance will pick up any of that cost.

Let me know if you have any further questions or concerns regarding the information provided and I look forward to chatting with you all soon! For those that are new here, be sure you JOIN the community by clicking the red button below so we can get a chance to get to know each other and I can answer any questions you may have. Make it a great rest of your day!

Chelsea

Your Advocate for Health & Hope

References: Healthline.com

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