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Congestive Heart Failure - Medical Negligence
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Congestive heart failure is also known as heart failure. It occurs when the heart is unable to pump enough blood around the body. The heart tends to be enlarged and the force of the contraction is weaker than normal. It can be due to conditions such as narrowed arteries in the wall of the heart or from high blood pressure that interferes with the force of heart contractions. The heart can become too stiff to contract normally. Congestive heart failure is usually a chronic condition that requires long term medications and lifestyle changes.
The major chronic heart failure symptoms include weakness and fatigue, shortness of breath on exertion or when lying flat, rapid or irregular beating of the heart, swelling of the ankles and feet, decreased exercise tolerance, abdominal swelling, wheezing or cough, usually with blood tinged sputum, overall fluid retention, nausea and lack of appetite, and decreased concentration or alertness.
If you have acute heart failure, the symptoms are basically the same but you have them occur suddenly with coughing, bloody sputum, foamy mucus when coughing, and pain in the chest that occurs when the chest pain is caused by a heart attack or angina. You need to seek medical attention if the symptoms suddenly worsen or change, especially if you are uncomfortable or short of breath.
There are many risk factors for congestive heart failure. These include:
- Coronary artery disease. A lack of circulation to the heart can cause the heart to beat inefficiently.
- High blood pressure. The heart will have to work harder if it has to pump against a higher circulating blood pressure.
- Having a heart attack. This can result in acute or chronic congestive heart failure or both.
- Diabetes. Diabetes increases the risk of coronary arterial dysfunction and high blood pressure.
- Having an irregular heartbeat. This causes the heart to pump inefficiently.
- Certain diabetic medications seem to increase the risk of congestive heart failure.
- Congenital heart defects. These are deformities of the heart that you are born with.
- Sleep apnea. This is when you have breathing problems at night due to blocked airway passages.
- Use of alcohol. This can weaken the muscle of the heart and can contribute to heart failure.
- Certain viruses can contribute to heart damage and weakness.
Doctors can diagnose congestive heart failure in many ways. Chest x-rays can show an enlarged heart that isn't pumping properly. An echocardiogram can detect, using ultrasound, the size, shape and blood flow within the heart. It can measure the ejection fraction of the heart, which is how much blood ejects from the heart at one time. The normal level is 55 percent. A blood test for brain natriuretic peptide or BNP is a way of checking the pressure of blood within the heart.
Doctors can also do a stress test, which assesses how the heart works during activity. It can be combined with an echocardiogram in a test called a "stress echo" which can tell if the heart is weaker after exercise. A CT scan of the heart can show the anatomy of the heart and the thickness of the muscle of the heart. The muscle is generally very thick if there is high blood pressure acting against the heart. An MRI of the heart works similarly to a CT scan of the heart. In some cases, doctors do a coronary angiogram, in which dye is inserted into the arteries of the heart and an x-ray can show how the heart functions and what is going on in the coronary arteries.
Treatment of heart failure involves medications and lifestyle changes. You will need to eat less salt, which increases the volume of blood your heart has to pump against. Regular exercise is important. You need to stop drinking alcohol and stop smoking.
Medications that help control congestive heart failure include medications that control the heart rate, the blood pressure, the strength of the heart and the amount of fluid in the system. Sometimes doctors can reverse congestive heart failure by fixing the underlying problem. Medications include angiotensin-converting enzyme inhibitors which dilate the arteries and help lower blood pressure. The workload on the heart is diminished. Angiotensin II receptor blockers such as Cozaar are also used in a similar way as ACE inhibitors. Digoxin strengthens the heart muscle directly and keeps the heart slow and steady. Beta blockers lower both the heart rate and the blood pressure. They directly manage some heart rhythm problems. Diuretics like Lasix keep fluid off the body and reduce the heart's workload. The same is true of Aldactone, which is a potassium sparing diuretic.
Some people will need surgery to correct their congestive heart failure. This can include coronary artery bypass surgery to open up the blood vessels and heart valve replacement or repair, which helps the heart function better. There are heart pumps that are implanted in the chest or stomach that helps improve the function of the heart. Pacemakers can keep the heart pumping at a regular, steady pass. In rare cases, a heart transplant is needed.