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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Chronic Systolic Congestive Heart Failure
Introduction
Chronic systolic congestive heart failure (CHF) is a condition in which the heart's ability to pump blood is weakened. This happens when the left ventricle, which is responsible for pumping oxygen-rich blood to the body, becomes weakened and cannot contract effectively. As a result, less blood is ejected with each heartbeat, leading to symptoms such as fatigue, shortness of breath, and fluid buildup.
Causes
Several conditions can lead to chronic systolic CHF, including: - Coronary artery disease (CAD): Blockages in the coronary arteries reduce blood flow to the heart muscle, leading to weakened contractions. - Hypertension (high blood pressure): Over time, high blood pressure forces the heart to work harder, leading to muscle weakening. - Cardiomyopathy: Diseases that affect the heart muscle can reduce its pumping ability. - Heart valve diseases: Improperly functioning heart valves can make the heart work harder and weaken over time. - Arrhythmias: Abnormal heart rhythms can make the heart less efficient.
Symptoms
Patients with chronic systolic CHF may experience the following symptoms: - Shortness of breath (especially during exertion or while lying down) - Fatigue and weakness - Swelling in the legs, ankles, and feet - Rapid or irregular heartbeat - Persistent cough or wheezing with white or pink-tinged phlegm - Difficulty concentrating
Diagnosis
To diagnose chronic systolic CHF, doctors use several tests, including: - Echocardiogram: Measures the ejection fraction (a percentage that indicates how well the heart is pumping). An ejection fraction of ≤40% suggests systolic heart failure. - Electrocardiogram (ECG): Identifies abnormal rhythms or past heart attacks. - Chest X-ray: Detects fluid buildup in the lungs. - B-type natriuretic peptide (BNP) test: Measures a hormone that rises when heart failure is present. - Cardiac MRI or CT scan: Provides detailed images of the heart’s size and function.
Treatment Principles
Management of systolic CHF involves a combination of lifestyle changes, medications, and sometimes procedures or devices.
1. Lifestyle Modifications
- Reduce salt intake to prevent fluid retention.
- Maintain a healthy weight.
- Engage in regular physical activity as advised by a doctor.
- Quit smoking and limit alcohol intake.
- Monitor daily fluid intake to avoid overloading the heart.
2. Medications
Several classes of medications are used to manage systolic CHF: - ACE inhibitors or ARBs: Help open up blood vessels, making it easier for the heart to pump. - Beta-blockers: Slow down the heart rate and reduce strain on the heart. - Diuretics: Help remove excess fluid from the body, reducing swelling and shortness of breath. - Aldosterone antagonists: Help prevent sodium retention and further heart damage. - SGLT2 inhibitors: Originally designed for diabetes but shown to improve heart failure outcomes.
3. Advanced Treatments
For severe cases, additional treatments may be necessary: - Implantable cardioverter-defibrillator (ICD): Prevents life-threatening arrhythmias. - Cardiac resynchronization therapy (CRT): Helps coordinate the heartbeat. - Heart transplant or ventricular assist devices (VADs): Used in end-stage heart failure.
Conclusion
Chronic systolic CHF is a serious but manageable condition. Early diagnosis and proper treatment can improve quality of life and prevent complications. Patients should work closely with their healthcare team to manage symptoms effectively.
Source recommendations
1. American Heart Association Guidelines on Heart Failure
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
- https://www.heart.org/en/health-topics/heart-failure
- https://professional.heart.org/en/guidelines-and-statements
- https://www.heart.org/en/professional/quality-improvement/get-with-the-guidelines/get-with-the-guidelines-heart-failure
- https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
2. European Society of Cardiology Guidelines on Heart Failure
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
- https://academic.oup.com/eurheartj/article/42/36/3599/6358045
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
- https://academic.oup.com/eurheartj/article/44/37/3627/7246292
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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