The American Heart Association reports that approximately 5 million Americans have congestive heart failure (CHF). CHF affects every body system. The heart cannot pump enough blood to the body. Tissues and organs do not receive vital nutrients and oxygen. Symptoms worsen as the degree of heart failure progresses. If left untreated, CHF will lead to death.
Weakness
People with CHF experience weakness and fatigue because the heart cannot pump enough blood throughout the body. The body compensates by shunting blood to the brain and major organs. Muscles get much less blood than normal. Mild exertion like walking down to the mailbox or showering can cause significant fatigue.
Central Nervous System
Donna D. Ignatavicius, MS RN, and M. Linda Workman, Ph.D, discuss CHF in the 2006 edition of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care." The failing heart causes low blood pressure or hypotension. Hypotension causes dizziness because there is not enough blood flow to the brain. The elderly are especially susceptible to the effects hypotension and may have confusion and difficulty concentrating.
Pulmonary Congestion
The American Heart Association explains that as the heart fails blood backs up into the pulmonary system. This increases the amount of pressure in the lungs, causing fluid to leak into the alveoli. Alveoli are the oxygen and carbon dioxide exchange units in the lung. As the alveoli fill with fluid, the lungs cannot oxygenate the blood. Patients will experience shortness of breath or dyspnea, cough and wheezing. As the fluid increases, the cough becomes productive with white or blood-tinged frothy sputum.
Edema
As blood backs up in the chambers of the heart, it also backs up in the venous system, causing venous congestion. Neck veins will appear distended and patients will have lower leg edema or swelling. Weight gain will also occur as fluid collects in the legs and abdomen.
Ascites
Ascites is fluid collection in the abdomen. Venous congestion causes fluid to leak into the abdominal cavity. This causes a feeling of fullness and a loss of appetite. The abdomen can hold up to 10 liters of fluid. Abdominal distention will cause dyspnea especially if CHF patients try to recline. The increased abdominal pressure will decrease normal gastrointestinal activity, leading to indigestion and constipation.
Organ Failure
CHF leads to venous congestion, which can cause blood to back up in the liver, resulting in an enlarged liver. The kidneys are susceptible to the effects of CHF. Hypotension causes the kidneys to retain fluid in order to increase blood pressure. Unfortunately this compensation mechanism only increases the amount of systemic fluid, increasing the work load on the heart. The result is a further drop in blood pressure. Over time, hypotension damages the kidneys. Oliguria, or decreased urine output, will occur and may lead to kidney failure.
References
- American Heart Association: What Is Heart Failure?
- "Medical-Surgical Nursing: Critical Thinking for Collaborative Care"; Donna D. Ignatavicius MS RN, and M. Linda Workman Ph.D; 2006
- American Heart Association: Signs and Symptoms of CHF
