The heart is an important organ in the body because it provides the power needed to keep it functioning. It pumps the blood around the body and allows for blood, oxygen and nutrients to be delivered to the different organs. Congestive heart failure is the process in which the heart is not able to eject blood and oxygen to the body. Risk factors include previous heart attacks, heart defects, high blood pressure and infections of the heart valves. The patient is usually tired and requires much rest. Several symptoms develop as a result of this failure.
Dypsnea, Orthopnea and Pulmonary Edema
When the heart is unable to pump out blood, there's a backflow, which results in too much volume overload and goes back to the lungs. This happens especially at night and results in difficult breathing. This symptom is known as dyspnea or shortness of breath. Lungs become congested, which is known as pulmonary edema. Orthopnea happens when the patient is unable to sleep without the aid of placing extra pillows under the head to help increase the effect of gravity and reduce blood returning to the heart. There is evidence of hemosiderin, which are heart failure cells that can be found in the congested lungs.
Heart Sounds
Certain abnormal heart sounds occur during congestive heart failure. Due to the volume overload, a heart sound known as S3 is heard in adults. This increases when the patient is told to hold her breath and then release it, or when the patient takes a deep breath. An S4 heart sound is also heard due to the extra pressure caused by excess blood hitting against the heart walls, resulting in an abnormal increase in pressure. These heart sounds are heard by the physician conducting a physical exam on a patient with congestive heart failure.
Hepatomegaly and Pitting Edema
The backup of blood in the lungs ends up going into the central veins of the liver. This sign is known as hepatomegaly. The liver becomes extremely enlarged. (This is also called nutmeg liver, because the liver has red dots all around it, like a nutmeg.) Hepatomegaly is quite painful as the liver is congested, and it also stops the liver from performing its functions such as drug detoxification.
Pitting edema results with the effect of gravity pulling down the excess volume of blood into the lower region of the body, the legs. There is noticeable swelling in the legs. When the physician presses on the legs, it creates an impression that takes a few seconds to disappear.
