The heart pumps blood, which supplies nourishment to all parts of the body, including
itself. During each contraction, the heart pumps out a certain amount of blood but under
certain circumstances, such as in severe anaemia, chronic infection of lungs, overactivity
of the thyroid gland, rheumatic or bacterial heart disease, disease of heart muscles, after
a larger myocardial infarction (heart attack) and high blood pressure, its pumping capacity
gets decreased. This condition is called heart failure or congestive heart failure. Heart
failure does not mean stoppage of the heart as is generally believed. The decreased output
of the blood leads to back pressure of blood, causing enlargement of the heart and
engorgement of the veins. Due to this back pressure, some amount of fluid and sodium ions
pass out of the capillaries and collect in the tissues, causing swelling or edema. There is
also congestion of blood in the lungs, leading to difficulty in breathing and inducesing
cough. There is a decrease in the working capacity and even walking may be difficult. An
X-ray of chest, electrocardiogram and echocardiogram (ultrasonic examination of heart)
usually reveals the cause of congestive heart failure (CHF).
Treatment and Drugs
The treatment of heart failure includes general measures and drug treatment.
Bedrest: The patient must take adequate bedrest, for 10 to 15 days. The rest decreases the
work of the heart and helps in early recovery.
Diet: In congestive heart failure there is collection of fluid with sodium in extracellular
tissues. The intake of sodium chloride in the diet should be drastically reduced to 2 to 3 g
per day.
Drugs: The aim of drug treatment is to increase the power of contraction of the heart
muscle, control sodium and water retention, and decrease the workload on the heart and
improve heart performance.
Drugs which can contribute to the CHF such as verapamil, pain relievers, steroid hormones,
propanolol should be stopped.
by Franchis Adam
