Keep the Beat

Congestive heart failure (CHF) is a common diagnosis indicating the heart isn't functioning as it should. Thankfully, the condition can be managed successfully.

In the past, CHF was often called dropsy. Old medical texts show blue-lipped people swollen up to their waists and struggling to breathe. Their only hope was an extract of the lowly foxglove plant digitalis. That changed when President Dwight D. Eisenhower was diagnosed with "congested heart disease" and was given a new drug, Lasix (furosemide).

Now, 50 years later, there are many treatments available, including cardiac catheterization, pacemakers and defibrillators. CHF has become a disease that more people live with than die from.

So, what exactly is CHF?

The heart is a muscle and, like other muscles, it gets a little weaker as we age. The heart's job is to pump blood throughout the body. If the muscle is weak, blood and fluids accumulate in the legs, causing swelling. Fluid also accumulates in the base of the lungs, causing shortness of breath. For some people, the first sign of CHF is coughing, as the body tries to rid itself of excess fluid in the lungs.

There are several ways of diagnosing CHF. The most common is an echocardiogram. This painless ultrasound of the heart yields a wealth of information. It may show left ventricular hypertrophy, which is a more precise way of describing an enlarged heart.

An echocardiogram is used to measure the ejection fraction (EF), a calculation that shows how well the heart is pumping. A normal EF is 60 percent. Many CHF patients have an EF of 35 to 50 percent. A decreased EF can make people feel tired, weak and short of breath.

Another finding you'll see on an echocardiogram is diastolic dysfunction. The heart is always pumping and relaxing, pumping and relaxing. The pumping stage is called systole (it's the top number in a blood pressure reading). The relaxing stage is called diastole (the bottom number in a blood pressure reading). Diastolic dysfunction means the heart doesn't relax back into shape, which may cause a type of heart failure.

Today, there are many opportunities to successfully manage CHF. Medications are now able to lessen the workload of the heart. A cardiology consultation is recommended, as well as CHF education and lifestyle changes such as eating healthfully and exercising routinely. Joining a CHF support group can improve the psychological and emotional effects of CHF while providing individuals with the opportunity to share and ask questions about their condition.

Support from Others with CHF

Parrish Medical Center's Stroke-Heart Survivors Group meets at the Parrish Health Village on the third Tuesday of each month from 2 to 4 p.m. Call 321-268-6800 for more information.