By William R. Ladd, M.D.
Director,
Nuclear Cardiology
Cardiocascular Institute of the South

Congestive heart failure is the term used to describe the inability of the heart to pump as much blood as the body needs. Its symptoms are widespread -- weakness, shortness of breath, swelling in the legs, abdominal discomfort or pain, and a loss of appetite.

Despite its pronouncement-of-doom sound and the wide range of symptoms, congestive heart failure is generally a treatable condition -- although calling it a "condition" is not exactly accurate. Congestive heart failure itself is a symptom of some underlying condition which is depriving the heart of the strength to meet the body's metabolic demands.

The most frequent cause of the condition in older patients is atherosclerosis -- the progressive narrowing of the heart's own arteries by cholesterol plaque buildups, which starves the heart itself for oxygen and nutrients. In younger patients, it is more likely to be from a faulty heart valve or from cardiomyopathy -- damage to the heart muscle from an infection or other cause.

The task of the cardiologist is to find and treat that underlying cause. In the case of atherosclerosis, balloon angioplasty to reopen the blocked arteries or bypass surgery to route blood around the constriction will often relieve the symptoms of congestive failure. In valve defect cases, valvuloplasty -- replacement of a defective valve -- may be needed. Cardiomyopathy may be addressed with medication, though, in extreme cases, the diseased heart may be incapable of recovering, and heart transplantation may be indicated.

While congestive heart failure is not as dramatic or specific in its effects as the pain of angina, it may be the patient's only indication of the heart's declining efficiency. Angina, the pressing chest pain most people associate with heart problems, is not a reliable indicator. Researchers in the nation's largest ongoing heart study reported recently that fully one fourth of all heart attacks didn't cause the patient enough discomfort to send them to the doctor!

So don't just attribute the symptoms described above to advancing age, lack of exercise, or some other untreatable or benign cause and ignore them. They could herald something serious -- but treatable.

1995 Cardiocascular Institute of the South

For further information, call Jane Arnette, Cardiocascular Institute of the South/Houma, 1-800-425-2565, or Jim Keyser at 1-800-848-2715. E-mail questions or comments to: jakeyser@cardio.com.

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