Congestive Heart Failure (CHF), also called Congestive Cardiac Failure (CCF) or just Heart Failure is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood through the body. Congestive heart failure can be caused by

1. Diseases that weaken the heart muscle
2. Diseases that cause stiffening of the hear muscles
3. Diseases that increase oxygen demand by the body tissue beyond the capability of the heart to deliver.

The heart is a pump that works together with the lungs. It pumps blood in 2 ways.

1. It pumps blood from the heart to the lungs to pick up oxygen. The oxygenated blood returns to the heart.
2. It then pumps blood out into the circulatory system of blood vessels that carry blood through the body.

Heart failure sounds frightening because it sounds like the heart just stops working. Do not be discouraged by the term heart failure-the heart has not stopped beating or pumping. Heart failure means the tissues of the body are temporarily not receiving enough blood and oxygen. With advancements in diagnosis and therapy for heart failure, patients are feeling better and living longer.

• Although heart failure is a serious medical condition, the heart does not just stop abruptly.
• Heart failure may develop gradually over several years, or move quickly after a heart attack or a disease of the heart muscle.

Congestive Heart Failure can affect many organs of the body. For Example

• The weakened heart muscles may not be able to supply enough blood to the kidneys, which then begin to lose their normal ability to excrete salt (sodium) and water.
• This diminished kidney function can cause to body to retain more fluid.
• The lungs may become congested with fluid (pulmonary edema) and the person's ability to exercise is decreased. Fluid may likewise accumulate in the liver, thereby impairing its ability to rid the body of toxins and produce essential proteins.
• The intestines may become less efficient in absorbing nutrients and medicines. Over time, untreated congestive heart failure will affect virtually every organ in the body.

Signs & Symptoms of Congestive Heart Failure
The symptoms of congestive heart failure vary among individuals according to the particular organ systems involved and depending on the degree to which the rest of the body has "compensated" for the heart muscle weakness. An early symptom of congestive heart failure is fatigue. While fatigue is a sensitive indicator of possible underlying congestive heart failure, it is obviously a nonspecific symptom that may be caused by many other conditions. The person's ability to exercise may also diminish. Patients may not even sense this decrease and they may subconsciously reduce their activities to accommodate this limitation. Some other signs & symptoms of congestive heart failure are as follows:

• Cough
• Decreased alertness or concentration
• Decreased urine production
• Difficulty in sleeping
• Fatigue, weakness and faintness
• Irregular or rapid pulse
• Loss of appetite, indigestion
• Nausea and vomiting
• Need to urinate at night
• Pronounced neck veins
• Sensation of feeling the heart beat (palpitations)
• Shortness of breath with activity, or after lying down for a while
• Swelling of feet and ankles
• Swelling of the abdomen
• Weight gain

Heart failure may decompensate easily; this may occur as the result of any intercurrent illness (such as pneumonia), but specifically myocardial infarction (a heart attack), Anaemia, hyperthyroidism or arrhythmias. These place additional strain on the heart muscle, which may cause symptoms to rapidly worsen. Excessive fluid or salt intake and medication that causes fluid retention may also precipitate decompile.

When to seek Medical Advice
If you have any of these symptoms, call your health care provider for an appointment. If the symptoms are severe seek immediate medical advice.

• You have shortness of breath that seems to be getting worse or causes difficulty sleeping.
• You fall asleep in bed but wake up at night with shortness of breath.
• You sleep better in a semi-upright position in a chair or recliner than flat in bed.
• Your shortness of breath develops with mild exertion and is worse than usual.
• You have unusual fatigue that is not relieved with rest.
• You have a dry cough that will not go away or seems otherwise unusual.
• You have swelling in your ankles, feet, or legs that does not go away.

Congestive heart failure usually does not cause chest pain. Remember, though, that other serious conditions that do cause chest pain, such as angina and myocardial infarction, can coexist with heart failure.

Causes of Congestive Heart Failure
Congestive heart failure (CHF) is a syndrome, not a disease that can be brought about by several causes. CHF is a weakening of the heart brought on by an underlying heart or blood vessel problem, often a combination of several different problems, including the following:

The most common causes of Congestive Heart Failure are:

• Coronary Artery Disease
• Disorders of the heart valves
• High blood pressure (hypertension)
• Longstanding alcohol abuse

Less common causes of Congestive Heart Failure are:

• Disorders of the heart rhythm
• Thyroid disorders
• Viral infections of the heart muscle

Other causes of Congestive Heart Failure are:

• Blocked blood vessels supplying the heart muscle (coronary arteries), leading to a heart attack
• Congenital heart diseases
• Damaged heart valves
• Infections
• Pericardial disease, such as pericardial effusion (a large collection of fluid around the heart in the space between the heart muscle and the thick layer of pericardium surrounding the heart) and/or a thickened pericardium, which does not allow the heart to fill properly
• Prolonged, serious arrhythmias
• Toxic exposures, like alcohol or cocaine
• Weakened heart muscle

Diagnosis of Congestive Heart Failure
Congestive heart failure is a clinical diagnosis. Doctors can usually make a diagnosis of congestive heart failure based upon a physical exam and the symptoms alone. During the physical exam, the doctor will check for a weak or rapid pulse rate, enlargement of the heart, swollen neck veins, swelling of the liver, fluid retention, sounds of fluid in the lungs, and abnormal heart sounds.

To confirm the diagnosis doctor may perform a number of tests, including Chest X-rays, Blood tests, Electrocardiograms (EKGs), Urinalysis, and Exercise stress tests.  Some other tests such as Electrocardiograms, Echocardiograms, and Angiography may be performed because these create images of the heart's activity and are also helpful in the diagnosis.

Diagnostic tests may include:

• Electrocardiogram (ECG or EKG): This painless test measures the electrical activity (rhythm) of the heart. Electrical sensors called leads are attached to predetermined positions on the arms, legs, and chest to record electrical activity and help assess heart function.
• Echocardiogram (cardiac echo): This is a type of ultrasound that shows the beating of the heart and the various cardiac structures. It can be used to detect abnormalities in the structure of the heart and to measure the ejection fraction. This very safe, painless technique is similar to that used to look at a fetus during pregnancy.
• Cardiac Catheterization: Cardiac catheterization is a medical procedure used to diagnose and treat certain heart conditions. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, doctors can perform diagnostic tests and treatments on your heart.
• Chest X-ray: This is very helpful in identifying the buildup of fluid in the lungs. Also, the heart usually enlarges in CHF, and this may be visible on the x-ray film.
• MUGA Scan: MUGA Scan stands for Multiple-Gated Acquisition Scanning. A small amount of a mildly radioactive dye is injected into a vein and travels to the heart. As the heart pumps the blood with the dye in it, pictures are taken. The pumping performance of the left and right ventricles can be determined.
• Stress test: A Stress test is used to help evaluate the cause or causes of heart failure, in particular, regarding coronary artery disease. This test is frequently combined with nuclear imaging or echocardiography to improve accuracy.
• Blood tests: You may have to undergone though some blood tests drawn for lab tests. Blood test including Blood cell counts test, Low blood cell counts (anemia) may cause symptoms much like CHF or contribute to the condition.

The purpose of these tests is to evaluate heart function (e.g., assess ejection fraction), and to detect coronary artery disease, heart attack, and valve dysfunction.

Treatment of Congestive Heart Failure
The treatment of congestive heart failure focused on treating the symptoms and signs of congestive heart failure and preventing the progression of disease. Treatment may include lifestyle changes, medicines, Tran catheter interventions, and surgery.

Lifestyle Changes

• Control High Blood Pressure, Cholesterol, Diabetes
• Eat a balanced diet low in calories, saturated fat, and salt.
• Limit alcohol intake
• Quit Smoking
• Start Aerobic exercise program
• Weigh yourself daily to watch for fluid buildup.
• Try to improve the flow of blood and oxygen through your body.

Medicines
Studies show that medicines also help improve your heart function and make it easier for you to exercise or do physical activity.

• Patients who experience swelling in the feet, ankles, legs, and abdomen are given drugs called diuretics. Diuretics stimulate the kidneys to increase urine production and remove sodium and water from the body.
• Patients with severe heart failure and lowered kidney function may need to be hospitalized and given diuretics intravenously until their condition is stable.
• Spironolactone has been shown to have the added benefit of preserving the body's potassium levels.
• Morphine may also be given to help reduce the anxiety caused by breathing difficulties associated with pulmonary edema.

Surgical Procedures
Surgery can correct malfunctioning heart valves and remove blockages from coronary arteries.

• Coronary Artery Bypass Surgery
• Correction of Congenital Heart Defects
• Heart Transplantation
• Heart Valve Repair or Replacement
• Mechanical Assist Devices
• Pacemaker Insertion

For long-term care, doctors recommend alternating periods of rest with gentle exercise, such as walking. Cardiac rehabilitation programs can provide medically supervised exercise programs for people with congestive heart failure. Heart transplants are only considered for patients with severe congestive heart failure. The best way to prevent heart failure is to practice healthy lifestyle habits that reduce your chances of developing a heart problem. Patients should carefully follow their doctors' advice. In doing so, they can continue to live full and productive lives.