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Heart failure is a condition that most of us associate with the elderly. Huffing and puffing, shortness of breath on slight exertion, doesn't seem so odd for an old person after a heart attack. But heart failure can also strike the young.

Congestive heart failure was the last thing 31-year-old Annie ever imagined would be her diagnosis.

For about a week, Annie had been feeling congested. She had availed herself of over the counter shortness of breath treatment, namely Afrin and Mucinex, and her runny nose and sinus congestion were better, but she felt really, really tired. She just wanted to sleep all day long. That was something that her job and her kids weren't going to let her do, so she decided to use one of the four free visits a year her insurance allowed with the doctor.

The first thing the doctor noticed was that Annie had swollen legs and fingers. And they certainly weren't due to seasonal allergies or a colds virus. A battery of tests revealed that Annie was suffering congestive heart failure.

Heart Failure Is Surprisingly Common

Just in the United States, nearly six million people have been diagnosed with heart failure [1]. More people have congestive heart failure than have all the various forms of cancer combined. Heart failure is the leading reason for hospitalization for people on Medicare [2]. But heart failure occur can occur at any age, from childhood to old age [3].

Heart failure is a disease in which the heart has failed in its adaptation to stress. Maybe there has been a heart attack that forced the heart to remodel itself, to grow new tissue to compensate for the tissue that has been destroyed by myocardial infarction. Or maybe there was continuous high blood pressure, that damaged the cells in arterial walls in the bends and turns in the coronary arteries that provide the heart with oxygen and nutrients. Congestive heart failure can be due to a congenital, hereditary defect in the heart. Or it can result from alcohol abuse, methamphetamine abuse, diabetes, thyroid disease, sleep apnea, chemotherapy, or radiation, or a combination of all of the above. [4]

Shortness of Breath Is the Most Common Symptom of Heart Failure

Congestive heart failure usually does not cause heart pain. The primary symptom of heart failure is shortness of breath. The New York Heart Association (NYHA) classifies the severity of heart failure by the severity of the shortness of breath:

  • Dyspnea (shortness of breath) on exertion.
  • Orthopnea, shortness of breath when lying flat, forcing the person who has congestive heart failure to sit up in a chair or to use extra pillows to lie in bed.
  • Paroxysmal nocturnal dyspnea, waking up out of breath (but not because of obstructive sleep apnea).
  • Dyspnea at rest.
  • Pulmonary edema, swelling in the lungs.

Shortness of breath isn't necessarily constant. The degree of severity of shortness of breath may vary from day to day. There are some coronary artery disease symptoms that also occur in congestive heart failure. Heart failure may also cause any of the following:

  • Loss of appetite, that may paradoxically be accompanied by
  • Weight gain. Gaining more than 3 pounds (1.5 kg) overnight is usually a sign of congestive heart failure. This is due the body's inability to move fluids. Over time, fluid accumulation may be obvious in the ankles, feet, lower legs, fingers, and finally the torso.
  • Weakness.
  • Fatigue.
  • Nighttime urination (getting up to urinate).
  • Lack of urination (oliguria).
  • Mental symptoms of varying severity, ranging from uncharacteristic aggression, memory problems, to poor judgment. [5]

Untreated, the symptoms of congestive heart failure only get worse [6]. But any and all of these symptoms could also be caused by some other condition.

How Does Your Doctor Know It's Really Heart Failure?

Before doctors diagnose congestive heart failure, they will rule out other conditions that cause the same symptoms. Here are some of the illnesses your doctor may also consider if you come in with symptoms that could match heart failure:

  • The doctor will rule out other heart problems, including bradycardia (slow heat beat) and tachycardia (fast heart beat), as well as problems with the heart muscle itself.
  • The doctor will rule out relatively common non-heart problems such as sepsis (systemic bacterial infection),which increases the body's demand for oxygen, anemia, which reduces the blood's ability to carry oxygen, kidney failure (which increases fluid), and obesity-hypoventilation syndrome, which places an unusual demand on the right side of the heart. The doctor may look specifically for right-sided heart failure in obese patients who have diabetes and/or sleep apnea.
  • The doctor will also rule out bacterial and viral pneumonia, chronic obstructive pulmonary disease (COPD) such as emphysema, venous insufficiency, and, of course, the acute symptoms of a previously undiagnosed heart attack.

When all of these conditions and more have been considered, then it is usually possible to provide symptom relief. Even if you are an expert in herbal medicines, you usually don't want to rely on natural ways to manage dyspnea by themselves. Work with your doctors, not independently of them.

Don't Rely On Dr. Google

If you were to Google "congestive heart failure," you might some really grim statistics. mortality following hospitalization for patients with heart failure is 10.4% at 30 days [7], 22% at 1 year [8], and 42.3% at 5 years [9], despite tremendous improvements in medication and medical devices. You might even find an especially grim statistic that every hospitalization for congestive heart failure increases the probability of death in the next year by about 20 to 25 percent [10].

You aren't a statistic. There are people who live five, ten, twenty, twenty-five years and more after they are diagnosed with heart failure. They may have to spend a lot of time managing their symptoms, and they may not be able to do all the things that they did before their diagnosis, but life can be full and rich, far beyond the cold, hard odds.

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