congestive heart failure

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congestive heart failure,

inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. In the healthy individual the heart can tolerate large increases of workload for a considerable length of time. Cardiac failure results from conditions, e.g., coronary artery diseasecoronary artery disease,
condition that results when the coronary arteries are narrowed or occluded, most commonly by atherosclerotic deposits of fibrous and fatty tissue. Coronary artery disease is the most common underlying cause of cardiovascular disability and death.
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, hypertensive heart disease (see hypertensionhypertension
or high blood pressure,
elevated blood pressure resulting from an increase in the amount of blood pumped by the heart or from increased resistance to the flow of blood through the small arterial blood vessels (arterioles).
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), valvular insufficiency, and rheumatic heart disease, that interfere with the nutrition and oxygenation of the heart muscle itself. Congestive heart failure develops in 50% to 60% of patients with such disorders, and it can be either acute or chronic. If the heart has time to compensate, the heart muscle may become hypertrophic (enlarged); this is caused by structural changes that impede blood flow and impair the ability of the heart to relax. Eventually the great demand for oxygen by the heart muscle cells cannot be met, and cell death results. Either the left or right ventricle alone may fail first, although combined failure is most common and almost always eventually occurs. Left ventricular failure is marked by shortness of breath (dyspnea), often accompanied by cough; pulmonary congestion and edema are evident. Failure of the right ventricle produces systemic edema, reflecting hepatic and visceral engorgement. Diagnosis is often confirmed by echocardiography. Treatment of cardiac failure usually includes dietary changes, restrictions on physical activity, rest, oxygenation, measures to improve myocardial contractility, and correction of arrhythmias. Restriction on sodium intake and the administration of diuretics (the dosages of which depend on the patient's weight) are used to remove excess sodium and water from the body. Digitalisdigitalis
, any of several chemically similar drugs used primarily to increase the force and rate of heart contractions, especially in damaged heart muscle. The effects of the drug were known as early as 1500 B.C.
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 is often prescribed to increase the speed and force of cardiac contractions, and ACE inhibitorsACE inhibitor
or angiotensin-converting enzyme inhibitor
, drug used to reduce elevated blood pressure (see hypertension), to treat congestive heart failure, and to alleviate strain on hearts damaged as a result of a heart attack (see infarction).
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 are used to decrease peripheral vascular resistance, making heart pumping easier and more effective.

congestive heart failure

[kən′jes·tiv ′härt ‚fāl·yər]
(medicine)
A state in which circulatory congestion exists as a result of heart failure.