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Congestive Heart Failure (CHF) Overview (cont.)

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What is the long term prognosis for patients with congestive heart failure?

Congestive heart failure is generally a progressive disease with periods of stability punctuated by episodic clinical exacerbations. The course of the disease in any given individual, however, is extremely variable. Factors involved in determining the long term outlook (prognosis) for a given patient include:

  • the nature of the underlying heart disease,
  • the response to medications,
  • the degree to which other organ systems are involved and the severity of other accompanying conditions,
  • the person's symptoms and degree of impairment, and
  • other factors that remain poorly understood.

With the availability of newer drugs to potentially favorably affect the progression of disease, the prognosis in congestive heart failure is generally more favorable than that observed just 10 years ago. In some cases, especially when the heart muscle dysfunction has recently developed, a significant spontaneous improvement is not uncommonly observed, even to the point where heart function becomes normal.

Heart failure is often graded on a scale of I to IV based on the patient's ability to function.

  1. Class I is patients with a weakened heart but without limitation or symptoms.
  2. Class II is only limitation at heavier workloads.
  3. Class III is limitation at everyday activity.
  4. Class IV is severe symptoms at rest or with any degree of effort.

The prognosis of heart failure patients is very closely associated with the functional class.

An important issue in congestive heart failure is the risk of heart rhythm disturbances (arrhythmias). Of those deaths that occur in individuals with congestive heart failure, approximately 50% are related to progressive heart failure. Importantly, the other half are thought to be related to serious arrhythmias. A major advance has been the finding that nonsurgical placement of automatic implantable cardioverter/defibrillators (AICD) in individuals with severe congestive heart failure (defined by an ejection fraction below 30% to 35%) can significantly improve survival, and has become the standard of care in most such individuals.

In some people with severe heart failure and certain ECG abnormalities, the left and right side of the heart don't beat in rhythm, and inserting a device called a biventricular pacer can significantly reduce symptoms.

Can congestive heart failure be prevented?

Congestive heart failure is the result of an underlying illness, often atherosclerotic heart disease. Controlling those risk factors may help with congestive heart failure prevention. These include lifelong control of high blood pressure, high cholesterol, and diabetes and smoking cessation. High blood pressure and diabetes are independent risks for congestive heart failure. Alcohol and drug abuse may be a cause of heart failure.

REFERENCES:

Roger, Veronique L., et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. "Heart disease and stroke statistics -- 2011 update: a report from the American Heart Association." Circulation 123.4 (2011): e18-e209.

Ho, K. K., et al. "The epidemiology of heart failure: the Framingham Study." Journal of the American College of Cardiology 22.4 Suppl A (1993): 6A-13A.


Medically Reviewed by a Doctor on 10/16/2013

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Congestive Heart Failure - Symptoms Question: What symptoms do you experience with congestive heart failure?
Congestive Heart Failure - Treatment Question: What treatment did you have for congestive heart failure?
Congestive Heart Failure - Prognosis Question: What's your prognosis with congestive heart failure?
Congestive Heart Failure - Causes Question: What are the underlying causes of your congestive heart failure?
Congestive Heart Failure - Lifestyle Changes Question: Have you made any lifestyle modifications including diet or exercise?
Source: MedicineNet.com
http://www.medicinenet.com/congestive_heart_failure_chf_overview/article.htm

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