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- A NYC First: Patient Participates in Stem Cell Clinical Trial to Repair Heart Damaged by Severe Coronary Artery Disease
- Diabetics Benefit Less from Anti-Hypertensive Treatment to Reduce Enlarged Heart
- Electrocardiogram Helps Predict Risk for Congestive Heart Failure in Hypertensive Patients
- For High-Blood-Pressure Patients, Preventing or Reducing Enlarged Heart Decreases Risk of Heart Failure
- Gene Test Detects Heart Transplant Rejection
- Left Ventricular Assist Devices May Improve Heart Function and Lead to Search for New Therapies To Obviate Need for Transplants
- NewYork-Presbyterian/Columbia Announces State-of-the-Art, Vivian and Seymour Milstein Family Heart Center in Washington Heights
- NewYork-Presbyterian/Weill Cornell Physician-Scientists Present Findings at American Heart Association's Annual Conference
Research and Clinical Trials
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Clinical Services
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- Advanced Diagnostics
- Alcohol Septal Ablation
- Angiograms
- Arrhythmia Control
- Artificial Heart Devices: LVAD
- Cardiac Electrophysiologic Studies and T-wave Alternans Testing
- Cardiac Rehabilitation
- Cardiology
- Catheter Ablation for Cardiac Arrhythmias
- Echocardiograms
- Electrocardiograms (ECGs), Stress Tests, Holter Monitor and Event/Loop Recorders
- Heart Transplant Surgery
- Implantable Converter Defibrillators and Biventricular Pacing
- Nuclear Imaging For Heart Disease (PET scans, MUGA scans)
- Pacemakers
- Pediatric Heart Surgery
- Tilt Testing
Congestive Heart Failure
What is congestive heart failure?
Congestive heart failure is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the loss in the heart's pumping action is a symptom of an underlying heart problem.
What causes congestive heart failure?
Congestive heart failure may result from any/all of the following:
- previous heart attack(s) (myocardial infarction) - scar tissue from previous attacks may interfere with the heart muscle's ability to work normally
- coronary artery disease - narrowed arteries that supply blood to the heart muscle
- heart valve disease - caused by past rheumatic fever or other degeneration of the valves
- cardiomyopathy - or another primary disease of the heart muscle
- coronary artery disease - narrowed arteries that supply blood to the heart muscle
- high blood pressure (hypertension)
- infections of the heart valves and/or heart muscle (i.e., endocarditis)
- congenital heart disease/defects (present at birth)
- cardiac arrhythmias (rapid heartbeats)
- chronic lung disease and pulmonary embolism
- drug-induced heart failure
- excessive sodium intake
- hemorrhage and anemia
How does congestive heart failure affect the body?
Congestive heart failure interferes with the kidney's normal function of eliminating excess sodium and waste from the body. In congestive heart failure, the body retains more fluid - resulting in swelling of the ankles and legs. Fluid may also collect in the lungs - resulting in shortness of breath.
What are the symptoms of congestive heart failure?
The following are the most common symptoms of congestive heart failure. However, each individual may experience symptoms differently. The severity of the condition and symptoms depends on how much of the heart's pumping capacity has been lost. Symptoms may include:
- weight gain
- visible swelling of the legs and ankles (due to a build-up of fluid), and, occasionally, the abdomen
- shortness of breath during rest or exercise
- fatigue
- loss of appetite and nausea
- persistent cough - often produces mucus or blood-tinged sputum
The symptoms of congestive heart failure may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How is congestive heart failure diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for congestive heart failure may include any, or a combination of, the following:
- laboratory tests
- chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
- echocardiogram (Also called echo.) - a noninvasive test that uses sound waves to produce a study of the motion of the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart.
- nuclear test (MUGA or RNCA) - a test involving a radioisotope which is injected into a vein. A camera records the amount of isotope in the blood pool of the heart to provide a measurement of how efficiently the heart is pumping.
Treatment for congestive heart failure:
Specific treatment for congestive heart failure will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
The goals of treatment are (1) to improve a person's quality of life by making the appropriate lifestyle changes and implementing drug therapy and (2) to prolong life. Treatment of congestive heart failure may include:
- controlling risk factors
- losing weight (if overweight)
- restricting salt and fat from the diet
- stop smoking
- abstaining from alcohol
- proper rest
- medication, such as:
- digitalis- to increase heart contractions
- angiotensin converting enzyme (ACE) inhibitors - to decrease the pressure inside the blood vessels
- diuretics- to reduce the amount of fluid in the body
- vasodilators- to dilate the blood vessels
- beta-blockers- to reduce the effects of adrenaline on the heart
- cardiac resynchronization
- implantable defibrillator (ICD) - a key consideration in treating patients with heart failure is a measure called the "ejection fraction". This refers to the amount of blood pumped by the heart with each heartbeat.
ICDs are indicated for patients with moderate to severe heart failure and ejection fractions less than or equal to 35%.
- heart transplantation, in the most severe cases
