Causes and Stages of Congestive Heart Failure

Dec 30, 2010 by Emilia

Coronary arteries

This far we have seen that aging of the heart does not significantly alter its ability to perform its functions. However, few adults have a completely normal heart due to some kind of heart disease, being atherosclerosis and congestive heart failure some of the most common coronary artery disorders.Unfortunately, these health conditions do get in the heart’s way to perform its job. 

Functions of the coronary arteries

When a person is at rest, the coronary arteries are normally wide enough to allow the blood to reach the heart cells. However, the demand of the heart for oxygen goes up and down based on the amount of work it has to perform.  Some conditions where the heart requires a higher supply of oxygen include: 

1. Increases in heart rate
2. Increases in stroke volume
3. Increases in width and thickness
4. Increases in blood pressure

Such increases occur when a person becomes physically active and as part of the aging process. The heart normally accommodates these increases by dilating its arteries to allow more blood to flow through them. 

Effects of atherosclerosis

The coronary arteries cannot supply adequate amounts of blood to the heart due to a disease called atherosclerosis. As I explained in my article “Here is how plaque in arteries develops as we age” atherosclerosis involves the formation and enlargement of plaque in the walls of the arteries. Plaque causes coronary arteries to: 

1. Become narrower, thus reducing blood flow.
2. Plaque stiffens the arteries, reducing their ability to dilate when more oxygen is needed by the heart.
3. It makes the inner lining of the arteries rough, causing exposure of the underlying collagen. Roughness and collagen cause the blood in arteries to form clots. Clots can stop blood flow completely.

Whenever the heart receives less amount of oxygen than it needs, it becomes weak and cannot pump enough blood to the body organs. 

Congestive heart failure

Congestive heart failure (CHF) is another disease that becomes more common and serious as we age. Approximately three million people in the U.S. have CHF and there are almost 400,000 new cases each year. More than 75 percent of cases are in people age 65 and over. 

Causes of congestive heart failure

Main causes of congestive heart failure are factors that weaken the heart. The most frequent causes are: 

1. Coronary artery disease. When the heart does not receive adequate amounts of blood, it has to work harder to obtain the oxygen needed.
2. High blood pressure. High blood pressure makes the heart work harder, increasing the amount of oxygen it needs, and eventually weakening the heart.
3. Disease of the heart valves. Valvular heart disease causes some of the blood in the heart to flow backward during each beat. The heart has to work harder trying to get rid of the remaining blood.
4. Obesity. Being overweight weakens the heart because it has to overwork to send blood to all our cells.
5. Kidney disease. Kidney disease is often a cause of high blood pressure, a condition we know puts the heart through extra work.

The underlying problem in this disease is years of overworking the heart. An overworked heart tries to get more strength by dilating and thickening itself. At first these changes will do the trick, but if the heart continues to overwork itself, it will continue to dilate and thicken. 

Stages of congestive heart failure

Although the heart is quite resourceful, if it continues to dilate and thicken to be able to carry out its main task, send blood to all our cells, it will become very weak.  Consequences of this weakening are: 

1. The blood in the heart chambers cannot be pumped effectively
2. The flow of blood to the body diminishes and organs begin to malfunction
3. Fluid accumulates in the lungs (pulmonary edema)
4. Difficult breathing. Individuals may feel out of breath after the slightest exertion or even when at rest.
5. Poor circulation in other areas of the body, especially the legs
6. Swelling that promotes varicose veins in the legs
7. Many ordinary activities become difficult or impossible

The heart tends to solve these problems by dilating and thickening even more, but this only aggravates the situation. Unless steps are taken to strengthen the heart and reduce the amount of work it needs to do, the heart will eventually become so weak that it will fail completely. When the heart fails, it means death. 

No need to die before due time

The seriousness of congestive heart failure cannot be overstated. The good news is that it can be prevented. The idea here is to spare the heart from working so hard that it will not throw the towel in before due time. Since we know atherosclerosis is one major health condition that causes the heart to work harder than it should, let us review some of the risk factors that cause atherosclerosis so we can take some measures to reverse them. 

1. Smoking. Inhaling tobacco smoke increases blood pressure and adds substances in the blood that seem to promote the formation of plaque.
2. High blood pressure. High blood pressure seems to cause repeated minor injuries to the arteries. As the arteries try to repair the damage, they form scar tissue and plaque. High blood pressure also makes the heart work harder, increasing the amount of oxygen it needs, and eventually weakening the heart.
3. High LDL cholesterol. When the level of LDL cholesterol is high, it can accumulate in the walls of arteries and contribute to the formation of plaque. On the other hand, HDL cholesterol reduces the accumulation of LDL
4. Diabetes type 2. This is a disease that alters many aspects of the body, including blood glucose levels and the maintenance and repair of arterial walls. In so doing, it promotes the formation of plaque.
5. Physical inactivity. The heart of people who are physically inactive gets less exercise because it does not have to work hard. Like every other muscle, heart muscle that gets little exercise becomes weaker. Lack of exercise promotes increases in blood pressure and in the ratio of LDL to HDL cholesterol.
6. Obesity. Being very overweight weakens the heart and makes it less efficient because the heart is being overworked and tends to become invaded with fat. Obesity also promotes high blood pressure, high levels of total and LDL cholesterol, and type 2 diabetes.
7. Stress. A constant high level of emotional tension or stress promotes atherosclerosis by causing prolonged periods of high blood pressure.
8. Other risk factors. High blood homocysteine, family history, menopause, personality, high blood iron levels and periodontal disease are also among the risk factors that can contribute to the formation of plaque in arteries.

Final words

I hope this article helps you realize that many of our health issues can be prevented or reverse. At the least, we can keep them under control so we age gracefully. We all want to live as long as possible, but in good health. Let us make a resolution to take steps to take care of ourselves because unless we do it, nobody will do it for us. 

To your health! 

Emilia Klapp, R.D., B.S.
www.TheDiabetesClub.com 

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Tags

• coronary arteries
• high blood pressure
• stages of congestive heart failure

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