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Forman DE, Sanderson BK, Josephson RA, Raikhelkar J, Bittner V; American College of Cardiology's Prevention of Cardiovascular Disease Section. Heart failure as a newly approved diagnosis for cardiac rehabilitation: challenges and opportunities. J Am Coll Cardiol. 2015;65(24):2652-2659. PMID: 26088305pubmed.ncbi.nlm.nih.gov/26088305/. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. PMID: 35363499pubmed.ncbi.nlm.nih.gov/35363499/. Lam CSP, Shah SJ, Solomon SD. Heart failure with preserved and mildly reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 51. Mann DL. Management of heart failure patients with reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 50. Last reviewed on: 10/5/2022 Reviewed by: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.  Congestive Heart Failure (CHF)
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If you've been diagnosed with congestive heart failure, the feeling of your chest constricting can be scary. With congestive heart failure, the heart’s capacity to pump blood cannot keep up with the body’s need. As the heart weakens, blood begins to back up and force liquid through the capillary walls. The term “congestive” refers to the resulting buildup of fluid in the ankles and feet, arms, lungs, and/or other organs. Almost 6 million Americans have congestive heart failure. However, with the correct treatment, patients can recover to good health.
The most common cause of congestive heart failure is coronary artery disease. Risk factors for coronary artery disease include:
In addition to coronary artery disease, several other conditions can damage the heart muscles, including infections, autoimmune diseases, and some treatments such as chemotherapy.
Most commonly, a patient may experience shortness of breath, fatigue, problems with the heart’s rhythm called arrhythmias, and edema—or fluid buildup—in the legs. Symptoms may be mild or severe and may not always be noticeable.
Patients will typically have an intake visit with a heart specialist and nurse or physician’s assistant. During this visit, the doctor will review the patient’s prior records and his or her current health status. This allows the doctor to establish a picture of where the patient is along the spectrum, and make a plan for prognosis and treatment. The process often takes more than one meeting and involves both the patient’s local cardiologist or referring physician.
Doctors will assess the current health status of the patient to establish a baseline, and develop a long-term health plan. This may involve the optimization of medicines and therapies, adding new medication, or possibly enrollment in a clinical trial. Stabilizing and/or reversing a patient’s condition often involves long-term, collaborative follow-up with a referring cardiologist or physician. In serious situations, advanced therapies, which include mechanical solutions, a heart transplant, or hospice, may be offered.
There are medicines and treatments that reverse many cases of heart failure, and in most cases, the outlook is generally very good.
Yale Medicine’s team comprises heart failure cardiologists and cardiac surgeons, dedicated advanced-practice, registered nurses and nurse coordinators, dietitians, exercise physiologists, financial counselors, immunologists specializing in transplants, psychologists, and specialists in palliative care. With a multidisciplinary approach, Yale Medicine physicians include the patient’s desires as well as input from the family to develop a comprehensive treatment plan that's right for them. Related Fact SheetsShowing 4 of 131
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