Health & Medical Diseases & Conditions

What Is Congestive Heart Failure and What Isn’T?

There are some misconceptions about congestive heart failure, also known as CHF. To answer the question what is congestive heart failure, it is necessary to first clarify what it is not. First of all, it is not distinct from heart failure. In the medical field both terms mean the same. Heart failure and congestive heart failure are therefore synonymous with respect to documentation and coding.

Heart failure does not mean the heart stops beating. The term for that is cardiac arrest. Cardiac arrest can be the terminal event of heart failure but many other conditions can cause it. A source of confusion is incorrect information on death certificates. When a death certificate asks for the cause of death it is not referring to the terminal event itself. Unfortunately, cardiac arrest sometimes appears on the death certificate as the cause of death when in fact an underlying disease was the cause of the cardiac arrest. In that case, the underlying disease that led to the cardiac arrest is the cause of death and cardiac arrest is the terminal event.

There are only two broad categories of terminal events. They are the failure of the heart to beat properly or at all and impaired or absent exchange of oxygen and carbon dioxide through the process of ventilation. Since the immediate event leading to the death of anyone who dies falls under one of these categories it is important to understand the distinction between the cause of death and the terminal event. Otherwise, many will believe that individuals died of CHF, when in fact they did not have it at all.

Congestive heart failure is a state of fluid and pressure buildup in the heart, blood vessels and lungs - plus or minus other tissues - resulting from mechanical dysfunction of the left side, right side, or both sides of the heart. It most commonly is a result of the cardiac muscle being too weak to pump out as much blood as it receives. Consequently, it is not able to eject sufficient amounts of blood to provide tissues with much needed oxygen. Additionally, the reduced blood flow to the tissues is not sufficient to remove carbon dioxide, a waste product produced by them.

Although a weak heart is the most common cause of CHF, it is a misconception to believe that the condition cannot exist when the strength of the heart is normal. That is because the same state of pressure and fluid buildup can occur when the heart cannot fully relax and normally fill with blood in between beats.

Congestive heart failure can be acute or chronic. The terms acute and chronic have more to do with how rapidly symptoms of the condition develop and whether or not they are stable than the severity of the symptoms.

Although a heart attack is a common cause of CHF many other conditions can cause it. Therefore the terms are not synonymous.

Heart disease is the major cause of death worldwide and congestive heart failure is one of the leading causes of death in the United States. Therefore knowledge of it is important. This is particularly true in today's changing health care climate in which health literacy is not an option but a must.


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