Integrated approach to heart failure

Abstract

Congestive heart failure (CHF) is the inability of the heart to pump blood effectively throughout the body. Such dysfunction may concern myocardial contractility, the ventricular preload, the end-diastolic volume, an obstacle to cardiac ejection, or excessive afterload and heart rate. The main causes of heart failure are long-term hypertension, previous myocardial infarction, disorders of the heart valves, cardiomyopathies, and chronic lung disease. A condition of compensation can be precipitated by some aggravating factors such as increased metabolic demand, as in the case of thyrotoxicosis, anemia, arteriovenous shunt, fever, fluid overload, increased sodium intake, environmental temperature that is too high or too low, renal or hepatic failure, respiratory insufficiency, emotional stress, pregnancy, obesity, arrhythmias, pulmonary embolism, alcohol ingestion, nutrient deficiency, uncontrolled hypertensive states, and beta-blockers, anti-arrhythmic drugs, and sodium-retaining drugs such as steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) [1].