Congestive Failure
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Congestive failure is a deterioration in the pumping action of the heart over a period of time. The result is poor blood circulation to the tissues of the body and from the extremities or the lungs. The symptoms include shortness of breath, swelling of the lower legs and hands, irregular heart beat, and waking at night with shortness of breath.

It is important for patients with congestive heart failure or people looking after them to monitor closely weight changes. A sudden increase in weight over a short period of time may reflect increased fluid retention in the lower limbs and this in  turn means worsening of the congestive failure. Daily weighing of patients with congestive heart failure may give adequate warning to adjust medication and avoid hospitalization for severe failure.

Patients should also avoid salt rich foods and restrict themselves to a "no added salt diet".

Over time, congestive heart failure can lead to cardiomegaly or enlargement of the heart. This change in the size of the chambers of the heart can also result in atrial fibrillation or a rhythm change which produces an irregularly irregular pulse. It is important that patients and care givers take the pulse rate frequently so that palpitations and rapid heart rates and irregular beats can be correlated with other symptoms contributing to increasing heart failure. 

It may seem over-simplified but people with congestive heart failure must take their medication. Most of the time congestive heart failure affects the elderly. This is a group that can be forgetful and can have difficulty in taking their own pills. One or two missed " water pills" can precipitate major changes.

A little education can have large rewards for people with congestive failure and their care givers. There are Patient Guidelines for what the patients should monitor and when the doctor should be notified. Prompt detection of worsening failure and appropriate input from the Physician should prevent some of the visits to the Emergency and acute hospital admission:

What to watch:

Chest pain

Increased Fatigue

Increased swelling of ankles

Increased shortness of breath or difficulty in breathing when lying down.

When to call the doctor:

For sudden changes in any of the above symptoms in the "What to watch" section.

If there is an increase in weight of 5 pounds in one week.

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