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Stage 4 Congestive Heart Failure

Stage 4 Congestive Heart Failure

Congestive heart failure is a condition that is characterized by the heart's inability to pump enough blood and supply it to the various parts of the body. Scroll down to find out more about the symptoms of stage 4 congestive heart failure along with the treatment options for the same.
Smita Pandit
Last Updated: Jan 21, 2018
The human heart is the key organ of the circulatory system of our body. The heart is divided into four chambers. The upper chambers and the lower chambers are referred to as atria and ventricles respectively. The right atrium and the right ventricle pump the deoxygenated blood that is received from the veins into the lungs. The left atrium and the left ventricle receive the oxygenated blood from the lungs.
The oxygenated blood is then carried to various parts of the body by the arteries. The term 'heart failure' refers to the state in which the heart is unable to pump enough blood for fulfilling the body's requirements. If the pumping action of the heart becomes weak, blood may back into the liver, lungs, abdomen and the lower extremities. Under such circumstances, one is diagnosed with congestive heart failure (CHF).
Left-sided heart failure is the most common form of heart failure. It often leads to right-sided heart failure. CHF is divided into four stages. The fourth stage is the final stage of this heart condition. During the fourth stage, even mild physical activity can put strain on the heart. Symptoms might be experienced even while one is resting. CHF must not be confused with heart attack or cardiac arrest.
Causes
Here are some of the medical conditions that can affect the pumping mechanism of the heart.
  • The coronary arteries that supply blood to the heart may get constricted due to buildup of fat deposits. This could affect the flow of blood and weaken the heart muscle.
  • Blood pressure, which is the pressure exerted by blood on the walls of the artery, may increase. Due to high blood pressure, the heart would have to work harder for pumping and supplying blood to other parts of the body.
  • Mitral valve, tricuspid valve, aortic valve and pulmonary valve are the valves that control the flow of blood through the heart. While mitral valve is located between the left atrium and the left ventricle, tricuspid valve is located between the right atrium and the right ventricle. The aortic valve is located lies between the left ventricle and the aorta, while the pulmonary valve is located between the right ventricle and the pulmonary artery. These open to allow the blood to flow from one chamber to another or out of the heart. These close to prevent blood from flowing back. They open and close according to the pressure differences. The flow of blood might also get affected due to heart valve disorders which in turn may cause CHF.
  • Those with congenital heart defects or those who have already had a heart attack or cardiac arrest are also susceptible to CHF. If these conditions are not treated soon, the disease would progress to end stage CHF.
Symptoms
CHF develops gradually. Symptoms may not be prominent in the initial stage. One might just feel slightly tired or fatigued after indulging in a physical activity. In the second stage, any form of physical activity might lead to shortness of breath, heart palpitations and severe fatigue, but the symptoms would disappear on taking rest. The symptoms become more pronounced in the third stage. One's ability to perform routine exercises or physical activity may become limited. Symptoms that may be experienced on performing mild physical activity include swelling in the legs or ankles, shortness of breath, dizziness, rapid heartbeat and severe fatigue.
Stage 4 congestive heart failure is marked by the patient's inability to perform any physical activity without discomfort. One experiences shortness of breath even while resting. Very mild physical activity could also cause strain on the heart which in turn leads to palpitations, severe fatigue and persistent cough. Fluid retention in the body causes swelling especially in the lower extremities. One may experience unexplained weight gain. Inadequate supply of oxygenated blood may also affect internal organs of the body adversely.
Treatment
The treatment may vary depending on the stage. In the early stages, drugs such as ACE inhibitors or beta blockers might help in dilating the blood vessels, thereby increasing the flow of blood. These drugs are extremely helpful in case of people suffering from coronary artery disease or hypertension. Beta blockers are often used for blocking the effect of epinephrine or norepinephrine that cause an accelerated heart rate, rapid breathing or increase in high blood pressure due to physical activity.
In advanced stages, diuretics might also be prescribed for treating fluid retention in the body. Digitalis medication is usually prescribed for enhancing the heart's ability to pump blood. Doctors may follow a symptomatic approach and prescribe medicines for treating specific symptoms caused by the underlying disease that might be affecting the heart's ability to pump and supply blood. Certain disorders associated with the valves may be treated with the help of surgery. Coronary bypass surgery might be performed for widening the constricted arteries. In severe cases, other surgical options might be considered for the patient in the final stage. Ventricular assist devices such as a pacemaker are surgically implanted so as to help the heart to pump blood.
In some cases, a biventricular pacemaker may be implanted to facilitate the contraction of both sides of the heart at the same time. Use of implantable cardioverter-defibrillator, which is a device that helps to monitor the heart rhythm, may be suggested. In severe cases, cardiac transplantation might be required. The prognosis of this heart ailment is generally poor, but the use of sophisticated treatment options and self-care measures may enable one to manage the symptoms in a better way. The life expectancy varies depending on the time when the condition is diagnosed. If diagnosed in the final stage, the prognosis and life expectancy would be poor.
A healthy heart is essential for the healthy functioning of the body, so make sure that you lead a healthy lifestyle. Hypertension, coronary heart disease and various other medical conditions make one susceptible to this heart disease. Those who have a family history of cardiomyopathy are also at a great risk. Smoking, alcohol abuse or drug abuse also make one prone, so refrain from making any such poor lifestyle choices. CHF is a serious disease, but an early diagnosis can certainly improve one's chances of a better life. So, make sure that you consult a doctor if you experience symptoms of heart failure. The fourth stage is the end stage of this deadly disease, and if the diagnosis is made when one reaches this final stage, managing the disease would be more difficult. So, pay attention to your heart's health and keep it in a good condition.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.