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Heart Failure

When the efficiency of the heart in its action as a pump is reduced, by disease of the heart muscle or malfunctioning of the valves, this is known as heart failure. It usually but not always affects both sides of the heart, and fluid tends to accumulate in the veins as a result. The term congestive heart failure is given to the condition when the whole of the heart is affected. In left-sided failure, blood returning from the lungs accumulates. The lungs become waterlogged and swollen, and this causes the main symptom of breathless­ness. In right-sided heart failure, fluid tends to accumulate in the rest of the body instead, especially in the legs, causing swelling (oedema). In bedridden patients the swelling may be most noticeable in the lower back. Right-sided heart failure may also cause the internal organs to become swollen, causing pain.

Treatment

All types of heart failure put a great strain on the heart which can be fatal, but depending on its underlying cause, treatment of heart failure can in certain cases result in complete recovery. Diuretic drugs remove excess fluid from the body by increasing urinary output. Rest is also important, but care must be taken to exercise the leg muscles to maintain circulation and prevent thrombosis. With drug treatment, the symptoms of breathlessness and swelling should subside, but if the heart fails to respond to drugs and rest, transplantation may be the only possible treatment.

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