heart failure, a condition in which the heart cannot pump enough blood to meet the metabolic requirements of body tissues. Many of the symptoms associated with heart failure are caused by the dysfunction of organs other than the heart, especially the lungs, kidneys, and liver. Ventricular dysfunction is usually the basic disorder in congestive heart failure. It often triggers compensatory mechanisms that preserve cardiac output but produce symptoms and signs such as dyspnea, orthopnea, rales, and edema. Heart failure is closely associated with many forms of heart disease, most of which initially affect the left side of the heart. Hence, clinicians commonly divide associated heart failure into left-sided heart failure and right-sided heart failure. Peripheral edema is associated with right-sided heart failure, and dyspnea and other respiratory disorders with left-sided heart failure. Heart failure in infants and children is usually the result of congenital heart disease but also may be caused by myocarditis and ectopic tachycardia. Rheumatic mitral disease and aortic valve disease frequently cause congestive heart failure in young adults. Mitral valve disease, especially mitral stenosis, is the most common cause of heart failure in young adults and affects more young women than men. The common causes of heart failure after 40 years of age are coronary atherosclerosis with myocardial infarction, anemia, diastolic hypertension, hypervolemia, valvular heart disease, pulmonary disease, renal disease, and diffuse myocardial disease. Some individuals may suffer heart failure caused by a combination of congenital heart disease and acquired disease. After 50 years of age, a common cause of heart failure, especially in men, is calcific aortic stenosis. Some of the extracardiac signs of heart failure are ascites, bronchial wheezing, hydrothorax, edema, liver enlargement, moist rales, and splenomegaly. Cardiac signs associated with heart failure are abnormalities in the jugular venous pulsation, the carotid pulse, and the apex wave on cardiographic tracings. Treatment for heart failure commonly involves reduction of the heart’s workload, administration of drugs such as beta-blockers, digitalis to increase myocardial contractility and cardiac output, salt-restricted diet, diuretics, angiotensin-converting enzymes to decrease afterload, and surgical intervention. Also called cardiac failure. See also compensated heart failure, congestive heart failure.
