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Congestive Heart Failure
January 2001

Q. What are the symptoms of congestive heart failure? What are the things that show or bring it on, i.e., swelling in ankles/feet? How do you know you are at risk? Once you know you are at risk, and the doctors put you on fluid pills and they do not work, how do you know if you have actually gone from "if we don't get this under control, it could cause CHF" to "you are now in CHF?"

A. The symptoms of congestive heart failure are not too specific; the symptoms can be caused by several different diseases. The primary symptoms are: shortness of breath, especially with exercise or at night, when asleep, and swelling of the ankles, especially later in the day. You are at risk if you have any of a variety of diseases, such as high blood pressure or a past history of a heart attack. Your question, however, is when do you cross the line between having risk factors and having heart failure.

In part this is a semantic or arbitrary distinction. In my opinion, once you start having the symptoms of heart failure caused by the heart (remember that the symptoms can be caused by other diseases, too), then you have congestive heart failure and you should be treated accordingly.

You can learn more about congestive heart failure at the American Heart Associationšs heart failure Web site (http://www.americanheart.org/). Exactly which of the current treatments is best for you is best determined by you and your doctor.

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