By Edward Pullen, MD | Check out DrPullen.com: A Medical Blog For The Informed Patient.

This is one of the oldest known medical conditions, but one for which a truly effective therapy has only recently emerged.  Historically known as “dropsy,” congestive heart failure (CHF) usually gives patients symptoms of fluid retention and swelling of the legs and feet, as well as shortness of breath.   Digitalis has been used to treat heart failure for hundreds of years and diuretic therapy has been used for decades. Until a better understanding of the physiology of heart failure on a cellular and biochemical level was achieved, physicians could do little to alter the dismal prognosis of this condition.

This has changed dramatically in the last decade.  Now we have effective treatments for CHF that have been shown to improve symptoms, reduce hospitalization and prolong life.  Effective treatment depends on first addressing the underlying causes of the heart failure.  CHF can be the result of longstanding high blood pressure, coronary artery disease, heart attacks, valve abnormalities in the heart, viral infections of the heart muscle, chronic alcohol misuse, and several other less common problems.

In addition to treating the underlying cause, directly treating CHF is now possible.  Treatment with two types of medications, beta-blockers and Angiotensin Converting Enzyme Inhibitors (ACE) or Antiotensin Receptor Blockers (ARB), has been shown to improve cardiac function, reduce symptoms of shortness of breath and fluid retention, and prevent hospitalizations and morbidity from CHF.  This is exciting for those of us in primary care.  We now manage care for many of our patients with CHF, often in consultation with other specialists like cardiologists.

Patients with CHF need to be actively involved in controlling this disease.  Salt reduction, weight loss (if appropriate), quitting tobacco use, exercise (as recommended by a physician), and consistent use of prescribed medications are very important to keep CHF under control.  The need for heart transplants has been reduced by effective long-term therapy for CHF.

With the proper diagnosis and treatment of CHF, patients can live longer and more active lives – a great leap from just a few years ago.