Congestive Heart Failure

Congestive heart failure (CHF) is a clinical syndrome resulting from the inability of the heart to meet the metabolic requirements of the body at normal filling pressures. Although heart failure can be precipitated by left ventricular systolic dysfunction, it can also be secondary to diastolic dysfunction. Occasionally, CHF can occur without impairment of myocardial function (Braunwald et al., 1976). CHF is highly prevalent in the United States, with more than 500,000 new cases diagnosed annually. Also, mortality remains very high, with over 300,000 people dying every year from this syndrome (Hunt et al., 2001). Hospitalization for CHF in the United States is rising in both men and women at a prohibitively high cost to the health care system (O'Connell and Bristow, 1993). It is important for family physicians to understand the patho-physiology of CHF and apply known effective therapies.

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