Even though it may sound like it, congestive heart failure does not necessarily mean that the heart has failed. However, heart failure is a serious condition where the heart does not pump blood around the body efficiently.
We depend on the pumping action of the heart to deliver nutrient- and oxygen-rich blood to every cell in the body. When cells are not nourished adequately, it is not possible for the body to function properly.

If the heart is weakened and cannot supply the cells with sufficient blood, the patient becomes tired and breathless. Everyday activities that were once taken for granted become challenging.

Heart failure is a serious condition, and there is usually no cure. However, with the right treatment, the patient can still lead an enjoyable, meaningful, and productive life.

According to the National Heart, Lung and Blood Institute, approximately 50.7 million people in the World have heart failure.

Heart failure, heart attack, and cardiac arrest
man experiencing a heart attack
Heart failure comes in many forms and has many causes.
Here, we explain some important terms:


Heart attack - this is death of heart muscle due to the blockage of a coronary artery. The heart muscle dies because it is starved of oxygen (because blood is not getting to it).
Heart failure - this means the heart muscle cannot pump blood around the body properly. It is not a heart attack.
Cardiac arrest - this means the heart stops, blood circulation stops, and there is no pulse.
Causes
Heart failure is caused by any conditions that damage the heart muscle. These include:

Coronary artery disease - the coronary arteries supply the heart muscle with blood. If these are blocked or the flow is reduced, the heart does not receive the blood supply it needs.
Heart attack - a sudden block of the coronary arteries; this causes scars in the heart's tissues and decreases how effectively it can pump.
Cardiomyopathy - damage to the heart muscle other than by artery or blood flow problems; for instance caused by drug side effects or infections.
Conditions that overwork the heart - for instance, valve disease, hypertension (high blood pressure), diabetes, kidney disease, or heart defects present from birth.
The following are risk factors for congestive heart failure; they may make it more likely:

Diabetes - especially diabetes type 2.
Obesity - people who are both obese and have diabetes type 2 have an increased risk.
Smoking - people who smoke regularly run a significantly higher risk of developing heart failure.
Anemia - a deficiency of red blood cells.
Hyperthyroidism - overactive thyroid gland.
Hypothyroidism - underactive thyroid gland.
Myocarditis - inflammation of the heart muscle, usually caused by a virus, leading to left-sided heart failure.
Heart arrhythmias - abnormal heart rhythms, they may cause the heart to beat too fast, creating more work for the heart. Eventually the heart may weaken, leading to heart failure. If heartbeat is too slow not enough blood may get out from the heart to the body, leading to heart failure.
Atrial fibrillation - an irregular, often rapid heart beat; patients with atrial fibrillation have a higher risk of hospitalization due to heart failure, a study found.
Emphysema - a chronic disease that makes it hard for the patient to breathe.
Lupus - the patient's immune system attacks healthy cells and tissues.
Hemochromatosis - a condition where iron accumulates in the tissues.
Amyloidosis - one or more organ systems in the body accumulate deposits of abnormal proteins.

Symptoms

The following are possible symptoms of heart failure:

Congested lungs - fluid builds up in the lungs and causes shortness of breath even when resting and particularly when lying down. It can also cause a hacking, dry cough.

Fluid retention - because less blood is being pumped to the kidneys, it can cause water retention. This can cause swollen ankles, legs, and abdomen. It can also cause weight gain and increased urination.

Fatigue and dizziness - because less blood is reaching the organs of the body, it can cause feelings of weakness. Because less blood is reaching the brain is can also cause dizziness and confusion.

Irregular and rapid heartbeats - to try and counteract the lack of blood being pumped with each contraction of the heart, the heart might pump more quickly.

Heart failure shares symptoms with other conditions, and if anyone has the symptoms, it does not mean they have heart failure.

However, anyone who experiences more than one of the symptoms should tell their doctor and ask for an evaluation of their heart.

People who have been diagnosed with heart failure should monitor their symptoms carefully and report any sudden changes to their doctor immediately.

Types
There are many different types of heart failure:

Left-sided heart failure
Left-sided heart failure is the most common form of congestive heart failure. The left side of the heart is responsible for pumping blood to the rest of the body. Blood backs up into the lungs as it is not effectively pumped away from the heart. This can cause shortness of breath and fluid buildup.

Right-sided heart failure
The right side of the heart pumps blood to the lungs where it collects oxygen. Right-side failure is, most often, caused by fluid build-up in the lungs due to left-side failure. Sometimes it can occur due to other conditions, including lung disease.

Diastolic heart failure:
This occurs when the heart muscle is stiffer than normal. Because the heart is stiff, it does not fill up with blood properly; this is known as diastolic dysfunction.

Because the heart does not fill up with blood, it cannot pass as much blood around the body as is necessary. This can occur on either side of the heart.

Systolic heart failure:
Systolic dysfunction describes the heart's inability to pump efficiently after filling with blood. It often occurs if the heart is weak or enlarged. This can occur on either side of the heart.

Diagnosis
Most people will initially see their doctor if they have symptoms. The doctor will discuss the symptoms with the patient. If the doctor suspects heart failure, he will recommend further tests, these may include:

Blood and urine tests - these will check the patient's blood count and liver, thyroid, and kidney function. The doctor may also want to check the blood for specific chemical markers of heart failure.
Chest X-ray - an X-ray will show whether the heart is enlarged. It will also show whether there is fluid in the lungs.
An ECG (electrocardiogram) - this device records the electrical activity and rhythms of the patient's heart. The test may also reveal any damage to the heart from a heart attack. Heart attacks are often the underlying cause of heart failure.
An echocardiogram - this is an ultrasound scan that checks the pumping action of the patient's heart. The doctor measures the percentage of blood pumped out of the patient's left ventricle (the main pumping chamber) with each heartbeat - this measurement is called the ejection fraction.
The doctor may also carry out the following additional tests:

Stress test - the aim here is to stress the heart and study it. The patient may have to use a treadmill or exercise machine, or take a medication that stresses the heart.
Cardiac MRI (magnetic resonance imaging) or CT (computed tomography) scan - they can measure ejection fraction as well as the heart arteries and valves. They can also determine whether the patient had a heart attack.
B-type natriuretic peptide (BNP) blood test - BNP is released into the blood if the heart is overfilled and struggling to function properly.
Angiogram (coronary catheterization) - a catheter (thin, flexible tube) is introduced into a blood vessel until it goes through the aorta into the patient's coronary arteries. The catheter usually enters the body at the groin or arm. A dye is injected through the catheter into the arteries. This dye stands out on an X-ray and helps doctors detect coronary artery disease (arteries to the heart that have narrowed) - another cause of heart failure.

Wrist pain is often caused by sprains or fractures from sudden injuries. But wrist pain can also result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome. Because so many factors can lead to wrist pain, diagnosing the exact cause can be difficult, but an accurate diagnosis is essential for proper treatment and healing.


What are the related symptoms?
Wrist pain may vary, depending on the cause. For example, osteoarthritis pain is often described as being similar to a dull toothache, while carpal tunnel syndrome usually causes a pins-and-needles feeling or a tingling sensation, especially at night. The precise location of your wrist pain also provides clues to what's behind your symptoms.


When to see a doctor?
Not all wrist pain requires medical care. Minor sprains and strains usually respond to ice, rest and over-the-counter pain medications. But if pain and swelling last longer than a few days or become worse, see your doctor. Delayed diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.


What are the causes?
Damage to any of the parts of your wrist can cause pain and affect your ability to use your wrist and hand.

Injuries
Sudden impacts: Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. A scaphoid fracture involves a bone on the thumb side of the wrist. This type of fracture may not show up on X-rays immediately after the injury.

Repetitive stress: Any activity that involves repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain's disease is a repetitive stress injury that causes pain at the base of the thumb.

Arthritis
Osteoarthritis: This type of arthritis occurs when the cartilage that cushions the ends of your bones deteriorates over time. Osteoarthritis in the wrist is uncommon and usually occurs only in people who have injured that wrist in the past.

Rheumatoid arthritis: A disorder in which the body's immune system attacks its own tissues, rheumatoid arthritis commonly involves the wrist. If one wrist is affected, the other one usually is, too.


Other diseases and conditions
Wrist bones
Carpal tunnel syndrome: Carpal tunnel syndrome develops when there's increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist.
Ganglion cysts: These soft tissue cysts occur most often on the part of your wrist opposite your palm. Ganglion cysts may be painful, and pain may either worsen or improve with activity.
Kienbock's disease: This disorder typically affects young adults and involves the progressive collapse of one of the small bones in the wrist. Kienbock's disease occurs when the blood supply to this bone is compromised.


What are the risk factors?
Wrist pain can happen to anyone. Whether you are sedentary or active. But your risk may be increased by:

Sports participation: Wrist injuries are common in many sports, both those that involve impact and those that involve repetitive stress on the wrist. These can include football, bowling, golf, gymnastics, snowboarding and tennis.
Repetitive work: Almost any activity that involves your hands and wrists even knitting and cutting hair. If performed forcefully enough and often enough can lead to disabling wrist pain.
Certain diseases or conditions: Pregnancy, diabetes, obesity, rheumatoid arthritis and gout may increase your risk of developing carpal tunnel syndrome.

What are prevention steps?
It is impossible to prevent the unforeseen events that often cause wrist injuries, but these basic tips may offer some protection:

Build bone strength: Getting adequate amounts of calcium — 1,000 milligrams a day for most adults and at least 1,200 milligrams a day for women over age 50, can help prevent fractures.

Prevent falls: Falling forward onto an outstretched hand is the main cause of most wrist injuries. To help prevent falls, wear sensible shoes. Remove home hazards. Light up your living space. And install grab bars in your bathroom and handrails on your stairways, if necessary.
Use protective gear for athletic activities. Wear wrist guards for high risk activities, such as football, snowboarding and rollerblading.
Pay attention to ergonomics. If you spend long periods at a keyboard, take regular breaks. When you type, keep your wrist in a relaxed, neutral position. An ergonomic keyboard and foam or gel wrist support may help.

What is Wheezing?
This high-pitched whistling noise can happen when you’re breathing in or out. It is usually a sign that something is making your airways narrow or keeping air from flowing through them.

Two of the most common causes of wheezing are lung diseases called chronic obstructive pulmonary disease (COPD) and asthma. But many other issues can make you wheeze, too, including:
Allergies
Bronchitis or bronchiolitis
Emphysema
Epiglottitis (swelling of the top flap of your windpipe)
Gastroesophageal reflux disease (GERD)
Heart failure
Lung cancer
Sleep apnea
Pneumonia
Respiratory syncytial virus (RSV)
Vocal cord problems
An object stuck in your voice box or windpipe
You can also start wheezing if you smoke or as a side effect of some medications. It’s not always serious, but if you have trouble breathing, are breathing really fast, or your skin turns a bluish color, see your doctor.

If you start wheezing suddenly after an insect bite or after eating food you may be allergic to, go to the emergency room right away.

Crackling (Rales): This is a series of short, explosive sounds. They can also sound like bubbling, rattling, or clicking. You’re more likely to have them when you breathe in, but they can happen when you breathe out, too. You can have fine crackles, which are shorter and higher in pitch, or coarse crackles, which are lower. Either can be a sign that there’s fluid in your air sacs.

They can be caused by:
Pneumonia
Heart disease
Pulmonary fibrosis
Cystic fibrosis
COPD
Lung infections, like bronchitis
Asbestosis, a lung disease caused by breathing in asbestos
Pericarditis, an infection of the sac that covers your heart
Stridor
This harsh, noisy, squeaking sound happens with every breath. It can be high or low, and it’s usually a sign that something is blocking your airways. Your doctor can typically tell where the problem is by whether your stridor sounds happen when you breathe in or out. It’s not always serious, but it sometimes can be a sign of a life-threatening problem that needs medical attention right away.

You may get stridor if you have:
Laryngomalacia (softening of the vocal cords in babies)
Paralyzed vocal cord
Narrow voice box
Unusual growth of blood vessels (hemangioma) just below your vocal cords
Croup
Infection of your trachea (windpipe)
Epiglottitis (when the “lid” of cartilage that covers your windpipe swells and blocks the flow of air to your lungs)
You can also have stridor if an object gets stuck in your windpipe. You might need surgery to fix that problem.

Rhonchi: These low-pitched wheezing sounds sound like snoring and usually happen when you breathe out. They can be a sign that your bronchial tubes (the tubes that connect your trachea to your lungs) are thickening because of mucus. Rhonchi sounds can be a sign of bronchitis or COPD.

Whooping: This high-pitched gasp typically follows a long bout of coughing. If you hear a “whoop” when you breathe in, it may be a symptom of whooping cough (pertussis), a contagious infection in your respiratory system.

Pleural Friction Rub: The membranes that cover the walls of your chest cavity and the outer surface of your lungs are called pleura. If they get inflamed and rub together, they can make this rough, scratchy sound. It can be a sign of pleurisy (inflammation of your pleura), pleural fluid (fluid on your lungs), pneumonia, or a lung tumor.

Mediastinal Crunch: This sound, also called Hamman’s sign, tells your doctor that air is trapped in the space between your lungs (called the mediastinum). It’s a crunchy, scratchy sound, and it happens in time with your heartbeat. That’s because your heart movements shift the trapped air and cause the scratching sounds.

These crunching sounds can sometimes mean you have a collapsed lung, especially if you also have chest pain and shortness of breath. They also can be a sign of lung disease like COPD, pneumonia, or cystic fibrosis.


What are the test options?
Your doctor can get important information about the health of your lungs by listening closely as you breathe. The easiest and most common way to do this is to hold a stethoscope to the skin on your back and chest. This is called auscultation. As your doctor listens, she’ll ask you to take deep breaths through your mouth. She also may ask you to speak certain phrases and see how they sound through your chest or back. Some examples of this include:

Bronchophony: Your doctor will ask you to say “ninety-nine.” Normally, your lungs will muffle the words. If the words sound clear through the stethoscope, it may be a sign that your lungs are filled with blood, fluid, or mucus.

Whispered pectoriloquy: This involves whispering “ninety-nine” or “one, two, three.” Healthy lungs will dampen the sound and make the words faint, but they’ll be louder if your lungs are filled with fluid.
Egophony: If you have fluid in your lungs, your doctor uses this test to check for a collapsed lung. As you say an “e” sound, your doctor will listen to see if it’s muffled and sounds like “e” or if it’s louder and sounds like “a,” which means fluid is changing the sound.

What is West syndrome (infantile spasms)?
Infantile spasms are a type of epilepsy with a characteristic age of onset (typical age when seizures start), the pattern of seizures and electroencephalogram (EEG). This means that it is an ‘electroclinical epileptic syndrome’. The syndrome is called ‘West syndrome’ after Dr West, who first described the condition in his 4-month-old son in 1841. This type of epilepsy occurs in about one in 2,500-3,000 children.

What are the symptoms?
In 9 out of 10 children with the condition, infantile spasms occur in the first year of life, typically between 3 and 8 months old. To begin with, the attacks are usually brief and infrequent and do not occur in clusters. Therefore it is quite common for the diagnosis to be made late. The parents may initially be told their infant has colic because of the pattern of the attacks and the cry that a child gives during or after an attack.

The typical pattern is of a sudden flexion (bending forward) in a tonic (stiffening) fashion of the body, arms and legs. Sometimes, the episodes are different, with the arms and legs being flung outwards (these are called ‘extensor’ spasms). Usually, they affect both sides of the body equally.

Typically, each episode lasts just 1 to 2 seconds; there is then a pause for a few seconds followed by a further spasm. While single spasms may happen, infantile spasms usually happen in ‘runs’ or ‘clusters’ of several in a row. It is common for babies who have infantile spasms to become irritable and for their development to slow up or even to go backwards until the spasms are controlled. These babies can also behave as if they cannot see. These problems can improve if the spasms can be controlled and the EEG improves.

What is the diagnosis for West syndrome (infantile spasms)?
The diagnosis of infantile spasms is made by a combination of the typical features with a typical EEG. The EEG shows a much disorganised pattern called ‘hypsarrhythmia’. The EEG is always abnormal in children with West syndrome but sometimes this abnormality is seen only during sleep. Infantile spasms, like many other ‘electroclinical syndromes’, have lots of different causes. A particular cause will be found in 7 or 8 out of every 10 children with West syndrome. A video of the spasms is also very helpful.

Most children with infantile spasms will need a number of tests apart from the EEG. These include brain scans, blood tests, urine tests and, sometimes, spinal fluid and other tests in order to try to identify the underlying cause. The most important brain scan is the magnetic resonance imaging (MRI) scan.

What are the treatment options?
The main treatments used are corticosteroids or vigabatrin (Sabril). Nitrazepam and sodium valproate (Epilim) may also be used. There are different types of steroid that can be used. These are prednisolone (given by mouth), hydrocortisone (given by mouth or sometimes by injection) or tetracosactide (given by an intramuscular injection). Steroids must be used carefully as this treatment may cause some unpleasant side-effects. Vigabatrin may also be associated with some side-effects. Ketogenic dietary therapy (often called the ketogenic diet) may also be helpful for some infants. There may be research studies open that are relevant to this epilepsy syndrome. Your child’s doctor will be able to discuss this with you.

If your child has this syndrome they may have prolonged or repeated seizures. Your child’s doctor will discuss a ‘rescue’ or emergency care plan with you to treat any prolonged or repeated seizures. Information about treatments for children can be found on the Medicines for Children website.

In some children, infantile spasms respond easily to treatment, whereas in others they keep on happening. Most children unfortunately go on to have other kinds of seizures in later childhood including an epilepsy syndrome called Lennox-Gastaut syndrome. Most children also have learning difficulties and these may be mild or severe. The long-term outlook for West syndrome, for both the spasms stopping and the child’s development and learning, depends mainly on the cause of the syndrome.

What is common wart?
Common warts are small, grainy skin growths that occur most often on your fingers or hands. They are rough to the touch; common warts also often feature a pattern of tiny black dots, which are small, clotted blood vessels. Common warts are caused by a virus and are transmitted by touch. It can take a wart as long as two to six months to develop after your skin has been exposed to the virus. Common warts are usually harmless and eventually disappear on their own. But many people choose to remove them because they find them bothersome or embarrassing.

What are the symptoms?
Common warts usually occur on your fingers or hands and may be:
Small, fleshy, grainy bumps
Flesh-colored, white, pink or tan
Rough to the touch
Sprinkled with black pinpoints, which are small, clotted blood vessels

When to see a doctor?
See your doctor for common warts if:
The growths are painful or change in appearance or color
You've tried treating the warts, but they persist, spread or recur
The growths are bothersome and interfere with activities
You aren't sure whether the growths are warts
You are an adult and numerous warts begin to appear, which may indicate the immune system is malfunctioning

What causes Warts?
Common warts are caused by the human papillomavirus (HPV). The virus is quite common and has more than 150 types, but only a few cause warts on your hands. Some strains of HPV are acquired through sexual contact. Most forms, however, are spread by casual skin contact or through shared objects, such as towels or washcloths. The virus usually spreads through breaks in your skin, such as a hangnail or a scrape. Biting your nails also can cause warts to spread on your fingertips and around your nails.
Each person's immune system responds to the HPV virus differently, so not everyone who comes in contact with HPV develops warts.

What are the risk factors for Warts?
People at higher risk of developing common warts include:
Children and young adults, because their bodies may not have built up immunity to the virus
People with weakened immune systems, such as those with HIV/AIDS or people who've had organ transplants

What are the prevention options?
To reduce your risk of common warts:
Avoid direct contact with warts. This includes your own warts.
Don't pick at warts. Picking may spread the virus.
Don't use the same emery board, pumice stone or nail clipper on your warts as you use on your healthy skin and nails. Use a disposable emery board.
Don't bite your fingernails. Warts occur more often in skin that has been broken. Nibbling the skin around your fingernails opens the door for the virus.
Groom with care. And avoid brushing, clipping or shaving areas that have warts. If you must shave, use an electric razor.