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Kegagalan jantung, juga dikenali sebagai "kegagalan jantung kongestif," adalah satu gangguan di

mana jantung hilang keupayaannya untuk mengepam darah dengan cekap. Hasilnya ialah

bahawa badan tidak mendapat oksigen dan nutrien yang banyak kerana ia perlu, membawa

kepada masalah seperti kelesuan dan sesak nafas. Kegagalan jantung selalunya keadaan yang

kronik, jangka panjang yang diuruskan dengan ubat-ubatan dan perubahan gaya hidup.

(Walaupun kadang-kadang boleh membangunkan tiba-tiba.)

Gagal jantung kongestif atau Congestive Heart Failure (CHF) adalah keadaan di mana jantung

tidak dapat memompa darah secara maksimal agar dapat disalurkan ke seluruh tubuh yang

memerlukan.

Gagal jantung kongestif dapat disebabkan oleh penyakit-penyakit yang melemahkan atau

menyebabkan kekakuan pada otot-otot jantung dan penyakit-penyakit yang meningkatkan

permintaan oksigen diluar kemampuan jantung untuk memberikannya.

Berbagai penyakit seperti hemochromatosis atau amyloidosis penyusupan dapat menyebabkan

otot jantung menjadi kaku dan mengganggu fungsi jantung. Tekanan darah tinggi yangberkepanjangan juga dapat mengakibatkan penebalan jantung (hypertrophied).

Semua hal tersebut dapat menjadi pemicu gagal jantung kongestif. Gagal jantung kongestif dapat

berakibat buruk pada organ-organ tubuh. Otot-otot jantung yang melemah mungkin tidak mampu

mensuplai darah yang cukup ke ginjal.

Akibatnya, fungsi ginjal untuk mengekskresi garam (sodium) dan air terganggu sehingga tubuh

menahan lebih banyak cairan. Paru-paru mungkin menjadi padat dengan cairan. Kondisi ini

dikenal dengan istilah pulmonary edema.

Cairan juga mungkin terkumpul dalam hati, dengan demikian mengganggu kemampuannyauntuk menghilangkan racun-racun dari tubuh dan menghasilkan protein-protein penting. Usus-

usus mungkin menjadi kurang efisien dalam menyerap nutrisi-nutrisi dan obat-obat. Ya, jika

tidak dirawat, gagal jantung kongestif yang memburuk akan mempengaruhi setiap organ dalam

tubuh yang tentu saja mengancam kehidupan.

Apa Saja Gejala Gagal Jantung Kongestif?

Gagal jantung kongestif terjadi dalam beberapa tahap. Pada awalnya, penderita gagal jantung

kongestif akan mengalami kelelahan, lemas, dan sakit ketika penderita beraktivitas cukup berat.

Celakanya, gejala gagal jantung kongestif semacam ini sering diabaikan sehingga tidak

terdeteksi lebih awal karena dianggap tidak berbahaya.

Tahap selanjutnya, penderita gagal jantung kongestif mencapai tingkat lanjut yaitu jantung

berdebar secara cepat dan tidak normal. Orang tersebut tidak dapat lagi melakukan aktivitas

sehari-hari seperti biasanya. Jika merasa lelah sedikit saja, maka palpitasi akan terjadi. Maka,

orang yang mengalami gagal jantung akan lebih sering menghabiskan waktu di tempat istirahat.

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Berikutnya, akan terjadi pembengkakan (edema) di pergelangan-pergelangan kaki atau perut

karena penimbunan cairan di dalam tubuh akibat gagal jantung kongestif dan di malam hari,

penderita akan lebih sering buang air kecil. Jika cairan berakumulasi dalam paru-paru, penderita

akan mengalami sesak napas, terutama selama olahraga/latihan dan ketika berbaring rata.

Pada beberapa kasus, pasien bisa jadi terbangun di malam hari karena sesak napas. Bila cairanterkumpul dalam hati dan usus maka akan menyebabkan mual, nyeri perut, dan nafsu makan

yang berkurang. Pengidap gagal jantung kongestif juga akan merasakan sakit luar biasa serta

ketidakmampuan menjalankan kegiatan sehari-hari dan gejala-gejala yang menyertai gagal

jantung kongestif akan semakin meningkat intensitasnya.

Bagaimana perawatannya? Perawatan gagal jantung kongestif diberikan berdasarkan situasi dan

kondisi pasien. Pada tahap pertama, penderita gagal jantung kongestif diberi obat penghambat

ACE. Obat ini berfungsi untuk memperbesar pembuluh darah dan membantu lancarnya aliran

darah. Jika penderita juga mengalami tekanan darah tinggi, ia akan diberiBeta blockers untuk

mengontrol tekanan darah.

Selain obat-obat kimia tersebut, beberapa tanaman obat dapat membantu Anda yang mengalami

gagal jantung kongestif diantaranyaNoni JuicedanSarang Semut. Kedua herbal tersebut dapat

membantu mengatasi gejala-gejala gagal jantung kongestif.

Mekanismenya ialah dengan menyehatkan pembuluh darah yang menyempit dan melancarkan

peredaran darah serta dengan merevitalisasi sel-sel jantung yang mungkin rusak. Jika obat-

obatan medis dan herbal tidak lagi dapat mengatasi gangguan gagal jantung kongestif, operasi

dan transplantasi jantung merupakan pilihan terakhir bagi kehidupan Anda.

Treatment:

Use of diuretics, nitrates, analgesics, and inotropic agents are indicated for the treatment ofCHF and pulmonary edema. Calcium channel blockers, such as nifedipine and

nondihydropyridines, increase mortality and increase incidence of recurrent CHF with

chronic use. Conflicting evidence currently exists in favor, as well as against, the use of

calcium channel blockers in the acute setting; at this time limit their acute use to patients

with diastolic dysfunction and heart failure, a condition not easily determined in the ED

Congestive Heart Failure Causes

Congestive heart failure (CHF) is a syndrome, not a disease, that can be brought about by several

causes. CHF is a weakening of the heart brought on by an underlying heart or blood vessel

problem, often a combination of several different problems, including the following:

Weakened heart muscle Damagedheart valves Blocked blood vessels supplying the heart muscle (coronary arteries), leading to a heart attack Toxic exposures, like alcohol orcocaine

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Infections High blood pressure that results in thickening of the heart muscle (left ventricular hypertrophy) Pericardial disease, such aspericardial effusion(a large collection of fluid around the heart in

the space between the heart muscle and the thick layer ofpericardiumsurrounding the heart)

and/or a thickened pericardium, which does not allow the heart to fill properly

Congenital heart diseases Prolonged, serious arrhythmias

While these conditions often combine to produce CHF, sometimes the causes of diseased heart muscles

are not known; this is calledidiopathic cardiomyopathyor heart muscle disease of unknown cause.

CHF is often a result of the following lifestyle habits:

Unhealthy habits, such as smoking and excessive use of alcohol, are often to blame. Obesityand lack of activity may contribute to CHF, either directly or indirectly through

accompanying high blood pressure,diabetes, andcoronary artery disease.

Years of uncontrolled high blood pressure damages both heart and blood vessels.Along with lifestyle risk factors, a number of diseases (for example, diabetes, heart attack

[myocardial infarction], andcongenital heart disease) can damage the heart and lead to

congestive heart failure. Over a hundred other, less common, causes of CHF include a variety of

infections, exposures, complications of other diseases, toxic effects, andgeneticpredisposition.

Whether through disease or lifestyle choices, the pumping action of the heart can be impaired by

several mechanisms:

Heart muscle damage (cardiomyopathy): The heart muscle can become weak because ofdamage or disease and thus does not contract or squeeze as forcefully as it should. This damage

to the muscle can occur from coronaryheart disease(coronary artery disease) leading to a heart

attack, or long-standing high blood pressure,viral infection,alcohol abuse, diabetes, or many

other less common causes. Sometimes, the cause is not known.

Heart attack (myocardial infarction): A heart attack commonly causes severe pain in the chest,shortness of breath,nausea,sweating, and/or a feeling of impending doom. Heart attack may

rapidly lead to eithercardiac arrest(no heartbeat) or permanent damage of the left ventricle. If

this damage is bad enough, that part of the heart will not work properly, which leads to heart

failure.

High blood pressure (hypertension): Abnormally high blood pressure increases the amount ofwork the left ventricle has to do to pump blood out into the circulatory system. Over time, this

greater workload can damage and weaken the heart. This can lead to heart failure if this

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damage is allowed to go on unchecked. Proper treatment of high blood pressure can prevent

left ventricular hypertrophy and heart failure.

Heart valve problems: The valves of the heart normally keep the blood flowing in the rightdirection through the heart. Abnormal heart valves impede this forward flow in 1 of 2 ways.

o An incompetent valve is a valve that does not close properly when it should and allowsblood to flow backward in the heart, "against the current." When blood flows the wrong

way across a valve, the heart has to work harder to keep up its output. Eventually, this

backed up blood accumulates in the lungs and the body.

o A stenotic valve is a valve that does not open properly when it should. Blood flowthrough the narrowed opening is blocked, creating an increased workload on the heart.

Abnormal rhythm or irregular heartbeat: Abnormal heart rhythms lower the heart'seffectiveness as a pump. The rhythm may be too slow or too fast, or irregular. The heart has to

pump harder to overcome these rhythm disorders. If this excessively slow or fast heartbeat is

sustained over hours, days, or weeks, the heart can weaken, which can cause heart failure.

Other conditions may have injured the heart such asthyroiddisorders (too much or too littlethyroid hormone) or treatments forcancer(radiationor certainchemotherapydrugs).

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