May 20, 2022
Author: Jonathan Lam, PA-C
Nearly 5 million Americans are currently living with congestive heart failure (CHF), with over half a million new cases each year1.
There are many patients who experience chest pain or pain in the legs, but in reality this pain may be due to a weakening heart. As you can imagine, it is crucial to identify the source of this pain before determining the best treatment plan, so let’s talk about some ways we can identify if the pain you’re experiencing may be caused from CHF.
What Is CHF?
Congestive Heart Failure (CHF) is the inability of the heart to pump sufficient blood to meet the metabolic demands of the body. Some doctors refer to the condition as having a “leaky” heart.
This is most commonly due to coronary artery disease and is typically a chronic issue. However, patients can experience painful acute exacerbations that present as leg and/or chest pain.
There are multiple different forms of heart failure with several different causes2. Doctors typically classify patients’ heart failure based on the severity of their symptoms, and this classification is helpful in understanding the potential likelihood of these sudden painful experiences.
What Are The Symptoms?
Difficulty breathing (dyspnea) is the most common symptom of CHF. This can often be associated with congestion and swelling in the legs.
This is where the pain comes in.
Patients will often complain of pain in their legs when the swelling worsens. Sometimes when the pain gets bad enough, patients may go to the ER or to their pain clinic to seek assistance2.
How Is It Treated?
While opioids may be helpful in treating other types of acute pain, they will likely not benefit a patient who is having an acute heart failure exacerbation. Acute CHF exacerbations are often considered medical emergencies, especially if the patient is short of breath.
The pain that patients experience in their legs is usually due to increased fluid accumulation and swelling, which can be very painful. To treat this pain, the fluid must be pulled out of the surrounding tissues with medications, such as diuretics or “fluid pills.” Once stabilized, other medications such as vasodilators, beta-blockers, and a low sodium diet may be initiated.
It is important that the patients who are diagnosed with CHF follow up with their cardiologist regularly!
What Now?
If you or someone you know is experiencing pain that you suspect may be from CHF, we recommend that they see a doctor right away.
Even though CHF may not be an issue that we actively treat in interventional pain management, we can always help guide the patient in the right direction and make sure they get proper care. It is not uncommon that we will see a patient here at Genesis that is experiencing pain symptoms that mirror that of CHF pain.
If you are not sure where your pain is coming from, you can schedule a quick visit with any of our specialists and they can assist you in finding answers and ultimately solutions!
Resources
https://www.emoryhealthcare.org/heart-vascular/wellness/heart-failure-statistics.html#:~:text=Nearly%205%20million%20Americans%20are,middle%2Daged%20and%20the%20elderly
PANCE Prep Pearls by Dwayne A. Williams
Essentials of Diagnosis & Treatment by Lawrence Tierney, Jr., MD; Sanjay Saint, MD; and Mary Whooley, MD
