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1. Varicose veins are an indication of what problem associated with CHF?

2. What drugs are commonly prescribed to deal with CHF (please give at least 3 different classes of cardiac medication)?

3. What changes to his lifestyle can this patient implement to reduce the risk of congestive heart failure?

Case
Presentation: A 53 year-old man came to the emergency department complaining of chest pains while working in the yard.

History: The patient was recently promoted to a management position at an insurance company in the Hartford area. He quit smoking for his 50th birthday but maintains a diet of steak and potatoes with ice cream for desserts most nights.

Signs & Tests:
HR - 65 bpm
BP - 185/65
ECG - evidence of left ventricular hypertrophy (enlargement) and extra ventricular beats
lipids - total cholesterol: 288 mg/dL
HDL (High-Density Lipoprotein; "good" cholesterol): 48 mg/dL

Diagnosis: Congestive Heart Failure (CHF) is the result of damage to the muscle of the heart that makes it work less efficiently. Blood is not pumped through the system as well as it could and can back up in certain organs, which is where the term "congestion" comes from.

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