When this happens, in addition to dyspnea, patients sometimes have a cough that produces a pinkish froth. This is a life-threatening situation and the patient must go immediately to an emergency room. Right-side failure leads to the accumulation of fluid, first in the feet, next in the ankles and legs, and finally in the abdomen. The liver may also be enlarged. Although their appetites are often depressed, patients with congestive heart failure gain weight because they retain salt and water.
Heart failure is the most common reason for hospitalization in the elderly.
More than three million Americans now suffer from heart failure, and as the population ages the incidence of congestive heart failure is rising radically. The rate of new cases more than doubled from 377,000 in 1979 to 822,000 in 1992. Men are at higher risk than women, although the difference narrows with age. African Americans are at higher risk for the disease than white Americans and are two and a half times more likely to die from it before age 65. It is most dangerous in African American women.