Respiratory failure in CHF can be very gradual andmay progress slowly over hours or days. Acute respira-tory failure is characterized by the onset of shortness ofbreath that occurs over hours or days. This can occur inCHF patients when they exercise too much, don’t taketheir medicines, or have too much salt in their diets. Itcan also occur when the patient acquires a lung infec-tion or is exposed to lung irritants that cause inflam-mation and increased mucous production.
CHF can lead to severe respiratory failure. In respira-tory failure, there can come a point where the failurebecomes so marked that the body becomes deprived ofoxygen or the level of carbon dioxide too high. Whenthese conditions occur, other organs can begin to fail aswell from the lack of oxygen. The brain is particularlysensitive to lack of oxygen and the build-up of carbondioxide. In this state, the patient can become confused,unable to make appropriate decisions about his or hertreatment, may lose consciousness, go into a coma, andif this state is prolonged and the oxygen levels becometoo low, the patient can die.
Clearly, severe respiratory failure is a medical emer-gency; the patient is critically ill and requires the atten-tion of a physician and needs to be admitted to thehospital. Because of the effect of respiratory failure onthe brain, it is inappropriate to allow the patient in se-vere failure to make decisions about visiting the doctoror emergency room. This is a situation in which a rela-tive or friend must make decisions for the patient andget the proper emergency care.