CCF MEANS :- Congestive CARDIAC Failure. CARDIAC MEANS HEART. Heart failure is a pathophysiological state in which the heart is not able to pump adequate amounts of blood to meet the demands of the body. When the heart muscles become weak, it loses the capacity to pump the blood to different parts of the body or, because of some reason or other, the blood reaching the heart becomes less in quantity. Because of these two reasons, heart failure results. Commonest symptom is dyspnea, which is more marked in left-sided heart disease. Orthopnea, paroxysmal nocturnal dyspnea and Cheyne-Stokes respiration are seen in left-sided heart failure.Weakness, fatigue, and apathy are suggestive of low cardiac output states. Oliguria and nocturia may develop even before dependent edema manifests. Nocturia occurs in the early stages of heart failure. During daytime when the patient is ambulant cardiac function is impaired and fluid accumulates. At night, with recumbency edema fluid is reabsorbed into the circulation, cardiac function improves with rest, and the excess fluid is eliminated. Edema is the most prominent symptom in right-sided heart failure. Initially the edema is dependent, later it becomes generalized. In the early stages the edema readily pits on pressure but in long standing cases the part becomes indurated and pigmented. Hepatic congestion manifests with upper abdominal pain and tender hepatomegaly, In longstanding congestive heart failure, weight loss and emaciation develop as a result of inadequate intake of food and wasting of tissues. This picture is termed cardiac cachexia . Alterations in the cytokine system, especially increase in levels of tumor necrosis factor, interferon gamma and interleukin III also playa part in the production of cardiac cachexia.