In congestive heart failure, the heart becomes a slowly failing pump. CHF impairs the heart’s ability to supply sufficient blood flow to meet the body’s needs. Causes of CHF include coronary artery disease, long-term hypertension, and myocardial infarcts. If the left ventricle fails first, blood backs up in the lungs and can result in pulmonary edema, causing a shortness of breath on exertion, and fatigue. Conversely, if the right ventricle fails first, blood will then back up in peripheral vessels and result in edema in the extremities. Clearance from the client’s health care provider must be obtained prior to massage. A light massage of shorter duration is permissible because a vigorous massage stimulates the return of fluid to the blood, which may add stress to an already debilitated heart.

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