### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have congestive heart failure. Heart was 13 times to big, 2 years ago. Over the last week, I started failing. Blood pressure yesterday was 112 over78, 82 beats a minute, temp 97.6, but can t sleep and going down hill quickly now. I did find out, I breath better in the mountains at 5111ft or above.

### output:

Hi, After going through your case I want to know - 1) Your age and gender. 2) What is the cause of CCF, any heart attack in past3) Associated conditions like Diabetes, blood pressure or cholesterol problem. 4) Current medication are you on. 5) Earlier 2DEcho report if available. 6) Habits like smoking and alcohol. 7) Any current symptoms like puffiness of face, swelling over body, breathing difficulties. 8) In night you are not able to sleep it is because of breathing difficulties and inability to lie down flat on bed or some other causes. Anemia (low hemoglobin), kidney problem or new heart damage, undue exertion, febrile illnesses may aggravate the heart failure. I will advise you to consult cardiologist and get done clinical Examination. Following investigation may be advisable that can help in management. 1) ECG. 2) 2DEcho to know pumping capacity of heart. 3) Blood tests for heart like cardiac enzymes (troponin I/T, CLIMB), Pro - BNP. 3) Kidney, liver function test, urine Examination. 4) Complete blood count. 5) Chest X-ray. Following may be helpful for you - 1) Restrict salt and water intake. 2) Strict compliance with your medicines. 3) May need increased dose of diuretic medicine if already on or otherwise needs to start it.