Zusammenfassung der Ressource
Aisha is not feeling well
- later diagnosed with
- congestive heart failure
- occurs when
- The heart is unable to pump
blood at a rate that meets the
metabolic requirements of
the peripheral tissue;
inadequate cardiac output is
usually accompanied by
increased congestion of the
relevant venous circulation.
- Classification
- Left-sided versus right-sided failure
- Left ventricular failure and right ventricular failure
can occur independantly or together as congestive
cardiac failure
- RVH
- LVF
- Pulmonary stenosis
- Lung disease
- Symptoms
- Peripheral edema
- Ascites
- Nausea
- Facial engorgement
- Pulsation in neck and face
- Epistaxis
- LVH
- Dyspnea
- Poor exercise tolerance
- fatigue
- Orthopnea
- PND
- Nocturnal cough
- Wheeze
- Muscle wasting
- Weight loss
- Cold peripheries
- Nocturia
- Low-output versus high-output failure
- High-output heart failure
- Output is normal or
increased with increased
needs. Failure occurs when
cardiac output fails to
meet these needs. Occ- urs
with a normal heart but
ear- lier if there is heart
disease.
- Consequence
- Initially features of
RVF, then LVF becomes
evident
- Causes
- Anemia
- pregnancy
- Hyperthyroidism
- Paget's disease
- Low-output heart failure
- Cardiac output is decreased and fails to
increase normally with exertion.
- Causes
- Pump failure
- Systolic ordistolic
- Heart failure
- decreased HR
- Excessive overload
- MR
- fluid overload
- Chronic excessive after load
- AS
- Hypertension
- Systolic versus diastolic
failure
- Systolic failure
- Inability of the ventricle to
contract normally, resulting in
decreased cardiac output.
Ejection fraction is <40%.
- Causes
- IHD
- MI
- DCM
- myocarditis
- Diastolic Failure
- Inability of the ventricle to
relax and fill normally
causing increased fillinf
pressures. Ejection fraction
> 50%.
- Causes
- Constrictive pericarditiS
- Tamponade
- Restrictive cardiomyopathy
- Hypertension
- Acute versus chronic heart
failure
- Acute heart failure
- Is often used exclusively to mean
new onset acute or
decompensation of chronic heart
failure characterised by
pulmonary and/or peripheral
edema with or without signs of
peripheral hypoperfusion.
- Chronic Heart failure
- Develops or progresses
slowly, venous congestion
is common but arterial
pressure is well
maintained until very late.
- prognosis
- Poor with 25 - 50% of patients dying
within 5 years of diagnosis.
- Diagnosis
- Routine laboratory Test
- biomarkers
- Echocardiography
- ECG
- Recommended test in all heart failure patients.
- CXR
- Cardiomegaly
- Dilated prominent
upper lobe vessels
- pleural
effusion
- Kerley B lines
- Alveolar Edema
- Bat wisngs
- Interstitial edema
- ECG in CHF can show abnormalities as
arrhythmias, ischemia, MI, LVH, conduction
abnormalities such as PVCs, LBBB.
- Symptoms
- Risk factors
- Tobacco use
- Hyperlipidemia
- Hypercholestremia
- Diabetes
- Management
- Non-pharmacological
- Limiting salt intake for all HF patients
- Limiting fluid intake for those with
hyponatremia, high diuretics intake
and severe HF
- Exercise for those with stable heart
and stable volume levels
- Monitoring all HF patients
- Pharmacological
- Drugs used
- Decreased load on the heart
- Diuretics
- ACE inhibitors
- ARBs
- Vasodilators
- Increase the function of the heart
- Beta-blockers
- Adrenergics
- Inotropic-cardiotonic drugs
- Digoxin
- Phosphodiestrase inhibitors
- Dobutamine
- Adrenaline
- Manifestations upon physical examinatio
- complications
- Stages
- Cardiac cachexia
- Arrhythmia
- Kidney problems
- Anemia, stroke
- Leg venous stasis
- liver problems
- Hyponatremia
- of
- RHF
- JVD
- Hepatosplenomegaly
- Pitting Edema
- LVH
- Pulmonary congestion
- Decreased forward perfusion
- Cardiomegaly
- Tachycardia
- S3
- Ventricular Dilation
- Arrhythmia
- presented with
- Orthopnea
- definition
- Difficulty in breathing that occurs when
lying down and is relieved upon
changing to an upright position.
- Causes
- LFH
- Bronchial Asthma
- Mitral stenosis
- MarkedAscites
- Anxiety &
hyperventilation
- Bilateral
diaphragmatic
paralysis
- pericardial diesease
- Oedema
- definition
- Is the accumelation of
excessive fluid in the
subcutaneous tissue.
- Causes
- Impairment of
lymphatic drainage
- Generalized
- Congenital
deiciency of
lymphatics
- Localized
- Local infection
- Trauma
- Burns
- Animal bites / stings
- Increased plasma
hydrostatic pressure:
- Generalized
- CHF
- Vasodialatory
drugs
- Localized
- Venous
obstruction
- Decreased plasma
oncotic pressure
- Generalized
- Liver disease
- Renal disease
- Malnutrition/
malabsorption
- localized
- Milroy's disease
- Lymphoedema
praecox
- Malignant
infiltration
- Dyspnea
- definiton
- Is the uncomfortable
awareness of breathing
- Causes
- sudden
- Pneumothorax, Pulmonary embolism,
Aspiration, Anaphylaxis , Anxiety,
Chest trauma
- Acute
- Asthma, Respiratory tract infection,
Lung tumors, Pleural effusion,
Metabolic acidosis
- Chronic
- COPD, Cardiac failure, Fibrosing
alveoli's, Anaemia, Arrhythmia, Vavular
heart disease, Chest wall deformities,
Pulmonary hypertension
- Fatigue
- definition
- A subjective symptom of malaise and aversion to
activity or to objectively impaired performance.