Preload or left atrial filling pressure is increased
pulmonary congestion and dyspnea.
Although systemic blood pressure is often
reduced, there is an increase in systemic vascular
resistance (afterload) reduce cardiac output
Heart rate is generally increased as part of a
compensatory mechanism
inadequate to meet the peripheral demands of the
body
left sided leads to
Backward effect
Pulmonary congestion: Blood
is not drained from the
pulmonary circulation blood
vessels become engorged
Transudate (no
inflammation)
accumulates in the
alveolar sacs
RBCs engulfed by
macrophages
hemosiderin-laden
macrophages
Pulmonary Edema: Crackles
Forward effect
Reduced CO + less EF
because the heart is
unable to pump blood
Hypo-perfusion of organs occur
right sided leads to
Jugular venous distension
Painful hepatosplenomegaly
with “nutmeg” liver
Pitting edema (peripheral)
due to increased
hydrostatic pressure
signs and
symptoms
Rapid or irregular heartbeat
Fatigue
and
weakness
Lack of appetite and
nausea
how to check for them & confirm diagnosis
Investigations
chest X-ray
cardiothoracic ratio
ECG
blood tests
cardiac enzymes
renal function
glucose concentrations
catheterization
echocardiography
treatment
non-pharmacological
life-style modifications
pharmacological
Angiotensin-converting enzyme
inhibitors (ACEIs)
Angiotensin receptor
blockers (ARBs)
Aldosterone antagonists
β-Blockers
Vasodilators (long-acting nitrates
and hydralazine)
Diuretics
Digoxin
complications
Kidney damage or failure
Heart valve problems
Heart rhythm problems
Liver damage
prognosis
People with heart failure may
have severe symptoms, and
some may require heart
transplantation or support with a
ventricular assist device
The probability of someone with a
diagnosis of heart failure dying within five
years was 62% and 75% in men and 38%
and 42% in women, respectively
crackles on ascultation
causes
myocardial infarction
congenital
heart disease
Coronary artery
disease
arrhythmias
Abnormal heart valves
High blood
pressure
Pericarditis
Anemia
Broken ribs
Myasthenia gravis
an intense tightening in the chest, air
hunger or a feeling of suffocation
types
orthopnea
sensation of breathlessness in the recumbent
position, relieved by sitting or standing.
Paroxysmal nocturnal Dyspnea
sensation of shortness of breath that awakens
the patient, often after 1 or 2 hours of sleep.
edema
result of the activation of a series of humoral
and neurohumoral mechanisms that promote
sodium and water reabsorption by the
kidneys and expansion of the extracellular
fluid.