CHF 2Congestive heart failure occurs when there is a malfunction in the pumping action of either the left ventricle, right ventricle, or both which causes blood to pool in the pulmonary arteries and/or veins. This pooling causes pulmonary congestion (fluid buildup in the lungs), reduced cardiac output, increased strain on the heart, decreasedefficiency of the heart muscle contraction, reduced stroke volume, increased heart rate,and hypertrophy; leading to increased risk of cardiac arrest and a decreased blood supplyto the rest of the body. Since blood is the oxygen/nutrient supply to the cells, the effectsof CHF are systemic.Risk factors for developing CHF are disorders that increase cardiac workload anddisorders that disrupt the pumping ability of the heart. Examples of such diseases are,CAD, cardiomyopathy, acute myocardial infarction, disease of the heart valves, fluidvolume overload, hypertension, COPD, pulmonary hypertension, and anemia.My patient had triple bypass surgery six years ago, so the cause of her CHF is most likelyfrom acute myocardial infarction.The diagnosis of CHF is primarily made from a composite of patient history, physicalexam, laboratory studies, and radiographs. Lab studies that indicate CHF are, low serumsodium and Hct from hemodilution and inadequate oxygen levels in the arteries from poor pulmonary perfusion. The effects of CHF cause reduced renal funciton producingelevated blood urea nitrogen and creatinine levels.The treatment of CHF is directed on decreasing the effects of the underlying causes.Pharmaceuticals are used to decrease excess fluid (diuretics), and improve cardiac output(ACE inhibitors, Beta-adrenergic blockers, inotropics, and nitrates). Nonpharmaceutical
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