Congestive Heart Failure

y y Inability of the heart to pump sufficiently The hear t is unable to maintain adequate circulation to meet the metabolic needs at the body.

CAUSE/ETIOLOGY:
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narrowed arteries that supply blood to the heart muscle coronary artery disease past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work high blood pressure heart valve disease due to past rheumatic fever or other causes Primary disease of the heart muscle itself, called cardiomyopathy. Heart defects present at birth congenital heart defects. infection of the heart valves and/or heart muscle itself endocarditis and/or myocarditis Infiltrations of the muscle such as amyloidosis HIV cardiomyopathy (caused by human immunodeficiency virus) Connective tissue diseases such as systemic lupus erythematosus Abuse of drugs such as alcohol and cocaine Pharmaceutical drugs such as chemotherapeutic agents Arrhythmias

SYMPTOMS: All of the types of heart failure can result in similar symptoms, including the following:
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Shortness of breath, especially with activity such as walking Difficulty breathing when lying flat in the bed Waking up at night short of breath Fatigue Weakness Pale, blue or cool skin Palpitations Changes in blood pressure Fainting for no apparent reason Swelling in the abdomen Swollen legs

Symptoms of right-sided heart failure include:
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Swollen legs

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Liver and spleen enlargement Swollen neck veins Fluid buildup in the stomach Swollen abdomen Slow weight gain irregular heart rhythm Nausea Vomiting Appetite loss Weakness Fatigue Dizziness Fainting episodes

LABORATORY FINDINGS:
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CXR may reveal cardiomegaly ECG may identify cardiac hypertrophy Echocardiogram may show hypokinetic heart ABG and Pulse oximetry may show dereased O2 saturation PCWP is increased in LEFT sided CHF and CVP is increased in right sided CHF

TREATMENT: CHF usually requires a treatment program of:
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rest proper diet modified daily activities drugs such as o ACE (angiotensin-converting enzyme) inhibitors o beta blockers o digitalis o diuretics o vasodilators

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