Congestive heart failure

Mary triana xh/26

 Heart failure is a state of reduced cardiac output, in
definition which the heart cannot pump blood around the
body effectively. Congestive heart failure (CHF) is
a chronic progressive condition that affects the
pumping power of your heart muscles. While often
referred to simply as “heart
failure,” CHF specifically refers to the stage in
which fluid builds up around the heart and causes
it to pump inefficiently.
 The most common causes of heart failure are coronary
etiology artery disease and high blood pressure. Coronary artery
disease is the narrowing or hardening of arteries that
supply blood to the heart muscle, usually caused by a
buildup of fats and cholesterol. High blood pressure is
also called hypertension.
epidemiology

§ The overall prevalence of heart failure is

1 to 2% in middle-aged and older adults,
reaches 2 to 3% in patients older than age
65 years, and is 5 to 10% in patients beyond
age 75 years.
 Pathogenesis
/
pathophysiology
 § Shortness of breath (dyspnea) when you exert yourself or when you lie
down
§ Fatigue and weakness
§ Swelling (edema) in your legs, ankles and feet
§ Rapid or irregular heartbeat
§ Reduced ability to exercise
§ Persistent cough or wheezing with white or pink blood-tinged phlegm
Clinical § Increased need to urinate at night

symptoms § Swelling of your abdomen (ascites)

§ Very rapid weight gain from fluid retention
§ Lack of appetite and nausea
§ Difficulty concentrating or decreased alertness
§ Sudden, severe shortness of breath and coughing up pink, foamy mucus
§ Chest pain if your heart failure is caused by a heart attack
 Basic diagnosis

§ Laboratory examination

§ On laboratory examination: Hemoglobin 15 g / di,

§ Ht 46%

§ Leukocytes 7200 / mm3

§ Total Cholesterol 280 mg / dl

§ LDL Cholesterol 170 mg / dl

§ HDL Cholesterol 35 mg Idl. Tiglyceride 145 mg / dl

§ Sodium 136 mEg / L

§ Potassium 3.6 mEq / L.

§ Glucose 144 g / dl.

§ SGOT: 50 U / L

§ SGPT 58 U / L.

§ Creatinin 0.9 mg / dl.

§ Ureum: 14 mg / dl,

§ Uric acid: 7.6 mg / dl.

§ Troponin T: negative.

§ NT proBNP> 2000 pg / ml.

 § LAB TEST
§
§ Renal Function
§ Renal function should be assessed as a rough guide to the patient's
intravascular volume status and renal perfusion. A urinalysis is helpful in the
assessment of the patient's volume status. Electrolyte assessment and the
correction of electrolyte disturbances such
as hypokalemia, hyperkalemia and hypomagnesemia is critical in those
patients treated with diuretics. Hyponatremia (due to poor stimulation of the
baroreceptors and appropriate ADH release and free water retention) is
associated with a poor prognosis.

Lab test § Hematologic Studies

§ A complete blood count should be obtained to assess for the presence
of anemia which may exacerbate heart failure and to assess the patients
coagulation status which may be impaired due to hepatic congestion.
§ Thyroid Studies
§ The assessment of thyroid function tests is particularly important in the
patient who is being treated with concomitant therapy with an agent such
as amiodarone.
§
 § Kidney damage or failure. Heart failure can reduce the
blood flow to your kidneys, which can eventually cause
kidney failure if left untreated. Kidney damage from heart
failure can require dialysis for treatment.
§ Heart valve problems. The valves of your heart, which
keep blood flowing in the proper direction through your
heart, may not function properly if your heart is enlarged
or if the pressure in your heart is very high due to heart
failure.
complication § Heart rhythm problems. Heart rhythm problems
(arrhythmias) can be a potential complication of heart
failure.
§ Liver damage. Heart failure can lead to a buildup of fluid
that puts too much pressure on the liver. This fluid backup
can lead to scarring, which makes it more difficult for your
liver to function properly
 § Treatment depends on severity
§ Treatments can include eating less salt, limiting fluid intake
and taking prescription medication.
§
§ Lifestyle drug
§ Physical exercise, Quitting smoking, Weight loss, and Low
sodium diet

treatment §
§ Medications
§ Diuretic, Beta blocker, ACE inhibitor, Antihypertensive
drug, Dietary supplement, Blood pressure support,
Vasodilator, and Antianginal
§
§ Medical procedure
§ Cardiac resynchronization therapy
 § High blood pressure.
§ Coronary artery disease.
§ Heart attack.
§ Diabetes.
§ Some diabetes medications.
§ Certain medications t
§ Sleep apnea.

Risk factor § Congenital heart defects.

§ Valvular heart disease. .
§ Viruses.
§ Alcohol use.
§ Tobacco use.
§ Obesity.
§ Irregular heartbeat
 § The key to preventing heart failure is to reduce your
risk factors. You can control or eliminate many of the
risk factors for heart disease — high blood pressure
and coronary artery disease, for example by making

prevention lifestyle changes along with the help of any needed

medications.like Not smoking,Staying physically
active,Eating healthy foods,Maintaining a healthy
weight,Reducing and managing stress.
 § Although there have been recent improvements
in congestive heart failure treatment, researchers say
the prognosis for people with the disease is still bleak,

prognosis with about 50% having an average life expectancy of

less than five years. For those with advanced forms of
heart failure, nearly 90% die within one year.
recipe