Heart failure (HF) often called congestive heart failure (CHF) is generally defined as the inability of the heart

to supply sufficient blood flow to meet the needs of the body. The names "heart failure" and "congestive heart failure (CHF)" doesn't mean that the heart has actually "failed" or stopped but mean one or more chambers of the heart "fail" to keep up with the volume of blood flowing through them.

ventricle is one of two large chambers that collect and expel blood received from an atrium towards the peripheral beds within the body and lungs.

2 types of ventricles
right ventricle pumps blood into the pulmonary circulation to/for the lungs left ventricle pumps blood into the systemic circulation through the aorta (systemic circulation).

Two types of heart dysfunction can lead to heart failure

Systolic Heart Failure This is the most common cause of heart failure and occurs when the heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. In turn, it may not have the muscle power to pump the amount of oxygenated and nutrient-filled blood the body needs. Diastolic Failure The muscle becomes stiff and loses some of its ability to relax. As a result, the affected chamber has trouble filling with blood during the rest period that occurs between each heartbeat. Often the walls of the heart thicken, and the size of the left chamber may be normal or reduced.

Four Stages of Heart Failure

 Stage A: Patients at high risk for developing HF in the future but no functional or structural heart disorder;  Stage B: a structural heart disorder but no symptoms at any stage;  Stage C: previous or current symptoms of heart failure in the context of an underlying structural heart problem, but managed with medical treatment;  Stage D: advanced disease requiring hospital-based support, a heart transplant or palliative care.

Functional Classification
 Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.  Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.  Class III: marked limitation of any activity; the patient is comfortable only at rest.  Class IV: any physical activity brings on discomfort and symptoms occur at rest.

 Dyspnea  Tachycardia  Chest pain  Fatigue  Chronic cough  Irregular heartbeat  Lack of appetite or nausea  Mental confusion  Swelling  Rapid weight gain

Ischaemic heart disease Cigarette smoking Hypertension (high blood pressure) Obesity Diabetes Valvular heart disease (much higher in older populations)

Echocardiography Chest X-rays Electrocardiogram Blood tests Angiography

Kidney damage or failure Heart valve problems Liver damage Heart attack and stroke

Medications
Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Digoxin (Lanoxin) Beta blockers Diuretics Aldosterone antagonists

Surgery and medical devices

Coronary bypass surgery Heart valve repair or replacement Implantable cardioverter-defibrillators (ICDs) Cardiac resynchronization therapy (CRT) or biventricular pacing Heart pumps (left ventricular assist devices, or LVADs)

 Place the patient in Fowler's position and give him supplemental oxygen to help him breathe more easily. Organize all activity to provide maximum rest periods.  Weigh the patient daily, and check for peripheral edema. Also, monitor I.V. intake and urine output especially for patient with diuretic  Assess vital signs and mental status. Auscultation for abnormal heart and breath sounds.  Provide continuous cardiac monitoring during acute and advanced stages to identify and treat arrhythmias promptly.  To prevent deep vein thrombosis from vascular congestion, help the patient with range-of-motion exercises. Apply antiembolism stockings as needed. Check for calf pain and tenderness.

 Monitor the patient for signs and symptoms of fluid overload, impaired gas exchange, and activity intolerance explanation of the disease process helps the patient understand the need for the prescribed medications, activity restrictions, diet, fluid restrictions, and lifestyle changes. Helping the patient work through and verbalize these feelings may improve psychological well-being assess abnormal response to increased activity Increase of activity when no complaint Dyspnea, or not perceived Dyspnea increases