It's all about congestive heart failure or congestive cardiac failure. Explained in very easy words. All can understand easily. It's a very important topic for exam.

1. PRESENTED BY-
BIPLAB DHIBAR(GNM 2ND YEAR)
MANJUSHREE SCHOOL OF NURSING

2. INTRODUCTIO
N
The full form of CCF is congestive cardiac failure .
The names congestive heart failure or heart failure
doesn’t mean heart has actually failed or stopped but
means one or more chambers of heart has failed to keep
up the volume of blood flowing through them.
It is a serious, progressive condition that is usually
chronic and can be life threatening.
Here congestive/congestion means ‘excessive fluid build
up’ like nasal congestion.

3. DEFINITIO
N
Congestive cardiac failure can be
defined as physiologic state in which
the heart is unable to pump enough
blood to meet the metabolic needs of
the body at rest or during exercise even
though filling pressure are adequate

4. TYPE
S
ACCORDING TO THE SIDE OF HEART-
• 1.Right sided heart failure- The right ventricles loses its
pumping function and blood may back up into other
areas of the body .
• 2. Left Sided Heart Failure- The left heart is unable to
maintain its circulatory load ,with corresponding rise in
pressure in the pulmonary circulation.

5. TYPE
S
According to the phase-
• 1. Systolic Dysfunction :- its also called as reduced ejection fraction. here
heart muscles are too weak ,the ventricles stretch out (enlarged)and fail to
contract efficiently . less blood is pumped out .
• 2. Diastolic Dysfunction :-It’s Also Called As Preserve Ejection Fraction.
Heart Muscles Become Stiff, thick, rigid ,Inelastic. So That They No Longer
Fill Properly. It Can’t Relax Properly During Diastole.
• N.B- ejection fraction means amount of blood pumped out of the left
ventricles each time it contracts

6. CAUSES
SYSTOLIC DYSFUNCION:-
Ischemic heart disease.
Hypertension.
Diabetes.
Myocarditis.
Heart valve disease.
Overweight,smoke,alcohol.
DIASTOLIC DYSFUNCTION:-
Coronary artery disease.
Aortic stenosis.
Hemochromatosis.
Cardiac tembonadi.
Constrict pericarditis.
Myocardial infarction.

7. PATHOPHYSIOLOG
Y
DUE TO ETIOLOGY
PUMP FAILS-DECREASED STROKE VOLUME
COMPENSATORY MECHANISMS KICKS TO INCREASE CARDIAC OUTPUT
VASOCONSTRICTION
SODIUM AND WATER RETENTION
EXCESSIVE TACHYCARDIA
SIGN AND SYMPTOMS

8. CLINICAL
MANIFESTATION
LEFT SIDED FAILURE
 Paroxysmal nocturnal dispend.
 Elevated pulmonary capillary wedge
pressure.
 Pulmonary congestion
 Restlessness
 Tachycardia
 Cyanosis
 Fatigue
 Orthopnia
RIGHT SIDED FAILURE
 Fatigue
 Ascites
 Peripheral venous pressure increase
 Enlarged liver & spleen
 Distended jugular veins
 Weight gain
 Dependent edema
 Chronic pulmonary problem

10. DIAGNOSTIC
EVALUATION
 HISTORY COLLECTION.
PHYSICAL EXAMINATION.
ECG
EEG
CARDIAC CATHETERIZATION
EXERCISE TEST
MRI
X-RAY
BLOOD TEST

11. MEDICAL MANAGEMENT
 VASODIALATOR
CAPTOPRIL
ENALAPRIL
FOSINOPRIL
 DIURETIC
BUMETANIDE
FUROSEMIDE
METALAZONE
 BETA BLOCKER
METOPROLOL
CARVIDILOL
BISOPROLOL
 CALCIUM CHANNEL BLOCKER
NIFEDIPINE
AMLODIPINE
FELODIPINE

12. SURGICAL MANAGEMENT
Coronary artery bypass graft surgery
Coronary angioplasty
Implantable cardiac defibrillator
Intra aortic balloon pump
Left ventricular assist device
Valve replacement surgery
Pacemaker insertion
Heart transplantation

13. NURSING MANAGEMENT
Maintain the patient in high fowler's position
 Elevate extremities except when the patient is in acute distress• Frequently
monitor vital signs
Change position frequently
 Monitor intake and output and daily weight.
Restrict fluids as ordered
 Teach the patient and family and provide emotional support (life style
change)
 Explain the side effect of diuretic medications for additional actions (side
effects of diuretics include electrolyte imbalance, symptomatic hypotension
 Use aseptic procedures when caring for invasive lines

14. NURSING DIAGNOSES
oDecreased cardiac output
oActivity intolerance•
o Fluid volume excess
o Impaired gas exchange
oAnxiety
oDeficient knowledge