Successfully reported this slideshow.
Your SlideShare is downloading. ×

CCF.pptx

Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Loading in …3
×

Check these out next

1 of 35 Ad
Advertisement

More Related Content

Recently uploaded (20)

Advertisement

CCF.pptx

  1. 1. REVIEW OF ANATOMYAND PHYSIOLOGY……
  2. 2. INTRODUCTION • Heart failure is often referred as congestive heart failure (CHF). Occurs when heart is unable to pump sufficiently to maintained blood flow to meets the body needs This condition results of - • SYSTOLIC DYSFUNCTIONS OR • DIASTOLIC DYSFUNCTIONS.
  3. 3. INCIDENCE • More than 20 million people have heart failure worldwide • Prevalence of heart failure in India due to coronary heart disease, hypertension, obesity, diabetes and rheumatic heart disease to range From 1.3 to 4.6 million, with an annual incidence of 491 600-1.8 million. • Heart failure is the leading cause of hospitalization in people older than 65
  4. 4. CLASSIFICATION 1.Left sided v/s right sided heart failure 2. Forward v/s backward failure 3. Acute v/s chronic failure
  5. 5. LHF • In left sided heart failure, left ventricle cardiac output is less then volume received from pulmonary circulation; blood accumulates in the left ventricle, left atrium. • pulmonary congestion forcing fluid from pulmonary capillaries into pulmonary tissue and alveoli causing pulmonary interstitial edema and impaired gas exchange.
  6. 6. RHF • In right sided heart failure right ventricle cardiac output is less then volume received from the peripheral venous circulation, blood accumulates in RA, RV and peripheral venous system. • Increased venous pressure lead to JVD and increased capillary hydrostatic pressure throughout the venous system
  7. 7. FORVWARD V/S BACKWORD • Backward Heart Failure: One of the ventricles fails to pump out all of its blood that comes into it. Thus, the ventricular filling pressure and systemic or pulmonary edema increase. • Forward Heart Failure: The heart is not pumping out enough blood to satisfy the needs of the cells of the body.
  8. 8. ACUTE V/S CHRONIC • Acute failure occurs in response to a sudden decrease in cardiac output which results in rapid decrease in tissue perfusion. • So chronic failure, body adjusts to decrease in cardiac output through compensatory mechanism which results in systemic congestion.
  9. 9. ETIOLOGY The incidence of heart failure increases with advancing age and coronary artery disease • Diabetes • Cigarette Smoking • Obesity • Elevated Total Cholesterol • Abnormally High Or Low Hematocrit Level • Proteinuria Common Precipitating Causes Of Heart Failure Are As Follows • Anaemia • Infection
  10. 10. CONT…… • Thyrotoxicosis is a condition in which you have too much thyroid hormone in your body. • Arrhythmias • Bacterial Endocarditis • Valvular Dysfunction • Pulmonary Embolis • Paget's disease of bone is a chronic disease of the skeleton. In healthy bone, a process called remodeling removes old pieces of bone and replaces them with new, fresh bone. Paget’s disease causes this process to shift out of balance, resulting in new bone that is abnormally shaped, weak, and brittle.
  11. 11. CLINICAL PICTURE: IN LEFTSIDED HEARTFAILURE
  12. 12. INRIGHTSIDEDH E A RTFAILURE
  13. 13. BIVENTRICULARFAILURE • DULLNESS • PLEURAL EFFUSION
  14. 14. Common sign and symptoms of heart failure
  15. 15. DIAGNOSTIC ASESSMENT • History collection • Physical examination • ABG analysis • Serum chemistries • Liver profile • Chest X ray • Hemodynamic monitoring • 12 leads ECG • Nuclear imaging studies • Cardiac catheterization • 2D echocardiogram
  16. 16. MEDICAL MANAGEMENET -Acute Decompensation -Chronic management -Lifestyle -Medication -Minimally invasive therapies
  17. 17. PHARMACOLOGICAL MANAGMENT •DIGOXIN •BETA BLOCKER •INOTROPES •ARBS •ACE INHIBITORS •WATER PILLS
  18. 18. DIGOXIN • Exerts a direct and beneficial effect on the myocardial contraction in the failing heart. • Improved cardiac output enhances kidney perfusion, which may create a mild dieresis of sodium and water • DOSE: 0.125-0.25 mg PO/IV qDay; higher doses including 0.375-0.5 mg/day rarely needed
  19. 19. BETA-BLOCKERS TO TREAT CHF • Coreg (carvedilol)—6.25-50 mg; one 3.125, 6.25, 12.5 or 25-mg tablet 2x/day with food.
  20. 20. INOTROPES • Agent such as dopamine, dobutamine and amrinone may be ordered for clients with very low output heart failure. • These medications facilitate myocardial contractility and enhance stroke volume. • dopamine given in small doses(< 4 ug/kg/min)
  21. 21. ACE INHIBITORS • ACE inhibitors can raise potassium levels • Accupril (quinapril)—20-40 mg; one 10 or 20 mg tablet 2x/day on an empty stomach, 1 hour before or 2 hours after a meal or with a light, low-fat meal. • Altace (ramipril)—10 mg; one 5 mg capsule 2x/day with or without food. Swallow capsule whole.
  22. 22. WATER PILLS • There are many brands of diuretics. Some are taken once a day. Others are taken 2 times a day. The most common types are: • Thiazides. Chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), hydrochlorothiazide (Esidrix, HydroDiuril), and metolazone (Mykrox, Zaroxolyn) • Loop diuretics. Bumentanide (Bumex), furosemide (Lasix), and torasemide (Demadex)
  23. 23. SURGICAL MANAGEMENT HEART TRANSPLANTATION:  When the heart is irreversibly managed and no longer functions adequately and when the client is at risk of dying, cardiac transplantation and use of an artificial heart to assist or replace the failing heart are measures  A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed of last resort.
  24. 24. CONTAINDICATION Absolute contraindications: • Advanced kidney, lung, or liver disease • Active cancer if it is likely to impact the survival of the patient • Life-threatening diseases including acute infection or systemic disease such as systemic lupus erythematosus, sarcoidosis, or amyloidosis Vascular disease of the neck and leg arteries. • High pulmonary vascular resistance - over 5 or 6 Wood units.
  25. 25. Relative contraindications • Insulin-dependent diabetes with severe organ dysfunction • Recent thromboembolism such as stroke • Severe obesity • Age over 65 years (some variation between centers) - older patients are usually evaluated on an individual basis. • Active substance abuse, such as alcohol, recreational drugs or tobacco smoking (which increases the chance of lung disease)
  26. 26. HEART TRANSPLANTATION Pre-operative • A typical heart transplantation begins when a suitable donor heart is identified. The heart comes from a recently deceased or brain dead donor, also called a beating heart cadaver. • . The patient is also given immunosuppressant medication so that the patient's immune system does not reject the new heart.
  27. 27. CARDIOMYOPLASTY • Cardiomyoplasty is a surgical procedure in which healthy muscle from another part of the body is wrapped around the heart to provide support for the failing heart. • Most often the latissimus dorsi muscle is used for this purpose. • A special pacemaker is implanted to make the skeletal muscle contract. Cardiomyoplasty is related to damaged myocardium remodeling.
  28. 28. VENTRICULAR ASSIST DEVICE (VAD):
  29. 29. It is a Electromechanical device for assisting cardiac circulation, which is used either to partially or to completely replace the function of a failing heart. The function of VADs is different from that of artificial cardiac pacemakers; some are for short-term use, typically for patients recovering from myocardial infarction (heart attack) and for patients recovering from cardiac surgery
  30. 30. CARDIAC RESYNCHRONIZATION THERAPY
  31. 31. Cardiac Resynchronization Therapy (CRT). • It resynchronizes the contractions of the heart’s ventricles by sending tiny electrical impulses to the heart muscle, which can help the heart pump blood throughout the body more efficiently. • CRT defibrillators (CRT-D) also incorporate the additional function of an implantable cardioverter-defibrillator, to quickly terminate an abnormally fast, life-threatening heart rhythm.
  32. 32. MANAGEMENT •NURSING MANAGEMENT • PALLIATIVE CARE • CARDIAC REHABILITATION EXERCISE
  33. 33. NURSING MANAGEMENT : • The objective of nursing intervention will be: • 1. Improving cardiac output • 2. Improving gas exchange • 3. Restoring fluid volume balance • 4. Improving activity tolerance • 5. Supporting the patient experiencing hopelessness and • 6. Educating the patient and family regarding care.

×