This presentation enables viewers to understand the etiology and clinical features of Congestive Heart Failure. This enables the viewer to understand the pharmacotherapy of Congestive Heart Failure and facilitates rational drug prescription for this pathological condition.

1. Classification and Clinical
Features of Congestive Heart
Failure
Dr Ravi Shankar M
Professor and Head, Department of Pharmacology
Adichunchanagiri Institute of Medical Sciences, B G Nagara

2. DIASTOLIC AND SYSTOLIC HEART FAILURE

3. Classification of Heart Failure
Left-sided heart failure
• Myocardial Infarction
Right-sided heart failure (Chronic Cor Pulmonale)
• Chronic Obstructive Pulmonary
Disease (COPD)
1. Chronic Bronchitis
2. Emphysema
• Pulmonary embolism

9. Criteria for diagnosing CHF
• Major criteria
• Minor criteria
• 2 major or
• 1 major with 2 minor

10. Major criteria
• Paroxysmal Nocturnal Dyspnoea
(PND)/Orthopnea
• Neck vein distention
• Rales/Crepitations
• Cardiomegaly
• Acute pulmonary edema

11. • S3 gallop
• Increased venous pressure (>16 cm of water)
• Circulation time >/=25 sec
• Hepatojugular reflux

12. Minor criteria
• Ankle edema
• Night cough
• Dyspnea on exertion
• Hepatomegaly
• Pleural effusion
• Vital capacity (less than 1/3 maximum)
• Tachycardia (rate >/= 120/min)

13. NYHA Functional Classification of Heart Failure
• Class I : No limitations of physical activity. Ordinary physical activity does not
cause undue fatigue, palpitation or dyspnea (asymptomatic LV dysfunction)
• Class II : Slight limitation of physical activity. Ordinary physical activity results in
fatigue, palpitation, dyspnea or angina pectoris (mild CHF)
• Class III : Marked limitation of physical activity. Less than ordinary activity leads
to symptoms (moderate CHF)
• Class IV : Unable to carry on any physical activity without discomfort. Symptoms
of heart failure at rest (severe CHF)

14. Thank you