chronic heart failure

1. TARUN KUMAR DHATARWAL
GROUP NO.45
INTERNATIONAL SCHOOL OF
MEDICINE BISHKEK
KYRGYZSTAN

2. THERAPY PRESENTATION
CHRONIC HEART FAILURE

3. CHRONIC HEART FAILURE
Heart failure, sometimes known as congestive heart
failure, occurs when your heart muscle doesn't pump
blood as well as it should. Certain conditions, such as
narrowed arteries in your heart (coronary artery
disease) or high blood pressure, gradually leave your
heart too weak or stiff to fill and pump efficiently.

4. CAUSES
Chronic heart failure. More often, heart
failure develops
slowly as observed in the following states:
i) Myocardial ischaemia from atherosclerotic
coronary artery disease
ii) Multivalvular heart disease
iii) Systemic arterial hypertension
iv) Chronic lung diseases resulting in hypoxia and
pulmonary arterial hypertension
v) Progression of acute into chronic failure

5. CAUSES (CONTINUE)
 Other conditions that may increase your risk for developing heart failure include:
 cardiomyopathy, which is a disorder of the heart muscle that causes the heart to
become weak
 a congenital heart defect
 a heart attack
 heart valve disease
 certain types of arrhythmias, or irregular heart rhythms
 high blood pressure
 emphysema, a disease of the lung
 diabetes
 an overactive or underactive thyroid
 HIV
 AIDS
 severe forms of anemia, which is a deficiency of red blood cells
 certain cancer treatments, such as chemotherapy
 drug or alcohol abuse

6. In chronic heart failure, compensatory
mechanisms like tachycardia, cardiac dilatation
and cardiac hypertrophy try to make adjustments
so as to maintain adequate cardiac output. This
often results in well-maintained arterial pressure
and there is accumulation of oedema.

7. CHRONIC HEART FAILURE
Chronic heart failure is the most common cardiac
cause of chronic dyspnoea. Symptoms may first
present on moderate exertion, such as walking up a
steep hill, and may be described as a difficulty in
‘catching my breath’.
As heart failure progresses, the dyspnoea is
provoked by less exertion and ultimately the patient
may be breathless walking from room to room,
washing, dressing or trying to hold a conversation.
Other symptoms may include:

8. SYMPTOMS
• Orthopnoea. Lying down increases the venous
return to the heart and provokes breathlessness.
Patients may prop themselves up with pillows to
prevent this.
• Paroxysmal nocturnal dyspnoea. In patients with
severe heart failure, fluid shifts from the interstitial
tissues of the peripheries into the circulation within
1–2 hours of lying down. Pulmonary oedema
supervenes, causing the patient to wake and sit
upright, profoundly breathless.

9. SYMPTOMS
excessive fatigue
sudden weight gain
a loss of appetite
persistent coughing
irregular pulse
heart palpitations
abdominal swelling
shortness of breath
leg and ankle swelling
protruding neck veins

10. DIAGNOSIS
BLOOD TESTS
ECG
ECHOCARDIOGRAPHY
THYROID TEST
ELECTROLYTE AND SERUM UREA TEST
BNP:-Brain natriuretic peptide
(BNP) is elevated in heart failure and is a marker of
risk; it is useful in the investigation of patients with
breathlessness or peripheral oedema

11. DIAGNOSIS CONTINUE
Echocardiography is very useful and should be
considered in all patients with heart failure in order
to:
determine the aetiology
detect hitherto unsuspected valvular heart disease,
such as occult mitral stenosis, and other conditions
that may be amenable to specific remedies
identify patients who will benefit from long-term
therapy with drugs, such as ACE inhibitors

12. OTHER TESTS:-
CHEST X-RAY:-Specific abnormalities can rule out
CHF as an explanation for the person’s symptoms
and signs.
Cardiomegaly, pulmonary venous changes and
interstitial oedema of lung fields support the
diagnosis o f C H F.
Normal chest X-ray does not exclude CHF.

13. SURGERY
Some people with heart failure will need surgery,
such as coronary bypass surgery. During this
surgery, your surgeon will take a healthy piece of
artery and attach it to the blocked artery. This allows
the blood to bypass the blocked, damaged artery and
flow through the new one.

14. Your doctor may also suggest an angioplasty. In
this procedure, a tube, or catheter, with a small
balloon attached is inserted into the blocked or
narrowed artery. Once the catheter reaches the
damaged artery, your surgeon inflates a balloon to
open the artery. Your surgeon may need to place a
permanent stent into the blocked or narrowed
artery. A stent is a wire mesh tube that
permanently holds your artery open. A stent can
help prevent further narrowing of the artery.

15. THANK YOU