[Group 9] 1st Year 2nd Semester Kursk State Medical university

1. BY
KESHAV SWAMI Group – 09
1st Year , 2nd Semester
Kursk State Medical University

2. Definition
 Heart failure is the inability of the heart to maintain an
output adequate to meet the metabolic demands of
the body.
or
 The inability of the heart to pump out completely it’s
blood leaving behind about 40% of the blood in it’s
chambers

3. Epidemiology
 It is a common syndrome in both developed and
developing countries
 It is increasing in incidence and prevalence
 About 5million cases of heart failure are prevalent in
the US
 Incidence is estimated at 550,000 cases per year
 The 5 year mortality rate following diagnosis with
heart failure is almost 50%.

4. Epidemiology
 It increases in incidence with age, over 75% of existing and
new cases in > 65 years
 It occurs both in the young and old
 Causes varies with age
 Its more common in middle age and elderly

5. Causes
• Hypertension
• Severe anaemia
• Myocardial infarction
• Coronary atherosclerosis
• Rheumatic heart disease
• Thyrotoxicosis
• Congenital heart disease e.g. Ventricular septal
defect

6. Causes
• Coarctation of the aorta
• Circulatory overload e.g. Excess IVF
• Valvular disease. E.g. pulmonary stenosis or
incompetence, Aortic diseases etc.

7. PATHOPHYSIOLOGY
 When the heart fails, considerable changes
(adaptations) occur to the heart and peripheral
vascular system in response to the haemodynamic
changes associated with heart failure.
 These physiological changes are compensatory to
maintain cardiac output and peripheral tissue
perfusion.
 However, as heart failure progresses, these
mechanisms are overwhelmed and compromised.

8. PATHOPHYSIOLOGY
 If nothing is done to help the heart return to normal,
all these compensatory mechanism begins to fail and
the various symptoms of heart failure becomes evident
starting from the right side of the heart.

9. Types of cardiac failure
 Left or right HF
 Systolic or diastolic HF
 High-output or low-output HF
 Acute or chronic HF

10. RIGHT Heart Failure

11. LEFT Heart Failure

12. Clinical manifestation
• Dyspnoea-orthopnoea
• Paroxysmal nocturnal dyspnoea
• Tiredness
• Oedema-pitting pedal
• Productive cough
• Tachycardia
• Ascitis

13. Manifestation
• Oliguri
• Haemoptysis
• Proteinuria

14. Diagnostic process
 Major criteria- Tachycardia ≥ 120 bpm, raised JVP, S3
or S4, cardiomegaly
 Minor criteria- cough, edema, dyspnoea
 Diagnosis- 2 major +/- some minors

15. TREATMENT
 Non drug or non pharmacological- reduction in
salt intake, stop smoking & alcohol, exercise. Eat
good food - fruits and vegetables
 Pharmacological- Diuretics, Vasodilators
(hydrallazine, ACEI, ARBs,), Digoxin, beta
blockers, anticoagulants, hematinics
 Treatment of the underline cause e.g.
hypertension, CAD, HIV etc.
 Oxygen administration

16. SURGICAL PROCEDURES
 HEART VALVE REPAIR OR REPLACEMENT
 PACEMAKER INSERTION
 CORONARY ARTERY BYPASS
 HEART TRANSPLANTATION

17. complications
 Cardiac dysarrhythmias.
 Myocardial failure and cardiac arrest.
 Digoxin toxicity from decreased renal function and
potassium depletion.
 Pulmonary infarction, pneumonia, and emboli

18. conclusion
 When cardiac output fails the sympathetic
nervous system accelerates the heart rate to
maintain adequate output. this
compensatory mechanism may fail to
maintain adequate tissue perfusion if not
supported.

19. THANKS FOR
YOUR ATTENTION!!!
😄😄😄