1) Congestive heart failure results from structural or functional abnormalities that impair the heart's ability to pump or fill with blood adequately.
2) As a result, the heart cannot pump enough blood to meet the body's needs, leading to a buildup of fluid in the lungs or tissues.
3) Treatment focuses on lifestyle modifications, medications such as diuretics, ACE inhibitors, beta blockers, and device-based therapies as needed to manage symptoms and improve outcomes.
Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently. You have four heart chambers.
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.
Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently. You have four heart chambers.
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.
Angina pectoris is a medical condition resulting in chest pain or discomfort. Angina pectoris occurs when the heart is not getting enough blood supply. the pain related to angina is temporary, but if left untreated can make serious heart complications inevitable.
heart failure otherwise called congestive heart failure. causes of this is diabetes Mellitus, hypertension, excess intake of fat, stress, prevention of this according to the doctor's order take the medicine, follow a diet plan, without sodium, alcohol, should be avoided.then we free from congestive heart failure .
Angina also known as angina pectoris is a medical condition characterized by chest pain usually left sided due to inadequate blood supply (ischemia) to the heart muscles due to obstruction (like presence of blood clot), narrowing or contraction (vasospasm) of the supplying coronary arteries.
definition of heart failure, classification of heart failure, risk factors for heart failure, clinical features, general physical examination findings in heart failure
Angina pectoris is a medical condition resulting in chest pain or discomfort. Angina pectoris occurs when the heart is not getting enough blood supply. the pain related to angina is temporary, but if left untreated can make serious heart complications inevitable.
heart failure otherwise called congestive heart failure. causes of this is diabetes Mellitus, hypertension, excess intake of fat, stress, prevention of this according to the doctor's order take the medicine, follow a diet plan, without sodium, alcohol, should be avoided.then we free from congestive heart failure .
Angina also known as angina pectoris is a medical condition characterized by chest pain usually left sided due to inadequate blood supply (ischemia) to the heart muscles due to obstruction (like presence of blood clot), narrowing or contraction (vasospasm) of the supplying coronary arteries.
definition of heart failure, classification of heart failure, risk factors for heart failure, clinical features, general physical examination findings in heart failure
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Congestive cardiac Failure
1. Congestive Heart
Failure
Presented To : Dr. Abel
Presented By : Anish Kumar. K
Rajiv Gandhi University
Of Science and Technology
Clinical Rotation :Internal Medicine
Date:2015/10/27
2. Results from any structural or functional abnormality
that impairs the ability of the heart to eject blood (Systolic
Heart Failure) or to fill with blood (Diastolic Heart Failure).
Heart's pumping power is weaker than normal.
With heart failure , blood moves through the heart
and body at a slower rate, and pressure in the heart
increases.
As a result, the heart cannot pump enough oxygen
and nutrients to meet the body's needs.
Congestive Heart Failure (CHF)
Congestive Cardiac Failure(CCF)
Heart Failure (HF)
3. Congestive Heart Failure
Heart Failure can divided:
- Right Sided Heart Failure
- Left Sided Heart Failure
Can be Either From,
Diastolic Dysfunction(Inability to relax)
Systolic Dysfunction (Inability to Contract)
4. Congestive Heart Failure
Etiology
-Increase in Pulmonary pressure results fluid in alveoli
(PULMONARY EDEMA)
Increase in Systemic pressure results in fluid in tissues
(PERIPHERAL EDEMA)
Health conditions that either damage the heart or make it
work too hard
- Coronary Artery Diseases (CAD)
-Myocardial Infarction.
-Heart muscle diseases (cardiomyopathy)
-Heart inflammation (myocarditis)
6. Congestive Heart Failure
Decreased Blood Pressure and
Decreased Renal perfusion
Stimulates the Release
of renin, Which allows
conversion of
Angiotensin
to Angiotensin II.
Angiotensin II stimulates
Aldosterone secretion which
causes retention of
Na+ and Water,
increasing filling pressure
LV Dysfunction causes
Decreased cardiac output
7. Congestive Heart Failure
Pathophysiology
In order to maintain normal cardiac output, several
compensatory mechanisms play a role as under:
Compensatory enlargement in the form of cardiac
hypertrophy, cardiac dilatation, or both.
Tachycardia due to activation of neurohumoral system.
e.g. release of norepinephrine and atrial natrouretic peptide,
activation of renin-angiotensin aldosterone mechanism.
8. Congestive Heart Failure
STARLING’S LAW
Within limits, the force of ventricular contraction is a
function of the end-diastolic length of the cardiac
muscle, which in turn is closely related to the ventricular
end-diastolic volume.
This is achieved by increasing the length of sarcomeres in
dilated heart
Increases the myocardial contractility and thereby attempts
to maintain stroke volume.
9. Congestive Heart Failure
•Heart failure results in DEPRESSION of the
ventricular function curve.
•COMPENSATION in the form of stretching of
myocardial fibers results.
•Stretching leads to cardiac dilatation which
occurs when the left ventricle fails to eject its
normal end diastolic volume
10. Congestive Heart Failure
Sympathetic nervous system stimulation
Renin-angiotensin system activation
Myocardial hypertrophy
Altered cardiac Rhythm
Compensatory Mechanisms
14. Congestive Heart Failure
Types of Heart Failure
• Low-Output Heart Failure
– Systolic Heart Failure:
– decreased cardiac output
– Decreased Left ventricular ejection fraction
– Diastolic Heart Failure:
– Elevated Left and Right ventricular end-diastolic pressures
– May have normal LVEF
• High-Output Heart Failure
– Seen with peripheral shunting, low-systemic vascular resistance,
hyperthryoidism, beri-beri, carcinoid, anemia
– Often have normal cardiac output
• Right-Ventricular Failure
– Seen with pulmonary hypertension, large RV infarctions.
15. Congestive Heart Failure
Clinical Features
Left Sided Heart Failure:
1) Pulmonary Edema
a) Dyspnea (SOB)
b)Orthopnea
c)Paroxysmal Nocturnal Dyspnea
2)Decreased forward Perfusion
Activated Renin Angiotensin Aldosterone System, which cause fluid retention
and worsenen CHF.
16. Congestive Heart Failure
Clinical Features
Right Sided Heart Failure:
Most common cause of cause of Right Heart Failure is Left side
Heart Failure.
a) Dyspnea(SOB)
b)Jugular Venous Distention
c)Pitting Edema
d)Ascitis
e)Nutmeg Liver “Hepatomegaly”
17. Congestive Heart Failure
Physical Examination
• S3 gallop
– Low sensitivity, but highly specific
• Cool, pale, cyanotic extremities
– Have sinus tachycardia, diaphoresis and peripheral vasoconstriction
• Crackles or decreased breath sounds at bases (effusions) on lung
exam
• Elevated jugular venous pressure
• Lower extremity edema
• Ascites
• Hepatomegaly
• Splenomegaly
• Displaced PMI
• Apical impulse that is laterally displaced past the midclavicular line is usually
indicative of left ventricular enlargement>
18. Congestive Heart Failure
Diagnosis
1)Echocardiogram
-Distinguish systolic from Diastolic dysfunction by measuring Ejection Fraction
-Determining Myocardial Ischemia is the precipitating cause.
-Identify Valve Diseases.
2)B Type Natriuretic Peptide (BNP)
-Secreted by the Ventricles
-Differentiate between causes of dyspnea due to heart Failure from the other cause of
dyspnea.
3)Chest Xrays
• -Determine any Cardiomegaly. Cephalization of the pulmonary vessels
• Kerley B-lines
• Pleural effusions
4)EKG
-To Identify arrhythmias,Ischemic Heart Diseases,Right and Left ventricular
Hypertrophy, and presence of conduction delays or abnormalities.
20. Congestive Heart Failure
Lab Investigations
• CBC
– Since anemia can exacerbate heart failure
• Serum electrolytes and creatinine
– before starting high dose diuretics
• Fasting Blood glucose
– To evaluate for possible diabetes mellitus
• Thyroid function tests
– Since thyrotoxicosis can result in A. Fib,
and hypothyroidism can results in HF.
• Iron studies
– To screen for hereditary hemochromatosis as cause of heart failure.
• ANA
– To evaluate for possible lupus
• Viral studies
– If viral mycocarditis suspected
21. Congestive Heart Failure
• BNP
– With chronic heart failure, atrial mycotes secrete
increase amounts of atrial natriuretic peptide (ANP)
and brain natriuretic pepetide (BNP) in response to
high atrial and ventricular filling pressures
– Usually is > 400 pg/mL in patients with dyspnea due
to heart failure.
22. Congestive Heart Failure
Cardiac Testing
• Exercise Testing
– Should be part of initial evaluation of all patients with CHF.
• Coronary arteriography
– Should be performed in patients presenting with heart failure who have
angina or significant ischemia
– Reasonable in patients who have chest pain that may or may not be
cardiac in origin, in whom cardiac anatomy is not known, and in
patients with known or suspected coronary artery disease who do not
have angina.
– Measure cardiac output, degree of left ventricular dysfunction, and left
ventricular end-diastolic pressure.
• Endomyocardial biopsy
• Not frequently used
• Really only useful in cases such as viral-induced cardiomyopathy
23. Congestive Heart Failure
Classification of Heart Failure
• New York Heart Association (NYHA)
– Class I – symptoms of HF only at levels that would limit normal
individuals.
– Class II – symptoms of HF with ordinary exertion
– Class III – symptoms of HF on less than ordinary exertion
– Class IV – symptoms of HF at rest
• Guidelines
– Stage A – High risk of HF, without structural heart disease or
symptoms
– Stage B – Heart disease with asymptomatic left ventricular dysfunction
– Stage C – Prior or current symptoms of HF
– Stage D – Advanced heart disease and severely symptomatic or
refractory HF
24. Congestive Heart Failure
Chronic Treatment of Systolic Heart Failure
• Correction of systemic factors
– Thyroid dysfunction
– Infections
– Uncontrolled diabetes
– Hypertension
• Lifestyle modification
– Lower salt intake
– Alcohol cessation
– Medication compliance
• Maximize medications
– Discontinue drugs that may contribute to heart failure
(NSAIDS, antiarrhythmics, calcium channel blockers)
26. Congestive Heart Failure
• Loop diuretics
• Furosemide, buteminide
• For Fluid control, and to help relieve symptoms
• Potassium-sparing diuretics
• Spironolactone, eplerenone
• Help enhance diuresis
• Maintain potassium
• Shown to improve survival in CHF
27. Congestive Heart Failure
ACE Inhibitors
• Improve survival in patients with all severities
of heart failure.
• Begin therapy low and titrate up as possible:
• Enalapril –
• Captopril
• Lisinopril
• If cannot tolerate, may try ARB(Angiotensin II
receptor blockers)
28. Congestive Heart Failure
Beta Blockers
• Certain Beta blockers (carvedilol, metoprolol, bisoprolol)
can improve overall and event free survival in NYHA class
II to III HF, probably in class IV.
• Contraindicated:
– Heart rate <60 bpm
– Symptomatic bradycardia
– Signs of peripheral hypoperfusion
– COPD, asthma
– PR interval > 0.24 sec, 2nd or 3rd degree block
29. Congestive Heart Failure
Hydralazine plus Nitrates
• Dosing:
– Hydralazine
– Started at 25 mg po TID, titrated up to 100 mg po TID
– Isosorbide dinitrate
– Started at 40 mg po TID/QID
• Decreased mortality, lower rates of
hospitalization, and improvement in quality of
life.
30. Congestive Heart Failure
Digoxin
• Given to patients with HF to control symptoms
such as fatigue, dyspnea, exercise intolerance
• Shown to significantly reduce hospitalization
for heart failure, but no benefit in terms of
overall mortality.
31. Congestive Heart Failure
Statin Therapy
• Statin therapy is recommended in CHF for the
secondary prevention of cardiovascular
disease.
• Some studies have shown a possible benefit
specifically in HF with statin therapy
• Improved LVEF
• Reversal of ventricular remodeling
• Reduction in inflammatory markers (CRP, IL-6, TNF-
alphaII)
33. Congestive Heart Failure
Medications to avoid In HF
• NSAIDS
– Can cause worsening of preexisting HF
• Thiazolidinediones
– Include rosiglitazone (Avandia), and pioglitazone (Actos)
– Cause fluid retention that can exacerbate HF
• Metformin
– People with HF who take it are at increased risk of potentially
lactic acidosis
34. Congestive Heart Failure
Implantable Cardioverter-Defibrillators for HF
• Sustained ventricular tachycardia is associated with
sudden cardiac death in HF.
• About one-third of mortality in HF is due to sudden
cardiac death.
• Patients with ischemic or nonischemic cardiomyopathy,
NYHA class II to III HF, and LVEF ≤ 35% have a
significant survival benefit from an implantable
cardioverter-defibrillator (ICD) for the primary
prevention of SCD.
35. Congestive Heart Failure
Management of Refractory Heart Failure
• Inotropic drugs:
– Dobutamine, dopamine, milrinone, nitroprusside, nitroglycerin
• Mechanical circulatory support:
– Intraaortic balloon pump
– Left ventricular assist device (LVAD)
• Cardiac Transplantation
– A history of multiple hospitalizations for HF
– Escalation in the intensity of medical therapy
– A reproducable peak oxygen consumption with maximal
exercise (VO2max) of < 14 mL/kg per min. (normal is 20
mL/kg per min. or more) is relative indication, while a
VO2max < 10 mL/kg per min is a stronger indication