This document provides an overview of congestive heart failure (CHF), including its definition, causes, pathophysiology, clinical manifestations, diagnostic evaluation, and management. CHF is defined as a clinical syndrome where the heart cannot pump enough blood to meet the body's needs. It is most commonly caused by conditions that overload or damage the heart such as hypertension, heart attacks, and cardiomyopathy. Clinically, it presents with symptoms of fluid backup like dyspnea, edema, and fatigue. Diagnostic tests include chest x-rays, EKGs, blood tests like BNP, and echocardiography. Treatment focuses on managing symptoms, addressing the underlying cause, and preventing complications through medications, lifestyle changes, and potentially devices
Kindly leave your comment if you found this helpful ;)
Some of the slides, i hide it from my real presentations for my own reference. Download to see all of them.
Cardiomyopathy, or heart muscle disease, is a type of progressive heart disease in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart muscle's ability to pump blood is less efficient, often causing heart failure and the backup of blood into the lungs or rest of the body. The disease can also cause abnormal heart rhythms.
definition of heart failure, classification of heart failure, risk factors for heart failure, clinical features, general physical examination findings in heart failure
Kindly leave your comment if you found this helpful ;)
Some of the slides, i hide it from my real presentations for my own reference. Download to see all of them.
Cardiomyopathy, or heart muscle disease, is a type of progressive heart disease in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart muscle's ability to pump blood is less efficient, often causing heart failure and the backup of blood into the lungs or rest of the body. The disease can also cause abnormal heart rhythms.
definition of heart failure, classification of heart failure, risk factors for heart failure, clinical features, general physical examination findings in heart failure
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Endomyocardial fibrosis (EMF) is a disease that is characterized by fibrosis of the apical endocardium of the right ventricle (RV), left ventricle (LV), or both.
The clinical manifestations are largely related to the consequences of restrictive ventricular filling, including left and right sided heart failure.
The heart failure is associated with atrioventricular-valve regurgitation.
Endomyocardial fibrosis is a major cause of illness and death in areas where it is endemic, and in its severest form carries a very poor prognosis, with an estimated survival of 2 years after diagnosis.
Lecture on project governance and failure presented to a Master’s level class in strategic project management at University College London on March 25-26, 2009. The class was led by Dr. Andrew Edkins, UCL Senior Lecturer.
I blogged about this on ZDNet: http://blogs.zdnet.com/projectfailures/?p=2528
It includes emergency situations related to the cardiovascular aspect of humans. it focuses on the critical care aspect to manage certain emergencies. Nursing care is also included thus, fosters a better aspect of nursing individuals to manage a cardiovascular emergency.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
2. Congestive heart failure
Presentation and Diagnosis
The most common reason for hospitalization in
adults >65 years old
Dr Shahid Abbas
Consultant Interventional Cardiologist
3. Road Map
– Definition
– Causes and pathophysiology
– Types of heart failure
– Compensatory mechanism of heart failure
– Clinical manifestations
– Classification of heart failure
– Diagnostic evaluation
– Management
4. Definition
A clinical syndrome that develops when
the heart cannot maintain an adequate
cardiac output
The heart pumps blood inadequately,
leading to reduced blood flow, back-up
(congestion) of blood in the veins and
lungs Leading to
Other changes that may further weaken
the heart
5. 5
Etiology
• A syndrome of Pulmonary and/ or Systemic
congestion due to C.O
• Heart is unable to pump enough blood to
meet tissues O2 requirements
Pulmonary pressure fluid in alveoli
(PULMONARY EDEMA)
Systemic pressure fluid in tissues
(PERIPHERAL EDEMA)
6. 6
Etiology
• Heart failure is caused by systemic
hypertension in 75% of cases
• About one third of clients experiencing
myocardial infarction also develop heart
failure
• Structural heart changes, such as valvular
dysfunction, cause pressure or volume
overload on the heart
9. Cardiac Physiology
(remember this?)
• CO = SV x HR
• HR: parasympathetic and sympathetic tone
• SV: preload, afterload, contractility
10. Preload
• Passive stretch of muscle prior to contraction
• Measurement: Swan-Ganz
– LVEDP
• Really a function of LVEDV
• Affected by compliance
– Low compliance = higher LVEDP @ lower LVEDV
– False high estimate of preload
• Frank-Starling right?
11. Afterload
• Force opposing/stretching muscle after
contraction begins
• Measurement: SVR
• Really a function of:
– SVR
– Chamber radius (dilated cardiomyopathies)
– Wall thickness (hypertrophy)
12. Contractility
• Normal ability of the muscle to contract at a
given force for a given stretch, independent of
preload or afterload forces
• In other words:
– How healthy is your heart muscle?
• Ischemia, Hypertrophy (?), Muscle loss
13. CHF: the heart muscle
March 2013 ghennersdorf DGK ESC SES
14. CHF: the heart muscle sarcomere
March 2013 ghennersdorf DGK ESC SES
15. Pathophysiology
Renin + Angiotensinogen
Angiotensin I
Angiotensin II
Peripheral
Vasoconstriction
Afterload
Cardiac Output
Heart Failure
Salt & Water Retention
Plasma Volume
Preload
Cardiac Workload
Edema
Aldosterone Secretion
Renin-angiotensin system
16. Heart Failure
• Pathophysiology
• A. Cardiac compensatory mechanisms
– 1.tachycardia
– 2.ventricular dilation-Starling’s law
– 3.myocardial hypertrophy
• Hypoxia leads to dec. contractility
17. Acute decompensated heart failure
Pulmonary edema, often life-threatening
• Early
–Increase in the respiratory rate
–Decrease in PaO2
• Later
–Tachypnea
–Respiratory acidemia
18. Acute Decompensated Heart Failure
(ADHF) Pulmonary Edema
Pulmonary edema begins with an increased
filtration through the loose junctions of the
pulmonary capillaries.
As the intracapillary pressure increases, normally
impermeable (tight) junctions between the alveolar cells
open, permitting alveolar flooding to occur.
19. END RESULT
FLUID OVERLOAD > Acute Decompensated Heart Failure
(ADHF)/Pulmonary Edema
Medical Emergency!
21. MMildild
Heart Failure
(progression)
Drugs
Diet
Fluid
Restriction
Cardiogenic shock
Cardiomyopathy
CDHF(Pulmonary Edema) Severe End Stage
Irreversible
Needs new ventricle
VAD
IABP
VAD
IABP
Heart Transplant
Control With
Emergency-Upright, O2, morphine, etc
24. Classifying Heart Failure
• Anatomically
– Left versus Right
• Physiologically
– Systolic versus Diastolic
• Functionally
– How symptomatic is your patient?
25. Congestive heart failure
Types
• Left-sided heart failure
There are two types of left-sided heart failure
Systolic dysfunction
Diastolic dysfunction
• Right-sided heart failure
26. Left versus Right Failure
Left Heart Failure
- Dyspnea
- Dec. exercise tolerance
- Cough
- Orthopnea
- Pink, frothy sputum
Right Heart Failure
- Dec. exercise tolerance
- Edema
- HJR / JVD
- Hepatomegaly
- Ascites
30. Classification of heart failure
New York Heart Association (NYHA) Functional Classification
Class % of patients Symptoms
No symptoms or limitations in ordinary
physical activity
I 35%
Mild symptoms and slight limitation
during ordinary activity
II 35%
Marked limitation in activity even
during minimal activity. Comfortable
only at rest
III 25%
Severe limitation. Experiences
symptoms even at rest
IV 5%
31. Heart Failure
Clinical Manifestations
• Acute decompensated heart
failure (ADHF)
• Physical findings
• Orthopnea
• Dyspnea, tachypnea
• Use of accessory muscles
• Cyanosis
• Cool and clammy skin
•Physical findings
•*Cough with frothy,
blood-tinged sputum
•Breath sounds: Crackles,
wheezes, rhonchi
•Tachycardia
•Hypotension or
hypertension
32. ADHF/Pulmonary Edema
(advanced L side HF)
When PA WEDGE pressure is approx 30mmHg
– Signs and symptoms
• wheezing
• pallor, cyanosis
• Inc. HR and BP
• S3 gallop
• Rales,copious pink, frothy sputum
38. 38
PULMONARY EDEMA
Rapid fluid accumulation in lung spaces that
has leaked from engorged pulmonary
capillaries
Etiology – most common cause is sudden
deterioration of LV function
44. Can You Have RVF Without LVF?
• What is this called?
COR PULMONALE
45. What is present in this extremity, common to right sided HF?
46. Heart Failure
Complications
• Pleural effusion
• Atrial fibrillation (most common
dysrhythmia)
– Loss of atrial contraction (kick) -reduce CO by
10% to 20%
– Promotes thrombus/embolus formation inc.
risk for stroke
– Treatment may include cardioversion,
antidysrhythmics, and/or anticoagulants
47. Heart Failure
Complications
• **High risk of fatal dysrhythmias (e.g., sudden
cardiac death, ventricular tachycardia) with HF and
an EF <35%
– HF lead to severe hepatomegaly, especially with
RV failure
• Fibrosis and cirrhosis - develop over time
– Renal insufficiency or failure
48. Heart Failure
Diagnostic Studies
• Primary goal- determine underlying cause
– History and physical examination( dyspnea)
– Chest x-ray
– ECG
– Lab studies (e.g., cardiac enzymes, BNP- (beta
natriuretic peptide- normal value less than 100)
electrolytes
– EF
49. Clinical Data
• CXR
– Kerley’s lines : A and B
– Pulmonary Edema
– Cephalization
– Pleural Effusions (bilateral)
• EKG
– Left atrial enlargement
– Arrhythmias
– Hypertrophy (left or right)
51. Cardiomegaly/ventricular remodeling occurs as heart overworked> changes in size, shape, and function
of heart after injury to left ventricle. Injury due to acute myocardial infarction or due to causes that inc.
pressure or volume overload as in Heart failure
52. Clinical Data
• Laboratory Data
• Chemistry
– Renal Function: Be Wary
• BNP
– Used in ER departments the world over
– Good negative correlation
– Need baseline for positivity
– Pulmonary versus cardiac dyspnea