The document discusses congestive heart failure (CHF). It begins with objectives which are to define CHF, discuss its causes, pathophysiology, clinical features, and investigations. It then defines CHF and provides details on its various etiologies including depressed ejection fraction, preserved ejection fraction, pulmonary heart disease, and high-output states. The pathophysiology section explains how heart failure progresses following an initial decline in pumping capacity. It also covers types of CHF and lists common clinical features and investigations used to evaluate patients with CHF.

1. Congestive Heart Failure
(CHF/CCF/HF)
Dr Akshay Shetty
Asst.Professor
SSRAMCH INCHAL

2. Contents
• Objectives
• Definition
• Aetiology
• Pathophysiology
• Clinical features
• Investigations
• Summary
• References
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3. Objectives
At the end of the presentation the students must be able to
1. Define CHF
2. State aetiology of CHF
3. Discuss Pathophysiology of CHF
4. Illustrate Clinical features of CHF
5. Quote investigations of CHF
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4. Definition
• Heart failure (HF) is a clinical syndrome that occurs in patients who,
because of an inherited or acquired abnormality of cardiac structure
and/or function, develop a constellation of clinical symptoms
(dyspnea and fatigue) and signs (edema and rales) that lead to
frequent hospitalizations, a poor quality of life, and a shortened life
expectancy.
• Congestive heart failure (CHF) is a chronic progressive condition that
affects the pumping power of your heart muscles.
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5. Aetiology
Depressed Ejection Fraction (<40%)
Preserved Ejection Fraction (>40–50%)
Pulmonary Heart Disease
High-Output States
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6. Depressed Ejection Fraction (<40%)
Coronary artery disease
Myocardial infarction
Myocardial ischemia
Obstructive valvular disease
Hypertension
Nonischemic dilated
cardiomyopathy
Infiltrative disordersa
Familial/genetic disorders
Metabolic disordera
Viral
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7. Preserved Ejection Fraction (>40–50%)
Pathological
hypertrophy
Restrictive
cardiomyopathy
Secondary
(hypertension)
Aging Fibrosis
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8. Pulmonary Heart Disease
Cor pulmonale
Pulmonary vascular disorders
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9. High-Output States
Metabolic
disorders
Thyrotoxicosis
Nutritional
disorders
(beriberi)
Chronic
anemia
Systemic
arteriovenous
shunting
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10. Pathophysiology
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11. Contd….
• Heart failure begins after an index event produces an initial decline in
the heart's pumping capacity. Following this initial decline in pumping
capacity, a variety of compensatory mechanisms are activated,
including the adrenergic nervous system, the renin-angiotensin-
aldosterone system and the cytokine system
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12. Types of CHF
• Systolic Dysfunction
• Diastolic Dysfunction
• Low output HF
• High output HF
• Right ventricular Failure (RVF)
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13. Clinical features
• Fatigue
• Shortness of breath
• Coughing /Wheezing
• Anorexia
• Pedal oedema
• Weight gain.
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14. Investigations
• ECG
• 2D echo
• Stress test
• Heart catheterisation
• Chest x-ray
• Blood tests: CBC, BUN, Serum Creatinine ,RBS ,lipid profile ,TSH.
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16. Summary
Definition
Aetiology
Pathophysiology
Types
Clinical features Investigations
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17. References
1. Harrison's Principles of Internal Medicine 17th Ed.
2. https://www.slideshare.net/thunderrajesh/rajesh-ppt-28772056
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18. THANK YOU