This document provides information on congestive heart failure (CHF), including its definition, causes, risk factors, pathophysiology, signs and symptoms, diagnostic measures, nursing management, treatment, and prevention. CHF is defined as the heart's inability to pump enough blood to meet the body's needs. Common causes include coronary artery disease, heart attacks, valve disease, and hypertension. Diagnostic tests include echocardiograms, electrocardiograms, stress tests, and blood tests. Treatment involves medications to reduce workload on the heart and control symptoms, while prevention focuses on controlling risk factors like high blood pressure.

1. Done by RN,BScN
ABDULLA KHAMIS NGWALI
Congestive heart failure
(CHF)

2. Objectives
After the presentation each student should
be able to:
• Define congestive heart failure.
• Explain causes of CHF.
• Mention the risk factors of CHF.
• Describe pathophysiology of CHF

3. Objectives…..
• Explain signs and symptoms of CHF
• Describe different diagnostic measures of CHF
• Explain nursing managements of CHF
• Describe the treatment of CHF
• Describe the preventive measures of CHF

4. Definition
• Congestive Heart failure is a inability or failure
of the heart to adequately meet the needs of
organs and tissues for oxygen and nutrients.
• This decrease in cardiac output, the amount of
blood that the heart pumps, is not adequate
to circulate the blood returning to the heart
from the body and lungs, causing fluid (mainly
water) to leak from capillary blood vessels.

5. Cause of CHF
• There may be many potential reasons for a
patient to develop congestive heart failure.
• More than one cause may be present at the same
time.
Common causes of heart Failure including:
Coronary artery disease
Previous heart attack (myocardial infarction)

6. Causes…..
Valve disease
Congenital heart disease(condition born with)
 Cardiomyopath (enlargement of heart)
 High blood pressure(Hypertension)
 Diabetic

7. Diagram shown normal and abnormal
heart with CHF

8. Risk factors for CHF
• Congestive heart failure is often a
consequence of atherosclerotic heart disease
and therefore the risk factors are the same:
• Poorly controlled high blood pressure,
• High cholesterol, Diabetes, smoking
• And family history.
• Heart valve disease becomes a risk factor as
the patient ages

9. Pathophysiology
• In congestive heart failure, the heart is unable
to receive it’s normal flow of blood from
venous return and to pump out the required
amount through arterial circulation.
• The left ventricle does not empty into the
aorta and the blood that will be normal inter
right atrium from superior and inferior vena
cover can’t do so.

10. Pathophysiology
• Pressure rise in the venous circulation and the
organs and the tissues that are normal
drained by the venous become congested with
blood that is flowing slowly against increasing
pressure.
• The left ventricles try to do extra work to
pump blood and it become enlarged.

11. Signs and Symptoms
• In early stages the person will most not likely
in his/her health. But, as the condition get
worse, the person experiences gradual
changes in his or her body.
Symptoms the person may notice first.
• Fatigue and weight gain
• Swelling in you ankles, feet and legs.
• Increase need to urinate especially at night.

12. Sign and symptoms….
Symptom that indicate person condition
worsening.
• Irregular heartbeat
• A cough that develops from congested lung.
• wheezing

13. Sign and symptoms…
Symptoms indicate a severe heart condition
need immediately medical attention.
• Chest pain that radiates through the upper
body.
• Rapid breath
• Skin that appears blue(from lack of oxygen in
lungs)
• Fainting.

14. Diagnostic Measure
1. Echocardiogram (cardiac echo)
• Is an ultrasound examination of the heart
that produces detailed images of the organ.
• It can be used to detect abnormalities in the
structure of the heart and to measure the
ejection fraction.

15. Diagnostic Measures……..
• Electrocardiogram (ECG ) is a noninvasive test
used to measure electrical activity in the
heart.
• Electrical sensors called leads are attached to
predetermined positions on the arms, legs,
and chest to record electrical activity and help
assess heart function.

16. Diagnostic Measures……..
• Cardiac computerized tomography (CT) scan.
This test can be used to diagnose heart
problems, including causes of heart failure.
• In a cardiac CT scan, the patient lie on a table
inside a doughnut-shaped machine.
• An X-ray tube inside the machine rotates
around on patient body and collects images of
heart and chest.

17. Stress test:
• Stress tests measure how the heart and blood
vessels respond to exertion. The patient may
walk on a treadmill or pedal a stationary bike
while attached to an ECG machine.
• Or may receive a drug intravenously that
stimulates heart similar to exercise. Stress
tests help if individual have an coronary artery
disease.

18. Myocardial biopsy.
• In this test, a small flexible biopsy cord
inserted into a vein in neck or groin, and small
pieces of the heart muscle are taken.
• This test is performed to diagnose certain
types of heart muscle diseases that cause
heart failure.

19. Chest X-ray
• X-ray images help see the condition of lungs
and heart. In heart failure, heart may appear
enlarged and fluid buildup may be visible in
lungs.
• Can also use an X-ray to diagnose conditions
other than heart failure that may explain the
patient signs and symptoms.

20. Blood tests.
• Is type of test in which a sample of blood
taken to check the kidney and thyroid
function and look for indicators of other
diseases that affect the heart.
• A blood test to check for a chemical called N-
terminal pro-B-type natriuretic peptide (NT-
proBNP) can help in diagnosing heart failure.

21. Nursing Management of CHF
1.Reducing the workload of the heart
2. Achieve the desired clinical response
3. Limitation of physical activity
i. Avoid strenuous work
ii. Stop the heavy exercise
4. Sodium restriction

22. Nursing Management of CHF…..
5. Take Vital signs including blood pressure,
pulse rate, respiratory rate, oxygen saturation,
and body weight.
6. Stopping smoking

23. Treatment for CHF
• The goal of treatment for congestive heart
failure is to have the heart beat more
efficiently so that it can meet the energy
needs of the body.
Medication:
• Diuretic medications (water pills) may be
prescribed if appropriate. Common diuretics
include furosemide, bumetanide, and
hydrochlorothiazide

24. Treatment for CHF…..
• Angiotensin converting enzyme inhibitors) and
ARBs (angiotension receptor blockers) are
medicines that are also shown to increase
survival by decreasing hypertension; they are
often used with other drugs
• Beta blockers may control heart rate and increase
cardiac output and ejection fraction.
• Digoxin is an older medicine that may help
increase cardiac output and control symptoms.

25. Treatment for CHF…..
• Surgery:
• If medication are not effective on their own,
surgery may be required.
• Angioplasty, a procedure to open up blocked
arteries, is one option.
• Heart valve repair surgery are done to help
valves open and close properly

26. Prevention
• Congestive heart failure is prevented for
controlling those risk factors These include:
• lifelong control of high blood pressure, high
cholesterol, and diabetes and smoking
cessation.
• High blood pressure and diabetes are
independent risks for congestive heart failure.
Alcohol and drug abuse may be a cause of
heart failure

27. Smoking…!!!!!!!!!!!

28. References.
• Roger, Veronique L., et al. on behalf of the
American Heart Association Statistics
Committee and Stroke Statistics
Subcommittee. "Heart disease and stroke
statistics -- 2011
• "The epidemiology of heart failure: the
Framingham Study." Journal of the American
College of Cardiology 22.4 Suppl A (1993): 6A-
13A