This document provides an overview of cardiac failure/congestive heart failure. It begins with an introduction and objectives. It then reviews heart anatomy and physiology, including the structure of the heart, conducting system, heart sounds, and ECG. It defines cardiac failure and discusses epidemiology, causes, pathophysiology, clinical manifestations, classifications, diagnostic process, medical management, and complications. Nursing management is also addressed using the nursing process approach.

1. PRESENTED BY : DR. PALLAVI PATHANIA

2. CARDIAC FAILURE
Introduction
Objectives
Review of anatomy of the heart
Definition
Epidemiology
Causes
pathophysiology

3. Clinical manifestation
Classifications
Diagnostic process
Medical management
Complications
conclusion

4. INTRODUCTION
 Cardiac failure(CF) ,often referred to as
congestive heart failure; is the inability of the
heart to pump sufficient blood to meet the
needs of the tissues for oxygen and nutrients.
The term congestive heart failure is most
commonly used when referring to left-sided
and right-sided heart failure.

5.  The underlying mechanism of cardiac
failure involves impairment of the
contractile properties of the heart, which
leads to a lower than- normal cardiac
output.

7. REVIEW OF ANATOMY AND PHYSIOLOGY
OF THE CVS
1. Structure of the heart.
2. Cardiac circle:-conducting system of the heart.
3. Heart sound
4. Electrocardiogram
5. The circulatory system
6. Factor controlling BP

8. STRUCTURE OF THE HEART
 Is a hollow muscular pumping organ
 Location-mediastinum in the thoracic cavity
 Shape-cone shape with the base upward and the apex
downward
 Pericardial membrane; fibrous pericardium, serous
pericardium, myocardium and the endocardium

9. STRUCTURE OF THE HEART

10. CHAMBERS /VALVES OF THE HEART
 Four chambers;
 Left and right atria- separated by interatrial septum
 Left and right ventricles – separated by the interventricular
septum
 Valves- tricuspid, bicuspid, aortic, pulmonary valve

11. BLOOD SUPPLY TO THE HEART
Coronary artery and vein system
 Right and left coronary arteries branch off the aorta
 Branch into smaller vessels
 Cardiac veins deliver blood to coronary sinus, and back to
the right atrium

12. Coronary artery

13. COORDINATION OF CHAMBER CONTRACTION
AND RELAXATION

14. CONDUCTION SYSTEM OF THE HEART
 The cardiac cycle is a series of mechanical events that
is regulated by the electrical activity of the
myocardium.
 Nerve impulse are not required to cause contraction of
the heart. The heart generates its own beat.

15. CONDUCTING SYSTEM OF THE HEART

16. HEART SOUNDS
 There are two sound per heart beat
Lub-Dup
 1st sound is created by the closure of the AV valves(tri &
bicuspid )
 2nd sound is created by the closure of the aortic and the
pulmonary valves.
Improper closure of any valve result in heart murmur

17. ELECTROCARDIOGRAM (ECG)
 When the cardiac impulses passes through the
heart, electrical current also spread to adjacent
tissues and this spread to the surface of the body.
Electrodes placed on the skin can record the
current generated by the heart
 Normal ECG comprises of ;PQRS and T waves

18. ECG Con’t
 P-Q interval-atria contraction (0.16 sec)
 Q-T interval-ventricular contraction (0.35 sec)

19. ELECTROCARDIOGRAM

21. FACTORS CONTROLLING BP
1. Cardiac out put
2. Venous return
3. Blood volume
4. Heart rate
5. Peripheral resistance
6. Elasticity of the large arteries
7. Hormones – ADH, Aldosterone, etc.
8. Viscosity of the blood

22. 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

23. 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%.

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

25. RISK FACTORS

26. PATHOPHYSIOLOGY

29. CHRONIC HEART FAILURE

30. CHRONIC HEART FAILURE

33. LEFT Heart Failure

35. RIGHT Heart Failure

37. Diagnostic process

40. TREATMENT

45. Nursing management using the
nursing process approach
 ASSESSMENT
History taking
Assess patient for dyspnoea, fatigue, palpitation and
dizziness
Assess patient for oedema, oliguria, tenderness of the
calf of the legs. Cyanosis. Cough and haemoptysis
Assess the patient’s vital signs

46. Nursing management
IDENTIFIED NURSING DIAGNOSIS
Altered cardiac output related to weakness of the
cardiac muscle
Ineffective breathing pattern related to pulmonary
congestion
Fluid volume excess related to systemic congestion

47. Nursing diagnosis
Altered body comfort related to ascitis
Altered nutrition related to change in dietary regimen
Anxiety related to out come of illness
Self care deficit related to restriction of activity
Altered family process related to the disease and
hospitalization

48. COMPLICATIONS
 Cardiac dysrhythmias.
 Myocardial failure and cardiac arrest.
 Digoxin toxicity from decreased renal function and
potassium depletion.
 Pulmonary infarction, pneumonia, and emboli

49. I SINCERELY
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