heart Failure

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This document provides an overview of cardiac failure (congestive heart failure), including its pathophysiology, manifestations, causes, investigations, treatment and management. Some key points are: - Cardiac failure occurs when the heart cannot maintain sufficient output to meet bodily demands. It increases with age and many patients are repeatedly admitted. - It can manifest as left or right heart failure, depending on which side of the heart is affected, with different symptoms and signs for each. - Common causes include hypertension, ischemic heart disease and valvular issues. - Investigations include chest x-ray, ECG, echocardiogram and blood tests to determine the underlying cause. - Treatment involves

Health & Medicine

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definition This is a complex syndrome that can result from any stratural or functional cardic disorder that impairs the ability of the heart to function as a pump to support a physiological circulation. Loading… causes MAIN CAUSES •IHD •Cardiomyopathy (dilated) •Hypertension Other •Cardiomyopathy (undilated) •Vulvular heart disease •Congenital Heart •Alcohol and Drugs •Haemodynamic circulation (anaemia, thyrotoxicosis, hemochromatosis, pagets disease). •Arrhythmias •Infections (Chaga’s disease) e.g myocarditis. Classification of Heart Failure •Based on the side of the Heart Affected. 1.Left Sided Heart failure: MI, Aortic valve Disease, Mitral Stenosis. •Characterised by pulmonary edema (striking feature). Other Signs tachypnea, tachycardia, third heart sounds, pulsus alternans, cardiomegaly. 2.Right sided Heart Failure: Pulmonary Stenosis, PH, PE, Chronic Lung Disease. •Is characterized by the presence of peripheral edema, raised JVP and hypotension and congestive hepatomegalgy. 3.Biventricular Heart Failure: Cardiomyopathy, Right Side Heart Failure follows Left. •Characterised by both left sided and right sided heart failure. Based on ejection fraction 1.Heart failure with reduced ejection fraction (HFrEF):- EF <40% •These patients will have systolic dysfuction and concomintant diastolic dysfuction. Coronary artery disease is the major cause. 2.Heart failure with preserved ejection fraction (HFpEF):- EF >50% •The patients can be diagnosed by 1) clinical signs and symptoms and 2).evidence of pEF or normal EF or previous rEF 3). Evidence of abnormal LV diastolic dysfuction (echo/ LV catheterization) 3.Heart failure with mild range ejection fraction ( HFmrEF):- EF 40-50% BASED ON ACUTE OR CHRONIC 1.Acute heart failure:- acute MI, severe HTN, Acute Myocarditis, PE (Right sided heart failure) 2.Chronic heart failure:- can develop in all types of heart failure. -recurrent attacks - persistent symptoms High Output Failure •The normal heart fails to maintain normal or increased output conditions like Anemia, Hyperthyroidism, Pregnancy. •Usually right sided failure occurs followed by left sided failure with presence of shortened circulatory time. •Low Output Failure •Heart fails to generate adequate output in conditions like cardiomyopathy, valvular disease, tamponade and bradycardia. pathophysiology •When heart fails considerable changes occur to the heart and peripheral vascular system in the response to thehaemodynamic changes associated with heart failure. •The changes are compensatory and maintain cardiac output and peripheral perfusion. However, as heart failure progresses these mechanisms are overwhelmed and become pathophysiological. •Peripheral vasoconstriction and sodium retention in heart failure by activation of RAAS are a loss of beneficial compensatory mechanisms and represent cardiac decompensation. •Factors involved are venous retain, outfl

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