Heart failure (HF) is a condition where the heart cannot pump blood effectively to meet the body's needs, often distinguished into left-sided and right-sided failures with different symptoms and causes. Left-sided heart failure leads to pulmonary congestion and edema, while right-sided failure causes systemic edema and increased venous pressure. Diagnosis involves clinical signs, physical examination, and imaging, with treatment options including diuretics, vasodilators, and drugs to enhance myocardial function.

1. HEART FAILURE
VCP- 511
CHANDRANI GOSWAMI

2. DEFINITION-
Heart failure (HF), often used to mean chronic
heart failure (CHF), occurs when the heart is unable
to pump sufficiently to maintain blood flow to meet
the needs of the body.
**A heart failure is different from myocardial infarction.
** It is different from cardiac arrest

3. TYPES
 Heart Failure, Left-
Sided
 Heart Failure, Right-
Sided

4. Heart Failure, Left-Sided
Description-
Occurs when the left cardiac ventricle no
longer pumps blood efficiently.
This type of failure causes pulmonary
congestion and edema.
Left failure results in decreased blood
returning to the right and so both sides fail
simultaneously and vice versa.

5. CAUSES
1. Mitral Valve Problems (Stenosis or
Insufficiency)
2. Cardiomyopathies
3. Congenital Abnormalities
4. Myocardial Inflammation or Degeneration

6. SIGNS AND CLINICAL PATHOLOGY -
• Pulmonary congestion
• Pulmonary edema
• Pleural effusion
• low systemic blood pressure
• exercise intolerance
• Tachycardia
• weak femoral pulses
• pre-renal failure
• azotaemia.

7. Heart Failure, Right-Sided
 Occurs when the right cardiac ventricle no longer pumps blood
efficiently
 This type of failure causes congestion (backing up of blood)
throughout the veins and capillaries elevating the central venous
pressure and resulting in systemic edema.
 The areas of systemic edema formation are species specific
 Species Differences
• Horse & Ox: Ventral Abdomen & Brisket edema
• Dog: Ascites (abdominal edema)
• Cat: Hydrothorax (thoracic edema)

8. CAUSES
1. Left-Sided Heart Failure
2. Cardiomyopathies
3. Pericarditis
4. Hydropericardium
5. Increased Pulmonary Resistance
6. Myocardial Inflammation & Degeneration
7. Valvular Disease
8. Tumours (heart base)

9. SIGNS AND CLINICAL PATHOLOGY
• Edema
• jugular distension
• Hepatomegaly
• Pleural Effusion
• dyspnoea
• Tachypnoea
• lung crackling
• Splenomegaly
• Ascites

10. DIAGNOSIS
1. History and Clinical Signs
2. Physical Examination
- Observation
- Palpation
• Jugular pulses and/or jugular venous distension
and/or enlarged ventral abdominal veins
(indicates high venous pressure).
• Abdomen: pitting oedema, ascites, splenomegaly,
hepatomegaly and fluid thrill (fluid movement
causes a palpable vibration).

11. DIAGNOSIS (Contd.)
- Percussion
- Ausculation
- Heart Sounds
- Heart Murmurs
3. Electrocardiography (ECG)
4. Radiology

12. TREATMENT
I* Drugs used to decrease venous tone and fluid volume
which can help to relieve congestion & oedema.
1. Diuretics
• Loop Diuretics eg. Frusemide
• Thiazide diuretics eg. Chlorothiazide or
Hydrochlorothiazide.
• Potassium sparing diuretics eg. Spironolactone and
Amiloride.
2. Vasodilators includes ACE inhibitors (Enalapril (dogs &
cats), Benazepril (cats), alpha-antagonists and
Nitroprusside.

13. TREATMENT (Contd.)
II* Drugs used to Increase Myocardial Systolic
Function
3.
digitalis compounds (e.g. Digoxin, Digitoxin),
calcium sensitisers/ phosphodiesterase III.
inhibitor (e.g. Pimobendan),
pure phosphodiesterase inhibitors (e.g. Milrinone,
Amrinone) and
catecholamines (e.g. Dobutamine, Dopamine).

14. TREATMENT (Contd.)
III* Drugs used to Increase Myocardial Diastolic
Function
4.
beta blockers (e.g. Atenolol, Propranolol) and
calcium channel blockers (e.g. Diltiazem).
5. Management
6. Surgery