Downloaded 13 times
More Related Content
Similar to heart failure PPT.pptx B.Sc. Nursing AHN
heart failure PPT.pptx B.Sc. Nursing AHN
- 1. Congestive Heart Failure (CHF) BABLISHAMA M.Sc. MSN
- 2. Congestive Heart Failure(CHF) Congestive heart failure (CHF) is defined as a chronic progressive condition where the heart is unable to pump enough blood to meet the body's needs, resulting in fluid buildup in the lungs, liver, and peripheral tissues.
- 3. Definition of CongestiveHeart Failure (CHF) The American Heart Association (AHA) defines congestive heart failure (CHF) as a chronic progressive condition where the heart's output is insufficient to meet the body's needs, resulting in fluid buildup in the lungs, liver, and peripheral tissues. This condition occurs when the heart fails to pump enough blood, leading to congestion in the lungs and other parts of the body.
- 4. Etiology H -HTN E – Endocarditis A – Anemia R - RHD T – Thyrotoxicosis F – Failure to take medicine A – Arrythmia I – Infection & ischemia L – Lungs problem (COPD & PE) E – Endocrine D – Dietary Indiscretions
- 5. Types of HeartFailure Type Key Problem Main Symptoms Left-sided HF Pulmonary congestion Dyspnoea, crackles, orthopnoea, PND Right-sided HF Systemic congestion Peripheral edema, JVD, ascites Systolic HF Pumping/ contractility problem ↓ Ejection Fraction (<40%), fatigue, pulmonary edema
- 6. Types of HeartFailure Type Key Problem Main Symptoms Diastolic HF Filling/relaxation problem Preserved EF (≥50%), SOB, history of HTN Acute HF Sudden decompensation Severe SOB, pink frothy sputum, cyanosis Chronic HF Progressive heart failure Chronic fatigue, SOB, peripheral oedema
- 7. Clinical manifestations ofheart failure Left-Sided Heart Failure Pulmonary Symptoms (because blood backs up into the lungs): • Dyspnoea (shortness of breath) — especially with exertion • Orthopnoea — difficulty breathing when lying flat • Paroxysmal Nocturnal Dyspnoea (PND) — sudden nighttime breathlessness • Cough — dry or frothy sputum • Crackles/rales on lung auscultation (fluid in alveoli) • Cyanosis (bluish skin) — late sign • Fatigue and weakness — due to low cardiac output • Tachypnoea (rapid breathing)
- 8. Clinical manifestations ofheart failure Right-Sided Heart Failure Systemic Symptoms (because blood backs up into the body): • Peripheral edema (swelling of legs, ankles, feet) • Jugular Venous Distention (JVD) • Ascites (fluid accumulation in abdomen) • Hepatomegaly (enlarged liver) and Splenomegaly (enlarged spleen) • Nausea and anorexia (from abdominal congestion) • Weight gain (from fluid retention) • Nocturia (increased urination at night)
- 9. Clinical manifestations ofheart failure General/Systemic Manifestations (Both sides or Chronic HF) • Exercise intolerance • Fatigue and generalized weakness • Cool, pale, or sweaty skin (due to poor perfusion) • Tachycardia (compensatory mechanism) • Hypotension (in severe cases) • Confusion and restlessness (especially in elderly — due to reduced brain perfusion)
- 10. Clinical manifestations ofheart failure Manifestation Left-sided HF Right-sided HF Dyspnoea, Orthopnoea, PND ✅ ❌ Pulmonary crackles/cough ✅ ❌ Peripheral oedema, ascites ❌ ✅ Jugular venous distention (JVD) ❌ ✅ Fatigue, weakness ✅ ✅ Weight gain ❌ ✅ Confusion, dizziness ✅ ❌
- 11. NYHA Classification ofHeart Failure NYHA Class Description Symptoms Class I No limitation of physical activity. Ordinary physical activity does not cause fatigue, palpitations, or dyspnoea (shortness of breath). No symptoms with normal activity Class II Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitations, or dyspnoea. Symptoms with moderate activity (e.g., walking upstairs)
- 12. NYHA Classification ofHeart Failure NYHA Class Description Symptoms Class III Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes symptoms. Symptoms with minimal activity (e.g., walking to bathroom) Class IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure even at rest. Physical activity increases discomfort. Symptoms at rest
- 13. Diagnostic Procedures Test Purpose ECGDetect arrhythmias, MI, LV hypertrophy Chest X-Ray Check for cardiomegaly, pulmonary congestion Echocardiogram Evaluate EF, wall motion, valve function BNP/NT-proBNP Confirm diagnosis, severity of HF Cardiac MRI Detailed imaging of heart tissues Stress Test Detect underlying ischemia Cardiac Catheterization Identify coronary artery disease
- 14. Management of HeartFailure Lifestyle Modifications • Diet: • Sodium restriction (<2–3 g/day) • Fluid restriction (especially if hyponatremic) • Weight monitoring: • Daily weights to detect fluid retention early • Exercise: • Cardiac rehabilitation programs (based on tolerance) • Smoking cessation and alcohol limitation
- 15. Medical Management ofHeart Failure Drug Class Purpose Examples ACE Inhibitors ↓ Afterload, prevent remodelling Enalapril, Lisinopril ARBs (if ACEI not tolerated) ↓ Afterload and remodelling Losartan, Valsartan Beta-Blockers ↓ Heart rate, ↓ mortality Metoprolol succinate, Carvedilol Diuretics ↓ Fluid overload (symptomatic relief) Furosemide, Bumetanide
- 16. Medical Management ofHeart Failure Drug Class Purpose Examples Aldosterone antagonists ↓ Mortality in severe HF Spironolactone, Eplerenone ARNI (New class) ↓ Mortality better than ACEI/ARB alone Sacubitril-Valsartan (Entresto) Vasodilators Useful in patients who can't tolerate ACE/ARB Hydralazine + Isosorbide dinitrate Positive inotropes Improve contractility in severe cases (short- Digoxin, Dobutamine
- 17. Device Therapy (Advanced Cases) •Implantable Cardioverter Defibrillator (ICD): Prevents sudden cardiac death in reduced EF (<35%) Medical Management of Heart Failure
- 18. Cardiac Resynchronization Therapy(CRT): CRT is a specialized treatment for heart failure where a biventricular pacemaker is implanted to help the right and left ventricles contract together (synchronously). This improves heart efficiency, reduces symptoms, and increases survival. Medical Management of Heart Failure
- 19. • Left VentricularAssist Device (LVAD): For end-stage heart failure awaiting transplant Medical Management of Heart Failure
- 20. Surgical Management • HeartTransplant: For patients with refractory (end-stage) heart failure. • Coronary Artery Bypass Grafting (CABG): If HF is due to significant coronary artery disease.
- 21. Nursing Management ofHeart Failure ASSESSMENT Monitor vital signs: BP, HR, RR, SpO . ₂ Assess respiratory status: Breath sounds (crackles?), effort, orthopnea. Evaluate fluid status: Daily weights, edema, intake/output. Monitor heart sounds: S3 gallop may be present. Assess for fatigue, activity intolerance, and cognitive changes.
- 22. Nursing Management ofHeart Failure Diagnosis • Decreased Cardiac Output • Excess Fluid Volume • Impaired Gas Exchange • Activity Intolerance • Anxiety
- 23. Nursing Management ofHeart Failure Improve Oxygenation • Position in high-Fowler’s if dyspneic. • Administer supplemental oxygen as ordered. • Monitor ABGs if needed.
- 24. Nursing Management ofHeart Failure Manage Fluid Overload • Administer diuretics (e.g., furosemide) as prescribed. • Restrict fluids and sodium* if ordered. • Track daily weight — report gain >2-3 lbs in a day.
- 25. Nursing Management ofHeart Failure Enhance Cardiac Function • Administer cardiac medications: ACE inhibitors, beta-blockers, digoxin, etc as per prescription. • Monitor for medication side effects (e.g., hypotension, bradycardia, digoxin toxicity).
- 26. Nursing Management ofHeart Failure Plan rest periods between activities. Provide Education • Teach about low-sodium diet. • Instruct on medication adherence. • Teach signs of worsening CHF: weight gain, swelling, increased SOB. • Emphasize the importance of follow-up appointments.