LEFT-SIDED HEART FAILURE-1.pptx...Myocardiac infarction

LEFT-SIDED HEART FAILURE-1.pptx...Myocardiac infarction

• 1.
  LEFT-SIDED HEART FAILURE. GROUP 3 1
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  Participants: • HEP01/00032/24 • HEP01/00002/24 •HEP01/00016/24 • HEP01/00047/24 • HEP01/00052/24 • HEP01/00043/24 • HEP01/00036/24 • HEP01/00049/24 • HEP01/00033/24 2
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  Definition: LSHF occurs whenthe left ventricle of the heart fails to pump blood effectively into systemic circulation. As a result, blood backs up inti the lungs, causing pulmonary congestion and reduced oxygenation of blood. 3
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  Etiology: 1. Ischemic HeartDiseases [IHD] (e.g. myocardial infarction.) 2. Hypertension – increases afterload, straining the left ventricle. 3. Aortic Valve Diseases [AVD] (e.g. aortic stenosis or regurgitation.) 4. Mitral Valve Diseases [MVD] (e.g. mitral regurgitation.) 5. Cardiomyopathies (e.g. dilated cardiomyopathy.) 4
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  Pathophysiology: When the leftventricle fails: • It cannot eject blood efficiently leading to reduced cardiac output. • Blood accumulates in the left atrium and then in the pulmonary veins causing increased pulmonary venous pressure. • This leads to pulmonary congestion and edema. The Kidney responds to the low cardiac output by activating the RAAS leading to fluid retention, worsening the congestion. 5
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  Clinical Manifestation: Symptoms: • Dyspneainitially on exertion, later at rest. • Orthopnea. • Paroxysmal Nocturnal Dyspnea [PND]. • Fatigue and exercise intolerance (due to tissue hypoperfusion.) • Cough (often productive of frothy sputum – sometimes blood tinged) 7
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  Clinical Manifestation: Signs: • Tachypnea. •Fine crackles(crepitations) heard at lung bases (due to pulmonary edema.) • S3 gallop rhythm (from increased ventricular filling pressure.) • Cool extremities and weak pulse (poor peripheral perfusion.) • Cyanosis (in severe cases) 8
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  Complications: 1. Pulmonary edema. 2.Right-Sided Heart Failure (if prolonged) due to increased pulmonary pressure. 3. Renal impairment (from poor perfusion.) 4. Arrhythmias (due to myocardial strain or ischemia.) 10
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  Management: General measures: 1. Restrictsalt and fluid intake. 2. Encourage weight monitoring. 3. Elevate head of bed for comfort during sleep 4. Treat underlying cause (e.g. HTN, AVD, MVD, IHD.) 11
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  Management: Pharmacological: 1. Diuretics (e.g.furosemide) – reduce pulmonary congestion. 2. ACE inhibitors/ ARBs – reduce afterload and prevent remodeling. 3. Beta-blockers – reduce myocardial oxygen demand improving survival. 4. Aldosterone antagonist (e.g. spironolactone.) 5. Vasodilators – for afterload reduction. 12
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  Management: Advanced/supportive: 1. Oxygen therapyfor hypoxia. 2. Inotropes (e.g. dobutamine) in acute decompression. 3. Surgical options; valve repair/ replacement, cardiac resynchronization therapy, or heart transplant in end-stage disease. 13
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  Difference from Right-SidedHeart Failure. Left-sided HF • Primary congestion site is the lungs. • Major symptoms: i. Dyspnea. ii. Orthopnea. iii. Cough. • Caused by IHD, HTN, valve diseases Right-sided HF. • Primary congestion site is the systemic veins. • Major symptoms: i. Peripheral edema. ii. Hepatomegaly. iii. Ascites. • Caused by Pulmonary HTN, secondary to LSHF. 14
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  Diagnosis: Pt Hx: • Dyspnea •Orthopnea • PND • Fatigue • Breathlessness • Cough 16
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  Diagnosis : Physical exam: •Fune crackles • Tachypnea • Cold extremities 17
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  Diagnosis: Investigations: 1.Chest X-Ray 2.Electrocardiogram • Echocardiography 3.Bloodtests; • CBC for anemia • Urea/ creatinine & electrolytes for renal function tests • Liver function tests 4.Pulse oxymeter to detect hypoxia. 18