by ali alalawi
TRANSCRIPT
By
Ali Alalawi
Content of this lecture:
What is Congestive Heart Failure?
Epidemiology
Causes of Congestive heart Failure. Causes of Congestive heart Failure.
Signs and Symptoms.
Treatment.
What is Congestive Heart Failure?
Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs.other organs.
Epidemiology
US Health and Human Services. 5 million Americans suffer from CHF.
$17.8 billion spent annually.
400,000 new cases reported each year.
0.3/1000 < 45
3/1000 45-65
10/1000 >65
Causes of Congestive heart Failure:
This can result from:
Narrowed arteries that supply blood to the heart
muscle — coronary artery disease
Past heart attack, or myocardial infarction, with scar Past heart attack, or myocardial infarction, with scar
tissue that interferes with the heart muscle's normal work
Heart defects present at birth — congenital heart
defects.
Causes of Congestive heart Failure:This can result from:
High blood pressure
Heart valve disease due to past rheumatic fever
or other causes
Primary disease of the heart muscle itself, called Primary disease of the heart muscle itself, called
cardiomyopathy.
Infection of the heart valves and/or heart muscle
itself — endocarditis and/or myocarditis
Signs and Symptoms:
The most common signs of congestive heart
failure are :
Swollen legs or ankles
Difficulty breathing.
Weight gain when fluid builds up
Pulmonary edema.
Treatment:
When a specific cause of congestive heart failure is discovered, it should be treated or, if possible,
corrected for example:1. Some cases of congestive heart failure can be
treated by treating high blood pressure. treated by treating high blood pressure.
2. If the heart failure is caused by an abnormal heart valve, the valve can be surgically replaced.
Treatment:
The therapeutics goal for CHF is to increase cardiac
output.
CHF usually requires a treatment program which
help to reduce symptoms and prolonging life:○ Rest. ○ Proper diet. ○ Modified daily activities. ○ Drugs.
DRUGS AND DRUG CLASSES USED TO TREAT CHF
Vasodilators - Drugs that decrease either preload or afterload;
a) Arterial selective vasodilators decrease peripheral vascular resistance and
afterload on the failing myocardium. The reduction in afterload leads to an
increased cardiac output and improved tissue perfusion.
b) Venous selective vasodilators increase venous capacitance, thus decreasing b) Venous selective vasodilators increase venous capacitance, thus decreasing
preload. A small reduction in venous tone can result in a pooling of large
amounts of blood. This would decrease left ventricular filling pressure and
pulmonary congestion.
The major vasodilators used are ACE inhibitors and angiotensin II receptor
antagonists. Other agents include organic nitrates, hydralazine and nitroprusside.
DRUGS AND DRUG CLASSES USED TO TREAT CHF
Positive Inotropic Agents.Drugs that increase contractile force
Beta blockers.
Diuretics. Diuretics.diuretics promote the elimination of edematous fluid, improving tissue
perfusion and pulmonary function.