congestive heart failure

Congestive Heart/Cardiac Failure

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Definition

• Heart failure, also called "congestive heart failure," is a disorder where the

heart loses its ability to pump blood efficiently.

• The result is that the body doesn't get as much oxygen and nutrients as it

needs, leading to problems like fatigue and shortness of breath.

• Heart failure is almost always a chronic, long-term condition that is managed

with medications and lifestyle changes. (Although it can sometimes develop

suddenly.)


Causes• Occurs due to diminished pumping ability of the ventricles• Congestive heart failure can be caused by:

Diseases in which the heart muscle weakensDiseases in which the heart muscles stiffens

Conditions where oxygen demand by the body tissue is beyond the capacity of the heart (It is the heart that has to deliver adequate oxygen-rich blood)

• These causes include:• Weakened heart muscle• Damaged heart valves• Blocked blood vessels supplying the heart muscle (coronary arteries), leading to a heart

attack• Toxic exposures, like alcohol or cocaine• Infections• High blood pressure that results in thickening of the heart muscle (left ventricular

hypertrophy)


• Pericardial disease, such as pericardial effusion (a large collection of fluid

around the heart in the space between the heart muscle and the thick layer of

pericardium surrounding the heart) and/or a thickened pericardium, which

does not allow the heart to fill properly

• Congenital heart diseases

• Prolonged, serious arrhythmias

• While these conditions often combine to produce CHF, sometimes the causes

of diseased heart muscles are not known; this is called idiopathic

cardiomyopathy or heart muscle disease of unknown cause.


• CHF is often a result of the following lifestyle habits:

• Unhealthy habits, such as smoking and excessive use of alcohol, are often to

blame.

• Obesity and lack of activity may contribute to CHF, either directly or indirectly

through accompanying high blood pressure, diabetes, and coronary artery

disease.

• Years of uncontrolled high blood pressure damages both heart and blood

vessels.


Pathology

• Congestive heart failure (CHF) is an imbalance in pump function in which the

heart fails to maintain the circulation of blood adequately.

• The most severe manifestation of CHF, pulmonary edema, develops when this

imbalance causes an increase in lung fluid secondary to leakage from

pulmonary capillaries into the interstitium and alveoli of the lung.

• CHF can be categorized as forward or backward ventricular failure.

• Backward failure is secondary to elevated systemic venous pressure, while left

ventricular failure is secondary to reduced forward flow into the aorta and

systemic circulation.


• Furthermore, heart failure can be subdivided into systolic and diastolic dysfunction.

• Systolic dysfunction is characterized by a dilated left ventricle with impaired contractility, while diastolic dysfunction occurs in a normal or intact left ventricle with impaired ability to relax and receive as well as eject blood.


Symptoms and Signs

• People with congestive heart failure (CHF) sometimes do not suspect a

problem with their heart.

• The early symptoms are often shortness of breath, cough, or a feeling of not

being able to get a deep breath.

• If you have a known breathing problem, such as asthma, chronic obstructive

pulmonary disease (COPD), or emphysema, you may think you are having an

"attack" or worsening of that condition.

• If you usually do not have breathing problems, you may think you have a cold,

flu, or bronchitis.

• To make matters worse, any or several of these conditions may coexist along

with congestive heart failure.


Congestive heart failure has the following 3 major symptoms

• Exercise intolerance• Shortness of breath• Fluid retention and swelling As the buildup of fluid in the lungs becomes very severe, a frothy,

pink liquid may be coughed up Daily weight checks are mandatory in persons with heart failure

because the amount of fluid retention is usually reflected by the amount of increasing shortness of breath and weight gain.

Persons with heart failure should know what their dry weight is or what they weigh when they feel good with no pitting edema.


• Diagnosis• Chest x-ray • Electrocardiogram (ECG)• Blood tests: You may have blood drawn for lab tests. • Blood cell counts: Low blood cell counts (anemia) may cause

symptoms much like CHF or contribute to the condition.• Sodium, potassium, and other electrolyte levels, especially if the

person has been treated with diuretics and/or has kidney disease• Tests of kidney function• B-type natriuretic peptide (BNP)

– This is a hormone produced at higher levels by the failing heart muscle. This is a good screening test; the levels of this hormone generally increase as the severity of heart failure worsens.


• Treatment• Use of diuretics, nitrates, analgesics, and inotropic agents are indicated for the

treatment of CHF and pulmonary edema

congestive heart failure

Education

heart andor

definition heart failure

heart muscle coronary

heart attack toxic exposures

ventricular failure

backward failure

blood vessels

circulation of blood