8.2 Congestive Heart Failure (CHF)

Question 1

Clinical symptoms in L sided heart failure (4)

Answer 1

• pulmonary edema symptoms:
  1. Dyspnea
  2. Orthopnea
  3. Paroxysmal nocturnal dyspnea
  4. Crackles

Question 2

What do you see in lungs in L sided heart failure?

Answer 2

‘heart-failure cells’

• congested capillaries burst, leading to intraalveolar hemorrhage. macrophages ingest RBCs, which have hemosiderin.
• hemosiderin-laden macrophages look brown.

Question 3

First line therapy of CHF

Answer 3

• ACE inhibitors
• block the cycle of fluid retention

Question 4

cor pulmonale

Answer 4

RV hypertrophy/failure due to pulmonary HTN

Question 5

clinical features of R sided heart failure (3)

Answer 5

all caused by congestion:

1. jugular venous distension
2. pitting edema
3. painful hepatosplenomegaly (nutmeg liver), can lead to cirrhosis