Congestive heart failure Flashcards
What is congestive heart failure?
A condition marked by weakness, edema, and shortness of breath that is caused by the inability of the heart to maintain adequate blood circulation in the peripheral tissues and the lungs.
How is the pump failure divided in congestive heart failure?
Pump failure; divided into right- and left-sided failure
What are the causes of left sided heart failure?
Causes include ischemia, hypertension, dilated cardiomyopathy, myocardial infarction, and restrictive cardiomyopathy.
Why causes the clinical features?
Clinical features are due to decreased forward perfusion and pulmonary congestion
What are the two main clinical features in CHF?
- -Pulmonary congestion leads to pulmonary edema.
- -Decreased flow to kidneys leads to activation of renin-angiotensin system
What are the consequences of pulmonary edema in CHF?
1.-Results in dyspnea, paroxysmal nocturnal dyspnea (due to increased venousreturn when lying flat), orthopnea, and crackles
2-. Small, congested capillaries may burst, leading to intraalveolar hemorrhage; marked by hemosiderin-laden macrophages
What are the consequences of a decreased flow to kidneys leads to activation of renin-angiotensin system?
Fluid retention exacerbates CHF
What is the treatment for left sided heart failure?
Mainstay of treatment is ACE inhibitor.
What are the common causes of right sided heart failure?
Most commonly due to left-sided heart failure; other important causes include left to- right shunt and chronic lung disease (cor pulmonale).
What are the clinical features due to congestion in right sided heart failure?
- Jugular venous distension
- Painful hepatosplenomegaly with characteristic “nutmeg” liver; may lead to cardiac cirrhosis
- Dependent pitting edema (due to increased hydrostatic pressure)
