Congestive Heart Failure

Question 1

What is congestive heart failure (CHF)

Answer 1

heart cannot pump sufficient blood to meet the metabolic demands of tissues

Question 2

CHF Etiology / Underlying diseases

Answer 2

1. IHD
2. Hypertension
3. Miscellaneous - VHD (vascular heart disease), cardiomyopathies ( heart muscle disease), toxins

Question 3

CHF - S &S

Answer 3

LV - SOB, orthopnea and PND

RV - pedal edema and ascites

Question 4

CHF - Prognosis

Answer 4

less than 50% five year survival

Question 5

CHF - Treatment non-pharm

Answer 5

1. ID and treat underlying cause
2. Lifestyle modification - limit salt intake, exercise, weight loss
3. treat exacerbating factors - limit exposure to emotional stress

Question 6

CHF - Treatment Pharm

Answer 6

1. ACE Inhibitors (ARBs)
2. Beta blockers
3. Spironolactone
4. Digoxin
5. Diuretics

Question 7

What is spironolactone?

Answer 7

Pronounced - spy-row-no-lack-tone
Brand names - Aldoactone
Its a synthetic, steroidal antimineralcorticoid agent usually used as a diuretic and antihypertensive but also to reduce elevated/ unwanted androgen activity in body

Question 8

CHF - Treatment surgery

Answer 8

Implantable cardiovert-defibrillator (ICD)

Question 9

CHF dental considerations to measure severity of CHF according to NYHA

Answer 9

NYHA - New York Heart Association
I - no limitations
II - slight limitations of ordinary activity
III - significant limitations 
IV - symptomatic at rest 

*AVOID dental surgery at III or IV

Question 10

CHF - day of dental surgery

Answer 10

1. Continue meds perioperatively
2. Avoid exacerbating factors - esp. vasopressors and excessive fluids
3. Avoid supine position as it may precipitate orthopnea