Congestive Heart Failure (CHF) Flashcards
What is Congestive Heart Failure?
Pump failure divided into right- and left- failure
What are the causes of left sided heart failure?
-Ischemia, HTN (concentric left ventricular hypertrophy), dilated cardiomyopathy (muscle can’t contract as well), myocardial infarction and restrictive cardiomyopathy
What causes the clinical features of left sided heart failure?
- Decreased forward perfusion
- Pulmonary congestion
What does pulmonary congestion cause?
Pulmonary edema
- Results in dyspnea, paroxysmal nocturnal dyspnea (due to increased venous return when lying flat), othopnea, and crackles
- Small, congested capillaries may burst, leading to idntraalveolar hemorrhage; marked by hemosiderin-laden macrophages (‘heart-failure’ cells)
What does decreased forward perfusion cause?
Decreased flow to the kidneys which leads to activation of renin-angiotensin system.
-Fluid retention exacerbates CHF
What is the main treatment for Left CHF?
ACE inhibitor!
What causes right sided heart failure?
Left sided heart failure most commonly
-Other important causes: left-to-right shunt and chronic lung disease (cor pulmonae)
What are the clinical features of right sided heart failure? What causes these?
Congestion causes them:
- Jugular venous distention
- Painful hepatosplenomegaly with characteristic ‘nutmeg’ liver; may lead to cardiac cirrhosis
- Dependent pitting edema (due to increased hydrostatic pressure)