pathophysiology of congestion and oedema

Question 1

What happens in congestive heart failure

Answer 1

• The heart is unable to clear blood which leads to ischaemia and valve disease
• There is decreased cardiac output which leads to reduced GFR which activates the renin system RAAS - this leads to sodium and water retention and therefore excess fluid in the body

Question 2

What is the treatment of congestive heart failure

Answer 2

Diuretics

Question 3

What are the clinical signs of congestive heart failure

Answer 3

• Pulmonary oedema (left heart failure so blood flows back through the pulmonary veins to the lungs)
• Central venous congestion (right heart failure causes blood to flow back through the vena cava to the systemic circulation) - causes raised JVP, hepatomegaly and peripheral oedema

Question 4

What is an indicator of pulmonary oedema on chest X ray

Answer 4

Loss of the costophrenic angle