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Congestive Heart Failure Congestive Heart Failure (Causes (Other disorders…
Congestive Heart Failure
Risk Factors
Coronary heart disease
Hypertension
Diabetes
Unhealthy Behaviours
Obesity
Smoking
Poor diet
Inactivity
Clinical Presentation
Signs
JVD
Edema
Atelectasis
Abdominal ECG
S3 auscultation
Tachycardia
Symptoms (most common)
Cough
Dyspnea
Fatigue
edema/swelling
Ankles
Feet
Neck veins
Abdomen
Legs
Symptoms (other)
Decreased exercise tolerance
PND
Palpitations
Weight Gain
Orthopnea
Abdominal discomfort
Alterations
Acute
Hypotension sign of shock
Decreased oxygen delivery
Typically Hypertensive
Upstream congestion
Downstream hypoperfusion
Decreased urine output
Cardiomyopathies
HFrEF and HFpEF
Chronic
Endothelial dysfunction
Inflammation
Impaired sodium excretion
Neural humoral activation
Treatment
Medications
Ace-inhibitors
Beta-blockers
ARBs
Amiodarone
Digoxin
Hydralazine/Isosorbide
Statins
Diuretics
Devices
ICD
Biventricular pacing
Ventricular assist devices
CardioMEMS
Transplant
Cardiac Rehab
End-stage
Inotrope infusion
Transplant
Hospice
Low sodium diet
Frequent follow-up needed
Causes
CAD
Alcoholism, Drugs
Genetics
Viruses, bacteria, fungal infections
Shock
Valvular heart disease
Congenital heart disease
Arrhythmias
Other disorders
Amyloidosis
Hemochromatosis
Thyroid disorders
HIV
PE
Diagnosis
Heart Biopsy
CT Scan
Stress test
Blood tests - BNP
Cardiac MRI
Cardiac Cath
RHC
Right side pressures
LHC
R/O CAD, measure LVEDP
Echo
ECG
CXR
Epidemiology
U.S. - 6.5 million adults
Increased morbidity + mortality
Death within 5 years of diagnosis
Significant Healthcare Costs
Expected increase
Aging population
Increased MI survival
Classification
ACC guidelines
New York Heart Association
Low incidence in children
Complications
Arrythmias
Blood clots
Sudden cardiac death
Cardiogenic shock
Renal failure
LIver failure
Stroke
