CONGESTIVE HEART FAILURE (Heart’s inability to pump enough blood to meet…
CONGESTIVE HEART FAILURE
(Heart’s inability to pump enough blood to meet body’s needs)
↓ cardiac output also cause ↓renal perfusion → activation of Renin-angiotensin-aldosterone system (RAAS) → production of aldosterone → vasoconstriction
Together, catecholamine and aldosterone cause ↑afterload, ↑BP, ↑heart rate and remodel ventricle by impairing contractility, enlarging heart cells and dilation of ventricle.
↓ cardiac output activates baroreceptors at left ventricle, aortic arch and carotid sinus → stimulates vasomotor regulatory centers in medulla → activates sympathetic nervous system (SNS) →release catecholamine → vasoconstriction.
50% who had heart failure would die within five years of diagnosis
Each year, $30.7 billion is spent for heart failure related expenses.
About 5.7 million people in the United States have heart failure.
1 million hospitalization of CHF in 2010
Heart valve repair or replacement
Coronary bypass surgery (if blocked arteries are reason for CHF)
Heart transplant (for severe heart failure)
Maintaining a healthy weight
Heart-healthy eating (low fat, low cholesterol and low salt)
Isosorbide dinitrate/hydralazine hydrochloride
Angiotensin II receptor blockers.
Angiotensin-converting enzyme (ACE) inhibitors
Race: Blacks are more likely to have heart failure and at a younger age than other ethnic groups
Behavior factor: overweight, smoking and unhealthy eating habits are risk for other heart problems and lead to heart failure
Age: heart muscles tends to weaken with age
Medical history: individuals with history of previous stroke, and other chronic diseases (diabetes, coronary heart disease, hypertension etc.) are at risk for developing heart failure
Chest pain/pressure and palpitations
Acute pulmonary edema
Fatigue and weakness
Nocturia and oliguria
Exertional dyspnea and/or dyspnea at rest
Anorexia, weight loss, nausea
Distention of neck veins
Weak, rapid, and thready pulse
Ascites, hepatomegaly, and/or anasarca
Central or peripheral cyanosis, pallor
Coronary angiography: with an aid of dye, helps to view flow of blood to heart muscles.
Stress test: Heart tests during activity or exercise
Cardiac cathererization: to view coronary arteries, check blood flow and collect blood sample
Cardiac CT scan or MRI: can aid in cause of heart failure
Holter monitor: portable recorder that records heart’s electrical activity for 24-48 hrs time
Thyroid function tests
Doppler ultrasound: measures the speed and direction of blood flow
Echocardiography: can identify blood flow to heart, heart muscles activity along with shape and size of heart.
Blood tests: to check rising level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) hormone.
Chest X-Ray: can detect enlarge heard, fluids in lungs or other lung disease
Electrocardiogram: records heart’s electrial activity
Physical exam: Heart and lung auscultation; possible s/s of heart failure
Medical and family histories