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Congestive Heart Failure (Left Sided) (Treatment (Beta Blockers, Inotropes…
Congestive Heart Failure (Left Sided)
Epidemiology
Women: similar values (8 and 79 per 1000)
Prevalence in African-Americans is reported to be 25 percent higher than in whites (Vasan & Wilson, 2019).
Men: 8 per 1000 at age 50 to 59 years, increasing to 66 per 1000 at ages 80 to 89 years
5.1 million people with HF in the United States in 2006, estimated 23 million people with HF worldwide
Pathophysiology
The combination causes an increased afterload, increased blood pressure, and increased heart rate as a response.
Decreased perfusion to the kidneys activates the renin-angiotensin-aldosterone system, which causes a retention of sodium and water.
This causes ventricular remodeling, which is hypertrophy and dilation of the ventricle (Huether & McCance, 2017).
Baroreceptors activate as a response which stimulates the medulla to allow the sympathetic nervous system to vasoconstrict.
Myocardial dysfunction causes infarction, ischemic heart disease, or hypertension which when causes decreased cardiac output, blood pressure, then perfusion to the kidneys
Ejection fraction less than 40% and inability to generate an adequate cardiac output to perfuse vital tissues
Risk Factors
Smoking
Obesity
Hypertension
Diabetes
Coronary heart disease
Valvular heart disease (Vasan & Wilson, 2019).
Clinical Presentation
Inadequate perfusion of systemic circulation
Hypotension of Hypertension
Pulmonary vascular congestion
Ejection fraction less an 40%
S3 gallop
Cyanosis, Inspiratory crackles, pleural effusions
Underlying CAD or HTN (Huether & McCance, 2017).
Pulmonary edema
Diagnosis
Stress Test
CT Scan
Echocardiogram
MRI
EKG
Chest XRay
Coronary Angiogram
NT-proBNP blood test
Myocardial biopsy (Heart Failure, 2017).
Treatment
Beta Blockers
Inotropes
Angiotensin II Blockers
Aldosterone Antagonists
Diuretics
Digoxin
ACE Inhibitors
ICD
Heart valve repair / replacement
CRT
CABG
VAD (Heart failure, 2017).
Heart transplant