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Congestive Heart Failure (Symptoms and Clinical Presentation (Dyspnea…
Congestive Heart Failure
Patho-physiology
Definition: weakness or stiffness of the heart muscle causing inefficient pumping of the blood
Complications
Kidney failure due to poor blood return to the kidneys
Heart valve damage
Heart dysrhythmia
Liver and other organ damage because of fluid buildup in the organs in the right-sided HF
Treatment
Prevention
Quitting tobacco use and smoking
Properly managing and treating chronic conditions
Good self-care
Proper exercise
Good nutrition
Managing stress
Weight reduction
Medications: Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitor, Beta blockers, diuretics, aldosterone antagonists, inotropes, digoxin
Diagnosis
Echo-cardiogram
Left ventricular ejection fracture <40%
Thorough H/P
Assess for JVD, ascites, & edema
Stress test to check heart's response to exertion
ECG to check for dysrhythmia
CXR to determine if fluid is present in lungs
Stress test to check heart function under exertion
Risk Factors
Hypertension
Coronary Heart Disease
Problems with heart valves
Cardiomyopathy
Myocarditis
Congenital abnormalities
Heart dysrhythmia
Chronic conditions
HIV, thyroid problems, hemochromatosis, diabetes, sleep apnea
Medications
Rosiglitazone & Pioglitazone (tx for diabetes)
NSAIDs
Majority of procedural, prescription, and over-the-counter meds
Tobacco
Alcohol
Obesity/sedentary life style
Symptoms and Clinical Presentation
Dyspnea
Upon exertion
Lying down
Sudden and severe
Weakness
Fatigue
Edema
legs/ankles/feet
Irregular or fast HR
Exercise intolerance
Coughing
Wheezing
White or pink-tinged, frothy oral secretions
Ascites
Weight gain
Inability to concentrate or confusion
Chest pain
Nausea
Poor appetite
Crackles
Types (part of patho)
Acute
Chronic
Left-sided
Blood backs up into the pulmonary system
Shortness of breath
Wheezing, pink/frothy sputum
Right-sided
Blood backs up in the body
Ascites, leg/ankle edema
Systolic
Problems with left ventricle contracting
Diastolic
Problems with right ventricle filling
Epidemiology
Older adults >60 years
3 million Americans
one of the greatest contributors to ER visits and hospital admissions