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Congestive Heart Failure (Heart Failure with Reduced Ejection Fraction)…
Congestive Heart Failure
(Heart Failure with Reduced Ejection Fraction)
Epidemiology
35% five year survival rate after hospitalization (Shah, 2017)
Affects 3 million U.S. citizens (Hammer & McPhee, 2019)
Risk factors
Male gender (Huether & McCance, 2017)
Past medical history of MI or ischemic heart disease (Heather & McCance, 2017)
65 year of age or older (Huether & McCance, 2017)
Hypertension (Dumitru, 2018)
Valvular Disease (Dumitru, 2018)
Diabetes Mellitus (Huether & McCance, 2017)
Clinical Presentation
Clinical Manifestations
Fatigue (Hammer & McPhee, 2019)
Tachypnea (Hammer & McPhee, 2019)
Rales/Inspiratory crackles (Hammer & McPhee, 2019)
Cardinal sign = Dyspnea/orthopnea/noctural dyspnea (Dumitru, 2018)
S3 Gallop (Huether & McCance, 2017)
Chest pain (Hammer & McPhee, 2019)
Pulsus Alternans (Hammer & McPhee, 2019)
Severe CHF exacerbation
Cyanosis (Dumitru, 2018)
Hypotension (Dumitru, 2018)
Confusion (Dumitru, 2018)
Dyspnea (Dumitru, 2018)
Diagnosis
Chest X-ray (Shah, 2017)
Pleural Effusions (Shah, 2017)
Pulmonary Edema (Shah, 2017)
Enlarged Cardiac Silhouette (Shah, 2017)
Past medical history/Clinical Exam (Shah, 2017)
Electrocardiogram (Shah, 2017)
Left Ventricular Hypertrophy (Shah, 2017)
Left Bundle Branch Block (Shah, 2017)
Previous MI (Shah, 2017)
Echocardiogram (Shah, 2017)
Ejection Fraction 40% (Shah, 2017)
Serum Labs (Shah, 2017)
BNP (Shah, 2017)
BMP (Shah, 2017)
CBC (Shah, 2017)
Treatment
Medication Management
ACE Inhibitors (Shah, 2017)
Angiotensin II Receptor Inhibitors (Shah, 2017)
Diuretics (Shah, 2017)
Beta Blockers (Shah, 2017)
Digoxin (Shah, 2017)
Lifestyle Changes
Daily weight monitoring (Shah, 2017)
Daily physical activity (Shah, 2017)
2L Fluid Restriction (Dumitru, 2018)
Alcohol cessation (Shah, 2017)
2g Sodium Restriction (Shah, 2017)
Interventions
Valve Replacement/Repair (Dumitru, 2018)
Left Ventricular Assistive Device (Shah, 2017)
Pacemaker (Dumitru, 2018)
Heart Transplant (Shah, 2017)
Correct the cause (Dumitru, 2018)
Pathophysiology
Myocyte Injury (Huether & McCance, 2017)
Decreased Contractility/Cardiac Output (Huether & McCance, 2017)
Decreased Renal Perfusion (Huether & McCance, 2017)
Activation of RAAS (Huether & McCance, 2017)
Sodium/Water Reabsorption (Huether & McCance, 2017)
Vasoconstriction (Huether & McCance, 2017)
ADH secretion (Huether & McCance, 2017)
Inflammatory Response (Huether & McCance, 2017)
Infiltration & Destruction of Myocytes (Huether & McCance, 2017)
Natriuretic Peptide Release (antagonist to RAAS) (Huether & McCance, 2017)
Ventricular Remodeling (Huether & McCance, 2017)
Release of Catecholamines/cytokines (Huether & McCance, 2017)