Heart failure

HEART FAILURE

Heart Failure – is inability of the heart to pump sufficient to blood to meet

the needs of the tissues of the oxygen & nutrients.

- HF was often referred to as CHF, because many pt’s experience pulmonary or peripheral congestion.

Chronic Heart Failure- The increase incidence of HF reflects not only the

increased number of elderly people but also improvements in treatment of cardiac diseases (MI), resulting in increased survival rates.

Clinical ManifestationsMay be produced by the different

types of HF (systolic, diastolic or both) are similar and therefore do not assist in differentiating the types of HF.

The S/S of HF can be r/t which ventricle is affected.

LSHF causes different manifestations than RSHF .

LEFT-SIDED HEART FAILUREPulmonary congestion occurs when the left

ventricle cannot effectively pump blood out of the ventricle into the aorta and the systemic circulation.

CM of pulmonary congestion: Dyspnea or SOB Cough Pulmonary crackles Low oxygen saturation level

CAUSES:CADMIMyocarditis or endocarditisHeart valve disordersArrthyhmiasPulmonary HPNPulmonary embolismHyper & HypothyroidismAnemiaKidney Failure

S/S of LSHF:CracklesDsypneaNonproductive coughBlood tinged, frothy sputumRestlessnessTachycardiaS3 & S4OrthopneaNocturnal dyspneaCool, pale skin

Tests: Electrocardiography (EKG) CXR Echocardiogram Pulmonary Artery pressure monitoring

Tx: Diuretics ACE inhibitors Angiotensin II receptor blockers Beta-blockers

RIGHT-SIDED HEART FAILURE- The right ventricles fails, congestion

in the peripheral tissues & the viscera predominates.

Causes:LSHFHPNAge, infiltration, Infections that cause

cardiac wall stiffnessHeart valve disordersLung disorders: COPD & PE

S/S: Hepatomegaly & splenomegaly Epigastric tenderness Ascites Edema Anorexia, fullness, edema JVD Nocturia

Tests: EKG CXR Echocardiogram PA pressure monitoring

Tx: Diuretics

→ Loop Diuretics: Furosemide (Lasix)

ACE inhibitors

→ lisonopril (prinivil), captopril (capoten), perindropil (aceon), ramipril (altace)

Angiotensin II receptor blockers

→ valsartan (diovan), eprosartan (teveten), telmisartan (micardis), losartan (cozaar)

Beta-blockers

→ metropolol (lopressor, toprol), atenolol (tenormin), carvedilol (coreg)

Calcium Channel Blockers

→ dihydropyrimides : amlodipine (norvasc), felodipine (plendil)