1.10.2012

HEART FAILURE

Posted on 10:20 PM by know about heart


It is also called congestive heart failure. It is an abnormality of cardiac function in which heart is unable to pump blood at an output sufficient to meet the metabolic demands of the tissue or can do so only at an elevated filling pressure .Heart failure is a syndrome that may be result from the end stage of many forms of chronic heart disease and systemic disorders.
TYPES OF HEART FAILURE
§Acute heart failure: Heart failure develops suddenly in this type of heart failure
 §Chronic heart failure: Here heart failure develops suddenly
§ Left sided heart failure: If left ventricular output is decreased and/or left atrial or pulmonary venous pressure increased, left sided heart failure occur.
§Right sided heart failure: In this condition right ventricular output is decreased.
§Biventricular failure: In this condition both sided heart failure occur.
§Compensated heart failure
§Forward failure: Due to inadequate output, forward failure occurs.
§Backward failure: Due to pulmonary and systemic venous pressure congestion backward failure occurs.
§Systolic dysfunction: Due to impaired myocardial contraction this type of heart failure developed.
§ Diastolic dysfunction: Due to poor ventricular failure and high filling pressure, diastolic dysfunction is developed.
heart
CAUSES:
1. Long standing systemic hypertension
2. Coronary hypertension
3. Cardiomyopathy
4. Obstuctive vulver disease
5. Myocardial infarction
6. Shock
7. Intracardiac left to right shunting
8. Extracardiac shunting
9. Infectious agent
10. Metabolic disorders
11. Idiopathic condition
12. Corpulmonale
13. Myocardial ischemia
14. Aging
15. Ischimic fibrosis
16. Endomyocardial disorders
17. Nutritional disorder
18. Thyrotoxicosis
19. Collagen vascular disease
20. Diabetes mellitus
21. Drug abuse: Cocaine
22. Lung disease
23. Nutritional: Beri beri, kwashiorkor, pellagra
Diagnosis:-
1. Signs and symptoms
          a) Dyspnea:-most common symptom of heart failure. Usually exertional dyspnea is present in heart failure
          b) Acute pulmonary edema
          c) Exercise intolarence
          d)Fatigue:-it is a common compliment of patients with heart failure.Usually there any muscular fatigue present
          e) Cough
          f) Third heart sound
          g)rales
          h)elevated jugular venous pressure
          i)Oliguria and nocturia
          j)Weight loss
         k)Infection
         l)Pulmonary embolism
        m)Tender hepatomegaly
        n)Arrhythmia
       o)IV fluid overload
INVESTIGATION:
ECG
Left ventricular hypertrophy
Arrhythmia
X-RAY:
Pulmonary congestion
Cardiomegally
MANAGEMENT:
 Without drug:
   Salt restriction
   Regular exercise
   Stop smoking
  Stop alcoholism
  Vaccination against influenza virus and pneumococcal pneumonia
 Drug treatment
1. Use diuretics drug. Bumetanide 0.5 to 1mg once or twice daily. Furosemide 20 to 40mg once or twice daily.Torsemide 10 to 20mg once or twice daily
2. Use beta blockers drug (Bisoprolol, Carvedilal etc)
3. Use digoxin drug
4. Use low dose of spironolactone

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