Aisha’s not feeling so good (Heart failure)

Aisha’s not feeling so good (Heart failure)

1. Heart Development

2. Edema

   • Increased hydrostatic pi Hypoalbuminemia
   • Increased permeability Lymphatic obstruction

3. Congestive heart failure

   • Inability of the heart to keep up with the demands on it, with failure of the heart to pump blood with normal efficiency.
   • Left HF
   • Right HF
   • Signs & symptoms
     • Dyspnea, Orthopnea, Fatigue, Swelling, Irregular heartbeat, Persistent cough (with blood), Chest pain
   • Risk factors
     • High blood pressure, Coronary artery disease, Heart attack, Congenital heart defect, Valvular heart disease, Alcohol and tobacco.
   • Compensatory physiological response
     • Increase sympathetic activity renin-angiotensin-aldosterone system Myocardial hypertrophy

4. Physical examination

   • Vital signs
   • Jugular Vein
   • Lungs
   • Hyperdynamic Apical Impulse

5. Investigations

   • Chest X-Ray
   • Echocardiography
     • preferred examination in CHF
   • Electrocaardiogram
     • common finding include: sinus Arrhythmia, pathological Q waves, ST elevation, LBBB, intraventricular conduction delays.

6. Management

   • Pharmacological therapy
     • Treat the cause and precipitating factor
     • 1. Digitalis glycosides (Digoxin) 2. Phosphodiestrase inhibitors 3. Dobutamine and Dopamine 4. Human Natriuretic Peptide 5. Endothelin R Antagonists
     • Cardio-inotropic drugs
   • Life style

7. Heart Sounds

8. Pathogenesis

   • Left HF
     • Ischemia, MI, Hypertension, Dilated cardiomyopathy, Restrictive cardiomyopathy, Hypertrophic cardiomyopathy.
   • Right HF
     • Left HF, Left to right shunt, Cor pulmonale.
   • Concentric hypertrophy in pressure overload
   • eccentric hypertrophy in volume overload

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