Heart Failure

Heart Failure

1. Failure of the heart to eject the blood that returned to it

   • Types
     • RHF
       • Causes
         • Left side heart failure
         • Left to righ shunt
         • Cor pulmonale
       • symptoms
         • Fatigue
         • increase peripheral venous pressure
         • Distended jagular vein
         • peripheral pitting edema
           • Edema
             • Types
               • According to location
                 • localized
                   • due to increased permeability of the blood vessel. example: release of inflammatory mediators like histamine ,bradykinin
                 • Generalized
                   • heart failure renal cause: nephrotic syndrome liver cirrhosis malnutrition allergic reaction
               • Based on clinical findings
                 • pitting
                   • pressing the affected area displaces the fluid, leaving a finger shaped depression that disappears within seconds
                 • non-pitting
                   • not compressible
         • hepatomegaly
     • LHF
       • Symptoms
         • Pulmonary edema
           • • Mechanism of action
               • increased hydrostatic pressure; reduced colloidal or oncotic pressure within blood vessels; increased tissue colloidal or oncotic pressure; increased blood vessel wall permeability (e.g., inflammation); obstruction of fluid clearance in the lymphatic system;
         • orthopnea
           • DDX
             • CHF
             • Asthma
             • Gerd
             • Sleep apnea
         • PND
         • Elevated pulmonary capillary pressure
       • Causes
         • Ischemia heart disease
         • Cardiomyopathies
     • CHF
       • Risk factors
         • Hypertension
         • CAD
         • Heart attack
         • diabetes

2. Prognosis

   • In spite of progressive heart failure therapeutic strategies, the prognosis for CHF remains comparable to many cancers
   • depend on
     • Mangemnt
       • Pharmachological
       • life style modification
       • If the management is not effective can lead to :
         • many complications
           • Kidney damage or failure
           • Heart valve problems
           • Heart rhythm problems
           • Liver damage
           • Depression
             • Criteria of MDD
             • Treatment

3. what is done in the clinic

   • CVS Physical examination
     • Inspection
     • palpitation
     • Ascultation
       • S3 heart sound could be heared
   • Investigation
   • History taking
     • Chief complain
       • Shortness of breath,using more pillows

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