Aisha is not feeling well

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Mind Map on Aisha is not feeling well, created by Menna Emam on 08/10/2017.
Menna Emam
Mind Map by Menna Emam, updated more than 1 year ago
Menna Emam
Created by Menna Emam over 6 years ago
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Resource summary

Aisha is not feeling well
  1. later diagnosed with
    1. congestive heart failure
      1. occurs when
        1. The heart is unable to pump blood at a rate that meets the metabolic requirements of the peripheral tissue; inadequate cardiac output is usually accompanied by increased congestion of the relevant venous circulation.
        2. Classification
          1. Left-sided versus right-sided failure
            1. Left ventricular failure and right ventricular failure can occur independantly or together as congestive cardiac failure
              1. RVH
                1. LVF
                  1. Pulmonary stenosis
                    1. Lung disease
                      1. Symptoms
                        1. Peripheral edema
                          1. Ascites
                            1. Nausea
                              1. Facial engorgement
                                1. Pulsation in neck and face
                                  1. Epistaxis
                2. LVH
                  1. Dyspnea
                    1. Poor exercise tolerance
                      1. fatigue
                        1. Orthopnea
                          1. PND
                            1. Nocturnal cough
                              1. Wheeze
                                1. Muscle wasting
                                  1. Weight loss
                                    1. Cold peripheries
                                      1. Nocturia
                3. Low-output versus high-output failure
                  1. High-output heart failure
                    1. Output is normal or increased with increased needs. Failure occurs when cardiac output fails to meet these needs. Occ- urs with a normal heart but ear- lier if there is heart disease.
                      1. Consequence
                        1. Initially features of RVF, then LVF becomes evident
                        2. Causes
                          1. Anemia
                            1. pregnancy
                              1. Hyperthyroidism
                                1. Paget's disease
                      2. Low-output heart failure
                        1. Cardiac output is decreased and fails to increase normally with exertion.
                          1. Causes
                            1. Pump failure
                              1. Systolic ordistolic
                                1. Heart failure
                                  1. decreased HR
                              2. Excessive overload
                                1. MR
                                  1. fluid overload
                                2. Chronic excessive after load
                                  1. AS
                                    1. Hypertension
                          2. Systolic versus diastolic failure
                            1. Systolic failure
                              1. Inability of the ventricle to contract normally, resulting in decreased cardiac output. Ejection fraction is <40%.
                                1. Causes
                                  1. IHD
                                    1. MI
                                      1. DCM
                                        1. myocarditis
                              2. Diastolic Failure
                                1. Inability of the ventricle to relax and fill normally causing increased fillinf pressures. Ejection fraction > 50%.
                                  1. Causes
                                    1. Constrictive pericarditiS
                                      1. Tamponade
                                        1. Restrictive cardiomyopathy
                                          1. Hypertension
                              3. Acute versus chronic heart failure
                                1. Acute heart failure
                                  1. Is often used exclusively to mean new onset acute or decompensation of chronic heart failure characterised by pulmonary and/or peripheral edema with or without signs of peripheral hypoperfusion.
                                  2. Chronic Heart failure
                                    1. Develops or progresses slowly, venous congestion is common but arterial pressure is well maintained until very late.
                                2. prognosis
                                  1. Poor with 25 - 50% of patients dying within 5 years of diagnosis.
                                  2. Diagnosis
                                    1. Routine laboratory Test
                                      1. biomarkers
                                        1. Echocardiography
                                          1. ECG
                                            1. Recommended test in all heart failure patients.
                                              1. CXR
                                                1. Cardiomegaly
                                                  1. Dilated prominent upper lobe vessels
                                                    1. pleural effusion
                                                      1. Kerley B lines
                                                        1. Alveolar Edema
                                                          1. Bat wisngs
                                                          2. Interstitial edema
                                                  2. ECG in CHF can show abnormalities as arrhythmias, ischemia, MI, LVH, conduction abnormalities such as PVCs, LBBB.
                                          2. Symptoms
                                            1. Risk factors
                                              1. Tobacco use
                                                1. Hyperlipidemia
                                                  1. Hypercholestremia
                                                    1. Diabetes
                                              2. Management
                                                1. Non-pharmacological
                                                  1. Limiting salt intake for all HF patients
                                                    1. Limiting fluid intake for those with hyponatremia, high diuretics intake and severe HF
                                                      1. Exercise for those with stable heart and stable volume levels
                                                        1. Monitoring all HF patients
                                                  2. Pharmacological
                                                    1. Drugs used
                                                      1. Decreased load on the heart
                                                        1. Diuretics
                                                          1. ACE inhibitors
                                                            1. ARBs
                                                              1. Vasodilators
                                                        2. Increase the function of the heart
                                                          1. Beta-blockers
                                                            1. Adrenergics
                                                              1. Inotropic-cardiotonic drugs
                                                                1. Digoxin
                                                                  1. Phosphodiestrase inhibitors
                                                                    1. Dobutamine
                                                                      1. Adrenaline
                                                    2. Manifestations upon physical examinatio
                                                      1. complications
                                                        1. Stages
                                                          1. Cardiac cachexia
                                                            1. Arrhythmia
                                                              1. Kidney problems
                                                                1. Anemia, stroke
                                                                  1. Leg venous stasis
                                                                    1. liver problems
                                                                      1. Hyponatremia
                                                          2. of
                                                            1. RHF
                                                              1. JVD
                                                                1. Hepatosplenomegaly
                                                                  1. Pitting Edema
                                                              2. LVH
                                                                1. Pulmonary congestion
                                                                  1. Decreased forward perfusion
                                                                    1. Cardiomegaly
                                                                      1. Tachycardia
                                                                        1. S3
                                                                          1. Ventricular Dilation
                                                                            1. Arrhythmia
                                                        2. presented with
                                                          1. Orthopnea
                                                            1. definition
                                                              1. Difficulty in breathing that occurs when lying down and is relieved upon changing to an upright position.
                                                                1. Causes
                                                                  1. LFH
                                                                    1. Bronchial Asthma
                                                                      1. Mitral stenosis
                                                                        1. MarkedAscites
                                                                          1. Anxiety & hyperventilation
                                                                            1. Bilateral diaphragmatic paralysis
                                                                              1. pericardial diesease
                                                            2. Oedema
                                                              1. definition
                                                                1. Is the accumelation of excessive fluid in the subcutaneous tissue.
                                                                  1. Causes
                                                                    1. Impairment of lymphatic drainage
                                                                      1. Generalized
                                                                        1. Congenital deiciency of lymphatics
                                                                        2. Localized
                                                                          1. Local infection
                                                                            1. Trauma
                                                                              1. Burns
                                                                                1. Animal bites / stings
                                                                        3. Increased plasma hydrostatic pressure:
                                                                          1. Generalized
                                                                            1. CHF
                                                                              1. Vasodialatory drugs
                                                                            2. Localized
                                                                              1. Venous obstruction
                                                                            3. Decreased plasma oncotic pressure
                                                                              1. Generalized
                                                                                1. Liver disease
                                                                                  1. Renal disease
                                                                                    1. Malnutrition/ malabsorption
                                                                                2. localized
                                                                                  1. Milroy's disease
                                                                                    1. Lymphoedema praecox
                                                                                      1. Malignant infiltration
                                                                        4. Dyspnea
                                                                          1. definiton
                                                                            1. Is the uncomfortable awareness of breathing
                                                                              1. Causes
                                                                                1. sudden
                                                                                  1. Pneumothorax, Pulmonary embolism, Aspiration, Anaphylaxis , Anxiety, Chest trauma
                                                                                    1. Acute
                                                                                      1. Asthma, Respiratory tract infection, Lung tumors, Pleural effusion, Metabolic acidosis
                                                                                        1. Chronic
                                                                                          1. COPD, Cardiac failure, Fibrosing alveoli's, Anaemia, Arrhythmia, Vavular heart disease, Chest wall deformities, Pulmonary hypertension
                                                                          2. Fatigue
                                                                            1. definition
                                                                              1. A subjective symptom of malaise and aversion to activity or to objectively impaired performance.
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