Heart failure

heart failure

is a common chronic health problem with acute episodes often causing hospitalization

3 major types:

left sided HF

right sided HF

high output failure

right sided: blood pools back into the liver, spleen, and legs.

Left sided: blood pools back into the lungs.

Classifications:

A: patients @ high risk for developing heart failure

B: patients with cardiac structural abnormalities or remodeling who have not developed HF symptoms

C: patients with current to prior symptoms of heart failure

D: patients with refractory end- stage HF.

compensatory mechanisms:

when cardiac output is insufficient to meet the demands of the body, compensatory mechanisms works to improve cardiac output.

sympathetic nervous system

renin angiotensin system (RAS) activation

renin angiotensin aldosterone (RAAS) activation

other chemical responses

myocardial hypertrophy

Risk factors:

Hypertension, CAD, cardiomyopathy, substance abuse, valvular disease, obesity, congenital defects, infection, diabetes, smoking, family HX.

S/S: left--> weakness, fatigue, dizziness, acute confusion, pulmonary, congestion, weak peripheral pulses, cool extremities.

S/S: right: JVD, Enlarged liver/ spleen, dependent edema, increased BP (Excess volume), distended abdomen, decreased BP (HF).

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labs:

sodium, potassium, mag, calcium, chloride

renal function (BUN/ CR)

Hbg, and HCT

BNP (fluid overload)

urinalysis (protein uria, Increased specific gravity)

ABG (fluid in lungs)

chest X-ray

ECHO

EKG

potential complications

kidney damage ( decreased blood flow to kidneys)

heart valve problems ( back flow of blood)

heart rhythm problems

(arrythmias)

liver damage ( build up of fluid too much pressure)

Meds:

morphine

loop diuretics

thiazide diuretics

potassium sparing

naturetic peptide

nitrates: nitroprusside/ nitrogylcerine

ACE/ARBS