heart failure

heart failure

1. treatment

   • non-pharmacological
     • life-style modifications
   • pharmacological
     • Angiotensin-converting enzyme inhibitors (ACEIs)
     • Angiotensin receptor blockers (ARBs)
     • Aldosterone antagonists
     • β-Blockers
     • Vasodilators (long-acting nitrates and hydralazine)
     • Diuretics
     • Digoxin

2. Investigations

   • chest X-ray
     • cardiothoracic ratio
   • ECG
   • renal function
   • cardiac enzymes
   • blood tests
   • catheterization
   • echocardiography

3. signs and symptoms

   • Rapid or irregular heartbeat
   • Fatigue and weakness
   • Lack of appetite and nausea
   • crackles on ascultation

4. pathophysiology

   • intrinsic decrease in muscle contractility
     • Preload or left atrial filling pressure is increased pulmonary congestion and dyspnea.
       • Although systemic blood pressure is often reduced, there is an increase in systemic vascular resistance (afterload) reduce cardiac output
         • Heart rate is generally increased as part of a compensatory mechanism
           • inadequate to meet the peripheral demands of the body
   • left sided leads to
     • right sided leads to
       • Jugular venous distension
         • Painful hepatosplenomegaly with “nutmeg” liver

5. causes

   • myocardial infarction
     • congenital heart disease
       • Coronary artery disease
   • Abnormal heart valves
   • High blood pressure

6. dyspnea

   • an intense tightening in the chest, air hunger or a feeling of suffocation
     • types
       • orthopnea
         • sensation of breathlessness in the recumbent position, relieved by sitting or standing.
       • Paroxysmal nocturnal Dyspnea
         • sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep.

7. edema

   • result of the activation of a series of humoral and neurohumoral mechanisms that promote sodium and water reabsorption by the kidneys and expansion of the extracellular fluid.

8. stages

9. types

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