Transcript Congestive Heart Failure

Congestive Heart Failure
Dean Handimulya,
M.D
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Summary
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Heart failure (sometimes known as
congestive heart failure [CHF]) is a
serious condition in which the heart is
not pumping efficiently. It is a chronic
condition that is the result of other
cardiac conditions.
Dean Handimulya UIEU 2005
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In the late stages of heart failure, the
heart is unable to meet the body’s
demand for oxygen. In addition, it may
cause congestion in the lungs or other
problems throughout the body. As a
result of the lack of oxygen–rich blood
flowing to the body, the heart tries to
work harder, which only makes the
problem worse.
Dean Handimulya UIEU 2005
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In the early stages, heart failure may not have
any symptoms. In the later stages, the patient
may have severe symptoms because their
weakened heart is unable to pump enough
oxygen–rich blood with each contraction to
satisfy the body. These symptoms may include
shortness of breath (dyspnea) that initially
occurs only during exercise, and later even
while at rest.
Dean Handimulya UIEU 2005
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Heart failure is a chronic and complex condition.
By itself, heart failure is not considered a
disease. Rather, it is the result of other
conditions that damaged the heart. These other
conditions include diseases of the coronary
arteries that lay on the surface of the heart,
heart valve disorders, high blood pressure
and damage to the heart muscle itself.
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Condition That Could Lead to
Heart Failure
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Coronary artery disease (CAD)
Arrhythmia
Heart attack (myocardial infarction)
High blood pressure (hypertension)
Dean Handimulya UIEU 2005
Condition That Could Lead to
Heart Failure
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Cardiomyopathy
Valvular heart disease
Congenital heart disease
Pulmonary hypertension
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Types and Differences of
Heart Failure
Heart failure may be classified by which
side of the heart it affects :
 Left–sided heart failure
 Right–sided heart failure
Dean Handimulya UIEU 2005
Heart failure is also commonly defined by
which portion of the cardiac cycle is
affected:
 Systolic heart failure
 Diastolic heart failure
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
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In addition to these classifications, heart
failure may be defined by how it affects
patients. The new York heart association
has developed a system that defines
heart failure by the functional limitation
it imposes on the patient. These levels
are as follows (with approximate
percentage of patients)
Dean Handimulya UIEU 2005
New York Heart Association
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Class I: no obvious symptoms, no limitations on
patient physical activity (35 percent of heart
failure patients).
.
Class II: some symptoms during or after normal
activity, mild physical activity limitations (35
percent of heart failure patients).
.
Dean Handimulya UIEU 2005
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Class III: symptoms with mild exertion,
moderate to significant physical activity
limitations (25 percent of heart failure patients).
.
Class IV: significant symptoms at rest, severe
to total physical activity limitations (5 percent
of heart failure patients).
Dean Handimulya UIEU 2005
The AHA/ACC Stages
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Stage A: the patient at high risk for heart
failure, but has no heart abnormalities.
.
Stage B: the patient has structural
abnormalities of the heart, particularly
the left ventricle, but no symptoms.
.
Dean Handimulya UIEU 2005
The AHA/ACC Stages
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Stage C: the patient has past or present
symptoms associated with heart failure.
.
Stage D: the patient has end–stage heart
disease, requiring specialized treatment (e.G.,
Continuous intravenous (IV) drug therapy, left
ventricular assist device, heart transplant)
or severely symptomatic heart failure.
Dean Handimulya UIEU 2005
Signs and Symptoms of Heart
Failure
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Shortness of breath (dyspnea).
Swelling (edema) of the legs.
Swollen neck veins.
Abdominal discomfort such as swelling,
pain or nausea.
Dean Handimulya UIEU 2005
Signs and Symptoms of Heart
Failure
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Mental confusion.
Racing or pounding heartbeat
(palpitations).
.
Kidney malfunction or failure (in the
later stages of heart failure).
Dean Handimulya UIEU 2005
Physical Examination
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Heart murmur
A crackling sound of fluid in the lungs
(rales),
A rapid heartbeat (tachycardia) or
abnormal heart rhythm (arrhythmias).
Dean Handimulya UIEU 2005
Physical Examination
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Swelling and fluid retention (edema) in the liver
or gastrointestinal tract (in advanced stages of
heart failure).
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Hypertrophy or enlargement of the heart.
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Liver malfunction.
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Diagnosis Methods for Heart
Failure
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Medical history
Physical examination
Blood tests
Echocardiogram
Electrocardiogram (EKG)
Exercise test stress.
Radionuclide imaging tests
Chest x-ray
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005
Dean Handimulya UIEU 2005