Heart Failure Tutorial
TUTORIAL 5
HEART FAILURE
Pathophysiology
B. Left-sided HF SOB
A. Right-sided HF
Orthopnea
Edema in the feet, ankles, legs, liver,
& abdomen.
If the amount of fluid is
fluid
accumulates in the abdomen.
Fluid accumulation in the liver or stomach nausea & loss of appetite.
Eventually, food is not absorbed well loss of weight & muscle.
This condition is called Cardiac Cachexia
Paroxysmal nocturnal dyspnea
Tiredness & weakness
A sudden accumulation of a high amount of fluid in the lungs (acute pulmonary edema) extreme difficulty in breathing, tachypnea, cyanosis, & feelings of restlessness & anxiety.
Bronchospasms & wheezing.
Cheyne-Stokes respiration
Stroke
Depression & decline in mental function
Tests & diagnosis
1. Medical history & physical examination.
2. Check for the presence of risk factors such as HTN.
3. Blood tests
1. kidney & thyroid function
2. BNP
4. Chest X-ray
In HF:1. The heart may appear enlarged.
2. Fluid buildup may be visible in lungs.
5. ECG heart rhythm problems & damage to the heart from a heart attack that may be underlying HF.
6. Echocardiogram.
7. Ejection fraction (EF).
Prevention
1.The key to preventing HF is to
risk factors.
2.Control or elimination of many risk factors for heart disease (HTN,
CAD) by making lifestyle changes along with the help of any needed medications. 1.Stop smoking
2.Weigh loss for obese patients
3. dietary sodium
4. alcohol & fluids
5. fat & cholesterol
6. stress
7.Exercise
8.Sleep easy
Values of therapeutic intervention
Therapy
Value
ACE inhibitors
Decrease afterload an Preload
Aldosterone antagonists
Oppose Aldosterone mediated effects: Renal Na+ retention
Cardiac and vascular remodeling
Inotropes (Digoxin, PDE inh., Dobutamine)
Increase myocardial cell contractility
Beta blockers
(Carvedilol, Bisoprolol, Metoprolol)
Lower deleterious sympathetic nervous system effects:
Slow Heart rate
HEART FAILURE
Pathophysiology
B. Left-sided HF SOB
A. Right-sided HF
Orthopnea
Edema in the feet, ankles, legs, liver,
& abdomen.
If the amount of fluid is
fluid
accumulates in the abdomen.
Fluid accumulation in the liver or stomach nausea & loss of appetite.
Eventually, food is not absorbed well loss of weight & muscle.
This condition is called Cardiac Cachexia
Paroxysmal nocturnal dyspnea
Tiredness & weakness
A sudden accumulation of a high amount of fluid in the lungs (acute pulmonary edema) extreme difficulty in breathing, tachypnea, cyanosis, & feelings of restlessness & anxiety.
Bronchospasms & wheezing.
Cheyne-Stokes respiration
Stroke
Depression & decline in mental function
Tests & diagnosis
1. Medical history & physical examination.
2. Check for the presence of risk factors such as HTN.
3. Blood tests
1. kidney & thyroid function
2. BNP
4. Chest X-ray
In HF:1. The heart may appear enlarged.
2. Fluid buildup may be visible in lungs.
5. ECG heart rhythm problems & damage to the heart from a heart attack that may be underlying HF.
6. Echocardiogram.
7. Ejection fraction (EF).
Prevention
1.The key to preventing HF is to
risk factors.
2.Control or elimination of many risk factors for heart disease (HTN,
CAD) by making lifestyle changes along with the help of any needed medications. 1.Stop smoking
2.Weigh loss for obese patients
3. dietary sodium
4. alcohol & fluids
5. fat & cholesterol
6. stress
7.Exercise
8.Sleep easy
Values of therapeutic intervention
Therapy
Value
ACE inhibitors
Decrease afterload an Preload
Aldosterone antagonists
Oppose Aldosterone mediated effects: Renal Na+ retention
Cardiac and vascular remodeling
Inotropes (Digoxin, PDE inh., Dobutamine)
Increase myocardial cell contractility
Beta blockers
(Carvedilol, Bisoprolol, Metoprolol)
Lower deleterious sympathetic nervous system effects:
Slow Heart rate