Transcript Heart Failure

Heart Failure
Cardiac Insufficiency
What is Heart Failure?
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Heart failure is a progressive disorder
in which damage to the heart causes
weakening of the cardiovascular
system.
It is when the heart is no longer able
to pump enough blood to sustain the
body’s metabolic needs.
What causes Heart
Failure?
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For heart failure to occur, there must be an
unresolved impairment of the heart that
compromises its ability to work as a pump.
The source of this can be a cutoff of blood
supply, an increase in workload due to high
blood pressure caused by non-functioning
valves or a genetic predisposition. Heart
failure can be worsened by a poor diet and
lifestyle.
The scenario below where the body is
entering the early stages of heart failure
due to blocked heart arteries
Heart Failure
Classifications
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Left Ventricular Failure
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Right Ventricular Failure
Left Ventricular Failure
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The inability of the left side of the
heart to pump into the systemic
circulation.
An increase pressure in the left side of
the heart backs up into the pulmonary
system & the lungs become congested
with fluid.
Left Ventricular Failure
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Fluid then leaks through the engorged
capillaries & permeates air spaces in
the lungs.
If during each heart beat the right
ventricle pumps out just one more
drop of blood than the left, with in 3
hours the pulmonary blood volume will
have expanded by 500 mL causing
Pulmonary edema & Pleural effusion
Right Ventricular Failure
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The inability of the right side of the heart
to adequately pump venous blood into
the pulmonary circulation.
Most often cause is from the increase
pressure from blood backing up from a
failing left ventricle
But right ventricular failure can also be a
result of chronic pulmonary disease and
pulmonary hypertension
Right Ventricular Failure
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When the right ventricle cannot pump
blood forward into the lungs results in
peripheral congestion.
It is unable to empty its blood volume
therefore it cannot accommodate all
the venous blood that is normally
returned to the right side of the heart.
Right Ventricular Failure
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Venous blood is reflected backwards
into the systemic circulation.
An increase venous volume and
pressure force fluid out into the
interstitial tissue causing peripheral
edema.
As a result of those failures,
symptoms can be due to:
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Forward Heart Failure - The inability of the
heart to pump blood at a sufficient rate to meet
the oxygen demands of the body at rest or at
exercise.
Backward Heart Failure - The ability of the
heart to pump blood at a sufficient rate ONLY
when heart filling pressures are abnormally
high.
Congestive Heart Failure - Fluid in the lungs
or body, resulting from inadequate pumping
from the heart and high heart filling and
venous pressures.
Signs and Symptoms:
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Edema- from right
ventricular failure
Angina- chest or arm
discomfort due to a
blockage of the
coronary arteries;
enough oxygen
when blood flow to
the heart muscle is
reduced.
Shortness of Breath
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Nocturnal Dyspnea
Orthopnea
Fatigue- Sluggishness
may be the result of
your organs not getting
enough oxygen.
Loss of Appetite- Fluid
accumulation in the
digestive organs can
cause you to feel full.
Medical Test
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Chest X-ray: Pulmonary congestion shows
up as cloudy areas on the x-ray
Medical Test
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Echocardiogram
Electrocardiogram
Tracer Studies
Treadmill Test /
Stress Test
Catheterization
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BUN
Creatine
Liver function
values
B-type natriuretic
peptide (BNP)
Treatment
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Cardiac Glyosides: digoxin (Lanoxin)
Diuretics: furosemide (Lasix)
Sedative and Analgesics:
Morphine & Temazepam (Restoril)
Nitrates: Nitroglycerin
ACE Inhibitors: Captopril (Capoten)
B-Adrenergic Blockers: Carvedilol (Coreg)
Inotropic Agents: Dobutamine (Dobutrex)
Potassium Supplements
Surgical Procedure
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Percutaneous Transluminal Coronary
Angioplasty (PTCA)
Angioplasty
Stenting
Coronary Artery Bypass Graft Surgery
Valve Surgery
Heart Transplantation
Surgical Procedure:
Left Ventricular Assist Device
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An electrically driven
mechanical pump about 1.5
pounds
an electronic controller
power supply- 2 external
batteries, via a cable through
the abdomen
The pump is Placed in the
abdominal cavity, the LVAD
takes blood from the left
ventricle and pumps it into the
aorta. The LVAD normally
pumps at a rate of 60-80
beats per minute, but can
increase to 120 beats per
minute with exercise.
Prevention
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Low in sodium- High in potassium
Exercise
Weight Management
Stress
Smoking
Alcohol