Heart Failure

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Heart Failure


(Congestive cardiac failure)

Types

  • Left Ventricular Failure
    • symptoms mainly due to poor cardiac output and back pressure on lungs
  • Right Ventricular Failure
    • symptoms mainly due to back pressure in venous system
  • Congestive Cardiac Failure = combination
  • High-Output

Aetiology

Pathophysiology

  • complex
  • impaired cardiac systolic function
  • neuro-hormonal response gives paradoxically worsening condition
  • sympathetic system up-regulated
    • fluid retention
    • renin-angiotensin-aldosterone axis activated

Symptoms

  • Dyspnoea
  • Orthopnoea / PND
  • Tiredness / weakness
  • fluid retention
    • peripheral oedema
    • ascites
  • hepatic congestion
    • pain
    • bloated feeling
    • nausea
    • LFT derangements

Examination

  • Dyspnoea
  • Oedema
  • Hands
    • cool
    • peripheral cyanosis
  • Pulse
    • tachycardia
    • poor volume
  •  ↓ BP
  • Neck
  • Praecordium
    • displaced apex beat
    • 3rd Heart sound
    • Mitral / Tricuspid Regurgitation murmurs
  • Lung Bases
  • Sacral Oedema
  • Peripheral oedema

Investigation

  • ECG
  • CXR
  • Bloods
  • Echocardiogram

Treatment

 

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