congestive heart failure Archives

Heart failure happens when the heart is too weak to pump efficiently. This restricts it from providing proper cardiac output to maintain the body’s metabolic needs.

Complex clinical syndrome that results from any structural or functional impairment of ventricular filling (diastole) or ejection of blood (systole)
2013 ACC/AHA

Systolic Heart Failure is attributed to a pumping problem experienced by the heart where it is unable to contract enough to pump blood to supply to the body, thus resulting in contraction and ejection fraction problems. In this case the patient presents with left ventricular failure with reduced ejection fraction of <40% and marked cardiomegaly (where the ventricle becomes enlarged in size).

Diastolic Heart Failure is attributed to a filling problem experienced by the heart where it is unable to relax the left ventricle, leading to a build-up in the lungs, resulting in relaxation and blood filling problems. In this scenario the patient presents with pulmonary congestion and at times with slightly enlarged ventricles, both due to an increased resistance to filling due to increased ejection fraction of >50%.

The ejection fraction is a comparison between the amount of blood in the heart and the amount of blood pumped out of the heart.

Cardiac output is the amount of blood pumped out of each ventricle per minute. Factors affecting cardiac output include the heart rate, blood volume, contractility and venous return.

Stroke volume is the volume of blood pumped out of each ventricle with every beat.

Cardiac Output = Heart Rate X Stroke Volume

Causes of HF include:

Coronary Artery Disease
Hypertension
Cardiomyopathy
Arrhythmias
Valvular and Congenital Heart Disease
Alcohol and Drugs

HF risk factors

Age
Obesity
Smoking
African Descent
Hypertension
High Cholesterol
Diabetes Mellitus
Coronary Artery Disease

Signs and symptoms of heart failure include shortness of breath, coughing, sleep disturbance, feeling overtired, loss of appetite, dizziness, swollen ankles and abdominal bloating.

HF can be classified in relation to:

CARDIAC OUTPUT: an issue with the ejection fraction (amount of pumped blood to the body). This can be subdivided into High Output Failure and Low Output Failure. High Output Failure occurs due to obesity, anaemia, hyperthyroidism and pregnancy. Usually presents as right sided heart failure followed by left sided heart failure. Low Output Failure happens when the heart fails to generate enough output due to left ventricular systolic or diastolic dysfunction, right ventricular dysfunction caused by changes in the heart rate, preload, afterload and heart contraction.

ANATOMY: issue or defect within the heart muscle

ONSET: acute or chronic

Left Sided HF is characterised by pulmonary oedema. Signs and symptoms include tachypnoea, tachycardia, third heart sound and cardiomegaly.

Right Sided HF is characterised by peripheral oedema, raised jugular venous pressure, hypotension and congestive hepatomegaly (enlarged liver which usually causes an enlarged abdomen).

Accessed from https://www.slideshare.net/raghukishoregalla/inotropic-therapy-for-heart-failure

Below you can find a collection of videos that can help provide a more visual approach to Heart Failure Treatment, Management, Nursing Interventions & Drugs.

Heart Anatomy and Physiology

Congestive Heart Failure (CHF) Treatment, Management, Nursing Interventions & Medications Part 1

Congestive Heart Failure (CHF) Treatment, Management, Nursing Interventions & Medications Part 2

Stroke Volume and Cardiac Output – Preload & Afterload

Special thanks to the creator of the featured videos on this post, specifically Youtube Channel Registered Nurse RN

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Cardiovascular disease is the main cause of death both globally and in Malta.

Cardiovascular disease risk factors

Non-Modifiable risk factors: age, gender and family history.

Modifiable risk factors: high cholesterol, high BP, diabetes, smoking, being overweight or obese, living an inactive lifestyle, excessive alcohol and excessive stress.

Cardiovascular diseases can be managed through lifestyle changes, which include incorporating a healthy diet as well as exercise routines, smoking cessation, alcohol reduction or cessation, as well as medication used to prevent and treat CV disease, slow the progression of disease and treat its symptoms, and increase life expectancy whilst improving the patients’ quality of life.

Cardiovascular Diseases:

HEART DISEASE: most usual through atherosclerosis, which is the build up of fats, cholesterol and other substances in and on the artery walls (plaque), which can restrict blood flow. The plaque can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body.
HEART ATTACK /MI: occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw.
STROKE: Ischaemic stroke is caused by a blockage in an artery that supplies blood to the brain. The blockage reduces the blood flow and oxygen to the brain, leading to damage or death of brain cells. Haemorrhagic stroke, also known as brain haemorrhage or brain bleed, happens due to bleeding in or around the brain.
HEART FAILURE: also known as congestive heart failure, occurs when the heart muscle doesn’t pump blood as well as it should.
ARRHYTHMIA: a problem with the rate or rhythm of the heartbeat where the heart can beat too fast, too slowly, or with an irregular rhythm.
HEART VALVE ISSUES: issues include regurgitation, stenosis, and atresia.

Below you can find a collection of videos that can help provide a more visual approach to cardiovascular disease.

Atherosclerosis and Cardiovascular Disease

Ischaemic Stroke Animation

Haemorrhagic Stroke Animation

Congestive Heart Failure

Cardiac Arrhythmias

Hypertension Overview, Symptoms and Risk Factors

More information about anti-hypertensives can be found here…

Special thanks to the creators of the featured videos on this post, specifically Youtube Channels Biolution, Cook Children’s Health Care System, Scientific Animations, Bupa Health UK, and Registered Nurse RN.