Heart Failure; Causes, classification,symptoms, Investigations and Management

HEART FAILURE

Heart failure, sometimes known as congestive heart failure, is a clinical state in which the heart is unable to generate enough cardiac output to meet up the metabolic demands of the body. The heart gradually becomes too weak or stiff to fill and pump efficiently.

 

ETIOLOGY / CAUSE

  • Hypertension
  • Cardiomyopathy
  • Rheumatic heart disease
  • coronary artery disease

CLASSIFICATION

  • Cardiac Heart Failure can be classified as;
  • Left or right-sided
  • Congestive
  • Acute or chronic

SIGNS AND SYMPTOMS

  • Productive cough of frothy sputum
  • Difficulty with breathing on exertion
  • Paroxysmal nocturnal dyspnea
  • Orthopnea
  • Fatigue
  • Abdominal swelling
  • Leg swelling
  • Oedema
  • Tachycardia
  • Raised jugular venous pressure.
  • Chest pain with or without crepitation.

Differential Diagnosis

  • Bronchial asthma
  • Liver failure
  • Renal failure
  • Chronic obstructive airways disease.

PROGNOSIS

Although there have been recent improvements in congestive heart failure treatment, researchers say the prognosis for people with the disease is still bleak, with about 50% having an average life expectancy of less than five years. For those with advanced forms of heart failure, nearly 90% die within one year

Investigations

  • Full blood count with differentials
  • Electrolyte ,Urea & creatinine (E,U,Cr)
  • Fasting blood sugar.
  • Urine microscopy and analysis.
  • Chest Radiograph.
  • Echocardiography
  • Electrocardiography

TREATMENT

  • Treatment is geared towards ;
  • Relieving symptoms
  • Enhancing quality of life
  • Preventing complications
  • Prolonging life

Non-pharmacological treatment

  • Bed Rest
  • Low salt diet
  • Goal directed exercise

MEDICAL TREATMENT

  • This should be strictly on Doctors, Pharmacist and consultant nurses prescription, who may prescribe based on their clinical findings any of this drugs:
  • Digoxin or any other anti arythmic drugs
  • Diuretics such as furosemides, spinrolactones etc
  • In some cases a defibrillator or pacemaker may be implanted.

 

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