Presentation on theme: "Congestive Heart Failure Ahmad Osailan. What is Heart Failure Results from any structural or functional abnormality that impairs the ability of the ventricle."— Presentation transcript:
Congestive Heart Failure Ahmad Osailan
What is Heart Failure Results from any structural or functional abnormality that impairs the ability of the ventricle to eject blood (Systolic Heart Failure) or to fill with blood (Diastolic Heart Failure).
Classification of Heart Failure based on area of affection –Systolic failure- decreased. Contractility –Caused by: – Coronary Artery Disease – Hypertension – Valvular Heart Disease –Diastolic failure- decreased. Filling – Hypertension – Coronary artery disease.
Key Concepts of HF CO = SV x HR-becomes insufficient to meet metabolic needs of body EF< 40% is an indicator of decreased SVEF< 40%
Understanding EF EF
Factors effecting heart pump effectiveness Preload: Volume of blood in ventricles at end diastole Depends on venous return Depends on compliance. Afterload Force needed to eject blood into circulation Arterial B/P, pulmonary artery pressure Valvular disease increases afterload
Mechanism of HF All organs (liver, lungs, legs, etc.) return blood to heart When heart begins to fail/ weaken> unable to pump blood forward-fluid backs up > Inc. pressure within all organs. Organ response LUNGS: congested > “stiffer”, inc effort to breathe; fluid starts to escape into alveoli; fluid interferes with O2 exchange, aggravates shortness of breath. Shortness of breath during exertion, may be early symptoms > progresses > later require extra pillows at night to breathe > experience "P.N.D." or paroxysmal nocturnal dyspnea. Pulmonary edema Legs, ankles, feet- blood from feet and legs > back-up of fluid and pressure in these areas, heart unable to pump blood as promptly as received > inc. fluid within feet and legs causes fluid to "seep" out of blood vessels ; inc. weight
Systolic Heart Failure Systolic failure- most common cause – Hallmark finding: Dec. in *left ventricular ejection fraction (EF) Due to – Impaired contractile function (e.g., MI) – Increased afterload (e.g., hypertension) – Cardiomyopathy Cardiomyopathy – Mechanical abnormalities (e.g., valve disease)
Diastolic Heart Failure Diastolic failure – Impaired ability of ventricles to relax and fill during diastole --> dec. stroke volume and CO – Diagnosis based on presence of pulmonary congestion, pulmonary hypertension, ventricular hypertrophypulmonary hypertension
The Vicious Cycle of Congestive Heart Failure Decreased Blood Pressure and Decreased Renal perfusion Stimulates the Release of renin, Which allows conversion of Angiotensin to Angiotensin II. Angiotensin II stimulates Aldosterone secretion which causes retention of Na+ and Water, increasing filling pressure LV Dysfunction causes Decreased cardiac output