Congestive heart failure can be caused by: The heart has two atria right atrium and left atrium that make up the upper chambers of the heart, and two ventricles left ventricle and right ventricle that make up the lower chambers of the heart.
Viber Congestive heart failure CHF otherwise known as cardiac failure refers as the inability of the heart to pump sufficient blood to meet needs of tissues for oxygenation and nutrition. CHF is a slowly developing condition where cardiac output is lower-than-normal.
Pathophysiology In CHF, the contractile properties of the heart are impaired. This leads to a decreased cardiac output. Heart rate is an autonomic nervous system function and in cases where CO falls, sympathetic nervous system increases heart rate to maintain adequate cardiac output.
When the compensatory mechanism fails to maintain adequate tissue perfusion, the properties of stroke volume must adjust to maintain CO. But if the main problem in CHF is the damage of heart muscle fibers, stroke volume is impaired and CO cannot be maintained to normal output.
The amount of blood pumped in each contraction is what Congested heart failure case study call the stroke volume SV. SV is dependent on three factors namely the preload which is the volume of blood filling the heart.
Amount of blood brought to the heart is directly proportional to the pressure applied by the length of stretch of the myocardial fibers. The second factor relating to stroke volume is the changes in the force of contraction occurring at the cellular level which is termed as contractility.
This factor is related to the length of myocardial fibers and the levels of calcium in the body.
The third factor is referred to as afterload. This is the amount of pressure of ventricles needs to come up to be able to pump blood across the pressure gradient that is created with the arteriole resistance.
Etiology of CHF Myocardial Weakness Common cause of myocardium weakness is ischemia related to Atherosclerosis and its stenosis of the coronary arteries.
When atherosclerosis progresses myocardial fibers undergo hypoxic injury leading to necrosis. These fibers are then replaced with fibrous connective tissue resulting to deteriorating pumping capacity of the heart and reduced ventricular compliance.
Other myocardial ischemia cause is thrombosis in the coronary arteries. Myocardial weakness can developed with myocarditis or cardiomyopathies. Inability of the valves to open widely causes decreased blood flow to the heart leading to a reduced cardiac output.
Congenital Heart Defects also restrict the pumping of the heart by interfering the free flow of blood in myocardium. The most common cardiac tumor, myxoma, is of endothelial origin and is most often located at the left atrium.
Its presence can occlude mitral valve which can cause instant death or can serve as a site for the formation of thromboembolus. Pumping may also be restricted by cardiac dysrhythmias, pericarditis and cardiac tamponade. Increased Afterload Inability to maintain cardiac output may also result from overload.
In cases where the myocardium is constantly exposed to high physical demand, the strain may overwhelm the heart and the result is declined contractility and stroke volume which is likely seen when cardiac afterload is increased.
The right ventricle faces this type of situation in certain lung diseases such as Cor Pulmonale where vascular damage causes pulmonary hypertension. Systemic hypertension can also increase afterload as elevated BP presents an increased resistance that the left ventricle must overcome to maintain an adequate CO.
Furthermore, valve disease or congenital defects in the cardiac outflow tracts, valves, pulmonary trunk or aorta can also produce excessive ventricular afterload. Gordon Hanford, 3rd Edition Pathogenesis Two significant factors are considered when congestive heart failure pathophysiology is discussed.
First, the heart is unable to clear itself with of the delivered blood. The second factor is how long it takes for the signs and symptoms to develop.
In this pathophysiology explanation, we will use mitral stenosis as the etiologic factor of CHF. Stenosis of the mitral valve produces hardened and thicker valve cusps that cannot fully open. This decreases the passageway of blood from the left atrium to left ventricle.
The stenosed portion interferes with ventricular filling leading to decline in stroke volume and cardiac output. When stenosis increases, cardiac output may even fail to meet demands even at rest. As a result the affected individual experiences weakness, fatigue and fainting.
When blood cannot easily flow, it backs into the right atrium and then to the lungs. Pulmonary congestion in return produces pulmonary hypertension with pressure sometimes rising times above normal. With high pressure, fluid accumulates in the lung interstitium, otherwise known as pulmonary edema which stiffens lungs making it less elastic and more firm.
Fluids are forced from pulmonary tissues to alveolar air spaces as the condition progresses. When fluids accumulate in alveoli and bronchioles, surface for diffusion is reduced resulting to airway obstruction and manifested as difficulty of breathing or dyspnea. In congestive heart failuredyspnea is aggravated when lying down, a condition called orthopnea.
The cause of orthopnea is the increased load placed on the failing heart.Diagnose new onset congestive heart failure, and understand the most appropriate tests in the work up for heart failure.
Key Point: While heart failure is a clinical diagnosis, the most sensitive test (that is the best test to rule out other diseases) is a brain natriuretic peptide.
Heart Failure Nurse Education. Nurses play a key role in providing acute inpatient and outpatient care for patients with heart failure care. Thus, optimizing their knowledge and skill in heart failure care promotes CHF QUERI's goals of reduced readmissions and improved outcomes for veterans with heart failure.
Congestive heart failure (CHF) otherwise known as cardiac failure refers as the inability of the heart to pump sufficient blood to meet needs of tissues for oxygenation and nutrition. This disease can affect the heart’s ability to respond to circulation demands of the body.
CHF is a slowly developing condition where cardiac output is lower-than-normal. Congestive Heart Failure or CHF is a severe circulatory congestion due to decreased myocardial contractility, which results in the heart’s inability to pump sufficient blood to meet the body’s needs.
C O N G E S T I V E H E A R T F A I L U R E. What is heart failure? What causes the weakening of the heart?
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