| General Illness Information |
Common Name: |
Heart
Failure, Dropsy |
|
Medical Term:
|
Congestive Heart Failure |
| Description: |
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Inability of heart to
pump sufficient blood to meet normal body requirements.
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Results in accumulation
of fluid in lungs (left heart failure) or fluid in liver and
extremities (right heart failure).
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This is the main complication
of heart disease, and accounts for the majority of heart disease
admissions to hospital.
|
| Causes: |
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* Coronary artery
disease.
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* High blood pressure.
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* Heart-valve disease.
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* Irregular heart beat
(atrial fibrillation, flutter).
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* Congenital heart
disease.
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* Cardiomyopathy.
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* Heart tumor (rare).
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* Heart muscle
infection.
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* Severe obstructive
lung disease.
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* Overactive thyroid
state.
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* Severe anemia.
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| Prevention: |
Treatment of underlying disorders
when possible. |
| Signs
& Symptoms |
|
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* Shortness of
breath, especially with exertion or when lying flat in
bed (orthopnea).
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* Fatigue, weakness
or faintness.
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* Cough (usually
with sputum).
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* Swelling of
the legs and ankles (edema).
* Swelling of the
abdomen with fluid (ascites)
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* Rapid or irregular
heartbeat.
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* Low blood
pressure.
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* Distended neck
veins.
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* Enlarged liver.
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Late stage congestive failure: |
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Cerebral dysfunction
Abdominal bloating (ascites)
Cyanosis
Hypotension
Pulsus alternans
Frothy and/or pink sputum
Cardiac cachexia
Cheyne-Stokes respirations |
|
| Risk Factors |
|
Inappropriate reduction of intensity of therapy
Inappropriate sodium
and/or fluid excess
Patient non-compliance
Intercurrent arrhythmia,
e.g., atrial fibrillation
Intercurrent infection
such as pneumonia
Administration of drugs
which reduce the pumping action of the heart.
Inappropriate physical,
emotional, or environmental stress
Thyrotoxicosis,
pregnancy, or any condition associated with increased metabolic
demand.
|
| Diagnosis & Treatment |
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Diagnostic tests may include laboratory blood
studies and urinalysis, echocardiography,
heart-catheterization studies; angiography, X-ray of the
heart, lungs and blood vessels; radioactive studies of heart
muscle efficiency
|
| General
Measures: |
|
When severe, admission to
hospital is necessary.
Immediate treatment of
the heart failure
Search for underlying
correctable conditions
Eliminate contributing
factors when possible
Supplemental oxygen
Antiembolism stockings
Fluid and sodium restriction.
Education about this is imperative for long term control.
Daily weights guide overall therapy.
Identify and control
underlying correctable conditions
Surgery may be advised for surgically correctable
conditions. |
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| Medications: |
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Diuretics, usually in combination
with digitalis are used to initiate therapy. ACE inhibitors
have become a mainstay of therapy. For acute pulmonary edema,
IV morphine remains cornerstone of therapy.
Small dose Beta-Blockers, and
IV Nitroglycerin is also used, with caution.
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| Activity: |
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During severe stage, bed rest with
elevation of head of bed and anti-embolism stockings to help
control leg edema
Gradual increase in activity
with walking will help increase strength.
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| Diet: |
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Sodium (salt)
restriction.
Weight reduction diet if
appropriate
Low fat diet to retard
coronary artery disease
Appropriate fluid restriction
|
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| Possible
Complications : |
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Electrolyte
disturbance
Atrial and ventricular
arrhythmias
Mesenteric insufficiency
Protein enteropathy
Digitalis intoxication |
|
| Prognosis |
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Result of initial treatment is usually good,
whatever the cause
Long-term prognosis variable.
Mortality rates range from 10% with mild symptoms to
50% with advanced, progressive symptoms.
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