Description:
INTRODUCTION-It is a coronargry heart disease may lead to development of heart failure. Heart failure is not a disease but group of manifestation inwhich inadequate pump performance of heart that leads to pulmonary & systemic congestion.
Definition-Heart failure is a physiological state inwhich the heart can not pump enough blood to meet the metabolic demand of the body. It is also known as heart failure.
Etiology-
1. Abnormal loading condition
– Hypervolemia
-Congenital heart disease
-Pulmonary hypertension
– Valvular stenosis [Narrowing of valve]
– Valvular regurgitation [In complete closure of valve]
– Valvular prolapse [Protrusion of valvular leaflet into the atrium]
2.Malfuncton of myocardium-
– coronary artery disease
– cardiomyopathy [Abnormality of myocardium muscles]
– Pericarditis
– Myocarditis
– Endocarditis
3. Condition which precipitate heart failure –
– Pregnancy
– Anemia
– Hypertension
– Renal disease
– Smoking, tobacoo, & alcohol
– Excess administration of fluid
– High intake sodium
PATHOPHYSIOLOGY
Due to etiological factor
Left ventricular hypertrophy
Ventricular hypertrophy leads to increase muscles fibers diameter
Increase contractile function of cardiac muscle fibers
Increase heart work load
When heart fail then compensatory mechanism of heart is do act (States)
If it is fail then Increase residual volume of left ventricles.
Receiving capacity of heart
Pulmonary edema
Pressure Increase on right ventricles
Right ventricles fail
Systemic congestion
Clinical manifestation:-
(1) RHF/RVF:-
• Oedema of ankle, knee & extremities
• Juglar vein distension
• Weight gain
• Hepatomegaly
• Spleeno megaly
• Ascites(Bowel sound absent)
• A, N, V & constipation
(2) LHF/LVF:-
• Dyspnoea
• Pulmonary oedema
• Crackle sound in lungs
• Coughing
• Wheezing
• Tachypnoea
• Cyanosis
• Paroxysmal nocturnal dyspnoea
Diagnostic Measures:-
• History taking
• Physical examination
• E.C.G (QRS-Large)
• Echo cardiography( Hypertrophy & dilataion Ejection Fraction)
• X-ray, USG, Lipid profile,CBC, BNP,CT-Scan, MRI
Treatement:-
• Digitalis/Digoxin/cardiac glucosides
Action:- Increase the force of myocardial contraction, increase cardiac output.
• Diuretics:- ex. Furosemide, thiazide
• Angiotensin coverting enzyme inhibitors ex. Captopril, Analapril
Surgical Management:– Heart transplantation
