Heart Failure: : Causes, symptoms, Diagnosis, management, Complications

Heart Failure:

It is the clinical syndrome or the condition in which the heart is unable to pump the amount of oxygenated blood necessary to meet the metabolic requirements of the body.

Causes:

1.     Heart failure has three main causes:

2.     Structural  abnormalities  such  as malfunctioning  of  valves and the abnormal communication between chambers.

3.     Inadequate contractible ability of the myocardium.

Cardiac arrhythmias.

Other causes include:

1.     Pulmonary embolism; chronic  disease.

2.     Hemorrhage and aemia.

3.     Anesthesia and surgery.

4.     Transfusions or infusions.

5.     Fever, infection, pregnancy.

6.     Physical and emotional stress.

Heart failure can be divided into two parts.

1.     Left sided heart failure

2.     Right-sided heart failure.

Left sided heart failure:

 Signs and symptoms:

1.     Shortness of breath.

2.     Dyspnea on exertion and orthopnea.

3.     Proxymal noctural dyspnea (Dyspnea after few hours of sleep)

4.     Dry and non-productive cough often worses in night.

5.     Fatigability- from low cardiac output, nocturia, insomnia, dysponea

6.     Tachycardia

7.     Chyene- stork respiration- A forms of irregular respiration.

Right sided Heart Failure:

Signs and symptoms

1.     Elevated pressures and congestion in systemic veins and capillaries.

2.     Peripheral edema

3.     Weight gain.

4.     Liver congestion

5.     Distended veins.

6.     Abnormal fluid on body cavity

7.     Anorexia and nausea.

8.     Nocturia occurs at night.

9.     Weakness.

Diagnosis:

1.     ECG

2.     Chest X-ray

3.     Echo cordiography

4.     ABG studies

5.     Liver Function studies.

Management:

Medical:

1.     Rest and sleep

2.     Oxygen administration (refer practicals)

3.     Diuretics.

4.     Digitalis

5.     Vasodilator theraphy:

Surgical:

Heart transplant:

Nursing management:

1.     Place the patient  in a comfortable position

2.     Provide complete bed rest

3.     Provide bedside commode.

4.     Check vital signs

5.     Administer medications as prescribed.

6.     Administer oxygen if necessary

7.     Encourage deep breathing exercises every 1 to 2 hours.

8.     Daily weight.

9.     Passive range of motion exercises

10.                        Give appropriate sedation

11.                        Restrict sodium as directed.

12.                        Constipation may be avoided

Complication:

1.     Cardiac dysarrthymias.

2.     Myocardial failure

3.     Digitalis toxicity

4.     Pulmonary infarction, pneumonia emboli