CONGESTIVE CARDIAC FAILURE. PPT

CONGESTIVE CARDIAC FAILURE
DEFINiTION- Congestive Cardiac Failure/Heart Failure(HF) is clinical syndrome caused by inability of the heart to pump sufficient blood to meet the metabolic needs of the body. HF can results from any disorders that reduces ventricular filling(diastolic dysfunction)myocardial contractility(systolic dysfunction)
CLASSIFICATION-
According to position
Backward Failure
Forward Failure
According to location
Left Ventricle Failure(aortic Failure)
Right Ventricle Failure(pulmonale Failure)
Biventricular Failure(total Failure)(4)(5)

CLINICAL MANESFESTATION-
Fatigue
Weakness
Shortness of Breath at rest and exertion
Cough and Wheezing
Fluid overload
Nocturia
Proxymal nocturnal dyspnea
Pulmonary edema
Mitral valve stenosis
Hypertropic cardiomayopathy

DIAGNOSIS-
Patient History 12.Acute Renal Injury
Physical Examination 13.Dilated cardiomayopathy
ECG-stress/rest 14.Pulse Oximetry
Doppler 2D 3D 15.ABG/VBG measurement
Cardiac Catheterization 16.TEE measurement
Chest Radiography 17.SPECT
Angiography 18.MRI-CT scan(7)
Blood Test
Fasting Lipid Profile(FLP)
Coronary Angiography
Myocardial Biopsy(7)

LAB FINDINGS-
BUN(Blood Urea Nitrogen) Test
Liver Function Test
Kidney Function Test
B-type Naturetic peptide Test(BNP)

TREATMENT-
1)SURGICAL TREATMENT-
Coronary Artery Bypass Graft surgery
Valve Surgery
Left Ventricular Reconstructions
Passive Cardiac Support
Artificial cardiac pacemakers
Cardiac Transplantations
Implantable Cardiovascular Defibrillator
Ventricular Assist devicesvad.jpg(2)(3)(4)(6)

PATIENT MEDICATION COUNSELLING-
Maintain Patient in high Fowler`s Position
Elevates extremities when patient is stress
Frequently Monitor vital signs
Monitor intake of salt and water
Restrict intake of fluid below 1.5 liters in a day
Teach patient and family about disease provide life style change therapy
Explain side effects of medince
Provide info for exertion of work so as not increase workload on heart (3)(6)(8)

1. CONGESTIVE CARDIAC FAILURE M.PHARM FY-CLINICAL PHARMACY 1 1 26-Mar-19

2. CONTENTS Definition Introduction Classification Pathophysiology Etiology Clinical manifestation Diagnosis Lab Findings Pharmacothearupetics Treatment Recent Approaches to HF Patient Medication C ouncelling 2 2 26-Mar-19

3. DEFINiTION Congestive Cardiac Failure/Heart Failure(HF) is clinical syndrome caused by inability of the heart to pump sufficient blood to meet the metabolic needs of the body. HF can results from any disorders that reduces ventricular filling(diastolic dysfunction)myocardial contractility(systolic dysfunction) (1)(5) 3 26-Mar-19 3

4. INTRODUCTION HF occurs when heart fails to supply adequate blood so body deficieny for oxygen and nutrients supply to body. Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help you live longer. Lifestyle changes such as exercising, reducing sodium in your diet, managing stress and losing weight can improve your quality of life . One way to prevent heart failure is to prevent and control conditions that cause heart failure, such as coronary artery disease, high blood pressure, diabetes or obesity. (2)(4) (6) (7) 4 26-Mar-19 4

5. CLASSIFICATION According to position Backward Failure Forward Failure According to location Left Ventricle Failure(aortic Failure) Right Ventricle Failure(pulmonale Failure) Biventricular Failure(total Failure) (4)(5) According to output High output Failure Low output Failure According to Function Systolic Failure( a fterload Failure) Diastolic Failure(preload Failure) (4)(5) 5 5 26-Mar-19

6. Normal ABNORMAL 6 26-Mar-19

7. CLASSIFICATION NYHA( New Y ork heart Association) Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities. Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion. Class III: marked limitation of any activity; the patient is comfortable only at rest. Class IV: any physical activity brings on discomfort and symptoms occur at rest .(1)(2)(3)(6) American College of Cardiology classification Stage 1 -Patient at high risk of HF Stage 2 -Patient with structural disease but no HF symptoms Stage 3-Patient with disease and symptoms Stage 4 -Refractory HF with specialized interventions (1)(2)(3)(6) 7 7 26-Mar-19

8. PATHOPHYSIOLOGY Cornary artery disese Heart attack Cardiomayopathy Heart Inflamation Congenital heart defect Sever lungs disease Diabates Sever Anemia Abnormal Rhytms 8 26-Mar-19

9. ETIOLOGY 9 9 26-Mar-19

10. CLINICAL MANESFESTATION Fatigue Weakness Shortness of Breath at rest and exertion Cough and Wheezing Fluid overload Nocturia Proxymal nocturnal dyspnea Pulmonary edema Mitral valve stenosis Hypertropic cardiomayopathy Pleural Enfusion Narrow Pulse Pressure Pulmonary Congestion Chenye-Stokes Respiration chyen stokes.jpg Cardiomegaly Hypertrophy Jugular venous distension Gallop rhythm Peripheral Pitting edema Orthopnea Kerly b lines 10 10 26-Mar-19

11. DIAGNOSIS Patient History 12.Acute Renal Injury Physical Examination 13.Dilated cardiomayopathy ECG-stress/rest 14.Pulse Oximetry Doppler 2D 3D 15.ABG/VBG measurement Cardiac Catheterization 16.TEE measurement Chest Radiography 17. SPECT Angiography 18.MRI-CT scan (7) Blood Test Fasting Lipid Profile(FLP) Coronary Angiography Myocardial Biopsy (7) 11 26-Mar-19 11

12. LAB FINDINGS BUN(Blood Urea Nitrogen) Test Liver Function Test Kidney Function Test B-type Naturetic peptide Test(BNP) 26-Mar-19 12

13. 13 26-Mar-19

14. 14 26-Mar-19

15. 15 26-Mar-19

16. SURGICAL TREATMENT Coronary Artery Bypass Graft surgery Valve Surgery Left Ventricular Reconstructions Passive Cardiac Support Artificial cardiac pacemakers Cardiac Transplantations Implantable Cardiovascular Defibrillator Ventricular Assist devices vad.jpg (2)(3)(4)(6) 16 26-Mar-19 15

17. PATIENT MEDICATION COUNCELLING Maintain Patient in high Fowler`s Position Elevates extremities when patient is stress Frequently Monitor vital signs Monitor intake of salt and water Restrict intake of fluid below 1.5 liters in a day Teach patient and family about disease provide life style change therapy Explain side effects of medince Provide info for exertion of work so as not increase workload on heart (3)(6)(8) 17 26-Mar-19 16

18. REFERENCE Dipiro T. Joseph, Robert L.Talbert, Gary C.Yee, L.Michael Posey textbook of Pharmacothearphy a Pathophysiology approach 7 th edition Roger Walker Cate Whittlesea textbook of Clinical Pharmacy and Thearupetics 4 th edition Kamlesh Kohli Clinical Pharmacothearupetics 4 th edition Richard A. Harvey Lippincott’s illustrated view textbook of pharmacology 5 th edition Harsh Mohan textbook of Pathophysiology 6 th edition 18 26-Mar-19

19. Bennett and Brown textbook of Clinical Pharmacology 6 th edition Medscape .scholar Langes charts of Pharmacology 26-Mar-19 19

20. THANK YOU 26-Mar-19 20