Congestive heart failure

1. Congestive Heart Failure (CHF)
CHF results from an inadequate or decreased cardiac
output which causes an increase in the blood volume
within the vascular system. The resulting congestion
within the venous system interferes with the
movement of body fluids, resulting in fluid
accumulation in the tissue spaces, causing edema.
Condition that occurs as a
result of impaired pumping
capability of the heart and is
associated with abnormal
retention of water and sodium.

2. General Cause of CHF #1:

Ventricular failure – a condition where the
contractions of the ventricles become weak and
ineffective, as in myocardial ischemia from coronary
artery disease.
Edema – An abnormal accumulation of fluid in
intercellular spaces of the body.
There are three general kinds of pathological
conditions that can cause CHF:

3. Left ventricular heart failure
Failure of the left ventricle to maintain a normal
output of blood.
Since the left ventricle does not
empty completely, it cannot
accept blood returning from the
lungs via the pulmonary veins.
The pulmonary veins become
engorged and fluid seeps out
through the veins and collects
in the lungs, which results in
pulmonary edema.

4. Right ventricular heart failure
Failure of the right ventricle to maintain a normal
output of blood.
Since the right ventricle does not empty completely, it
cannot fully accept blood returning from the body.
Pressure builds in the veins of the body causing fluid
to seep out and collect in the cells of the body –
especially the extremities. Engorgement of the
systemic veins, produces
pitting edema,
enlargement of the liver,
and ascites.

5. General Cause of CHF #2:
Mechanical failure – the ventricles fail to fill with
blood during diastole, which can occur when the
mitral valve is narrowed (mitral valve stenosis) or
when there is an accumulation of fluid within the
pericardial sac pressing against the ventricles,
preventing them from accepting a full load of blood.
Pericardium or Pericardial sac
The membranous sac filled with serous fluid that
encloses the heart and the roots of the aorta and
other large blood vessels.

6. Visceral pericardium - the innermost of the two layers
of the pericardium fused to the surface of the heart.
Parietal pericardium - the tough, outermost layer that
is attached to the diaphragm and the sternum.
The pericardial sac surrounds the heart to prevent
friction as the heart expands and contracts.

7. Pericardiocentesis
If excess fluid accumulates in the pericardial sac, the
fibrous pericardium limits expansion.
It may be necessary to remove that fluid so the heart
can expand normally.

8. General Cause of CHF #3:
An overload of blood in the ventricles during the
systole phase of the cycle. High blood pressure
(hypertension), aortic stenosis and aortic valvular
regurgitation are some of the conditions that can
cause ventricular overload.

9. Semilunar Valves
•Pulmonary
•Aortic

10. Atrioventricular Valves

11. Heart Sounds
“lub” is the sound of the
atrioventricular valves
closing
“dub” is the sound of the
semilunar valves closing
If a valve is not working
well it produces a murmur
(an “extra,” abnormal sound
made by blood leaking
through a malfunctioning
valve).

12. Aortic Valve Stenosis
•When the valve
narrows it can prevent
blood from flowing in
the right direction

13. hypertrophic cardiomyopathy - a disorder in which
the heart muscle is so strong that it does not relax
enough to fill the chambers with blood and so has
reduced pumping ability
hypertrophic cardiomyopathy (HCM) a form
marked by ventricular hypertrophy, particularly of the
left ventricle, with impaired ventricular filling due to
diastolic dysfunction.

15. cardiomyopathy
1. a general diagnostic term designating primary non-
inflammatory disease of the heart.
2. more restrictively, only those disorders in which the
myocardium alone is involved and in which the cause is
unknown and not part of a disease affecting other organs.

17. Echocardiogram - Echocardiogram
is a test that uses sound waves to
create a moving picture of the heart.
The picture is much more detailed
than X-ray image and involves no
radiation exposure.
This test is performed to evaluate the valves and chambers of
the heart in a noninvasive manner. The echocardiogram allows
doctors to evaluate heart murmurs, check the pumping
function of the heart, and evaluate patients who have had heart
attacks. It is a very good screening test for heart disease in
certain groups of patients.

18. Medications to treat B.P.
Vasoconstriction and Vasodilation