Congestive heart failure

Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently. You have four heart chambers.

1. Congestive heart failure (CHF) PRESENTED BY MR. ABHAY RAJPOOT

2. DEFINITION Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of the heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.

3. INCIDENCE: Incidence  rates  of heart failure , we conservatively estimate the  prevalence of heart failure in India  due to coronary  heart disease , hypertension, obesity, diabetes  and  rheumatic  heart disease  to range from 1.3 to 4.6 million,  with  an annual  incidence.

4. RISK FACTORS: MODIFIABLE RISK FACTORS: Tobacco use High blood cholesterol or triglyceride levels Lack of exercise Obesity Stress NONMODIFIABLE RISK FACTORS: Family history of heart disease Older age Diabetes High blood pressure

5. Types Left-sided heart failure Right-sided heart failure Systolic heart failure Diastolic heart failure(also called heart failure with preserved ejection fraction)

6. CAUSES Heart failure often develops after other conditions have damaged or weakened the heart. However, the heart doesn't need to be weakened to cause heart failure. It can also occur if the heart becomes too stiff.

7. SYMPTOMS: CARDIOVASCULAR- Ischemia - Ischemia   is a restriction in  blood  supply to  tissues , causing a shortage of  oxygen  that is needed for  cellula . Low cardiac output- Chest pain –chest pain occurs suddenly , severe immobilizing chest pain that not relieved by rest , position change and medications. Decrease pulse rate. BP may be elevated beacuase of sympathetic stimulation or decreased BP because of decreased contractility, development if cargiogenic shock . Myocardial infarction - when the blood flow decreases or stop to apart of the heart , causing damage to the heart muscle. Diaphoresis –excessive sweating ECG changes – ST segment and T wave changes, also show tachycardia, bradcardia , or dysrhythimas . Dysarrithmias

8. CONTI… RESPIRATORY- Shortness of breath.   Pulmonary edema Chest heaviness Dyspnea- difficulty of breathing Fatigue

9. CONTI…. Genitourinary- Decreased Urinary Output May Indicate Cardiogenic Shock. Gastrointestinal - Nausea And Vomiting Skin - Cool, Clammy ,Diaphoretic , And Pale Appearance On Skin

10. DIAGNPOSTIC EVALUATION Physical Examination History collection Stress test

11. Chest X-ray.  

12. Electrocardiogram (ECG).

13. Echocardiogram

14. Cardiac catheterization (angiogram).

15. TROPONIN-TEST

16. COMPLICATIONS: Heart attack Heart failure  Abnormal heart rhythm (arrhythmia) 

17. PREVENTION: Quit smoking Control conditions such as high blood pressure, high cholesterol and diabetes Stay physically active Eat a low-fat, low-salt diet that's rich in fruits, vegetables and whole grains Maintain a healthy weight Reduce and manage stress

18. MEDICAL MANAGEMENT: Various drugs can be used to treat coronary artery disease, including: Vasodilators (These drugs acts as blood vessel dilator): Nitrates Beta-Blockers (Decrease work load in heart): Propranolol 20-40 mg Calcium channel blocker (They improve coronary blood flow): Nifedipine Verapamil

19. CONTI…. Anticoagulant Drugs: Heparin Opiate Analgesic (For reduce pain) Morphine sulphate Thrombolytic Drugs: Streptokinase,Urokinase

20. ANTIHYPERTENSIVE MEDICINES - Methydopa - This medication is used alone or with other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Methyldopa works by relaxing blood vessels so blood can flow more easily. Sodium nitroprusside - It is used for lowering the blood pressure. Amlodipin e- Amlodipine is used with or without other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Dose-10 mg,20 mg.

21. SURGICAL MANAGEMENT Angioplasty and stent placement (percutaneous coronary revascularization):

22. Coronary artery bypass surgery:

23. NURSING DIAGNOSIS Impaired gas exchange related to decreased blood flow as evidenced by breathlessness Acute pain related to disease condition as evidenced by patient verbalization Impaired physical mobility related to weakness as evidenced by patient is unable to perform daily activity. Imbalanced nutrition less than body requirement related to less intake of food as evidenced by weight loss Disturbed sleep pattern related to hospitalization as evidenced by patient verbalization Anxiety related to hospitalization as evidenced by patient asking too many question. Knowledge deficit related to disease process and treatment as evidenced by patient is having many doubts

24. RESEARCH STUDY University of Alabama at Birmingham researchers now describe an important contributor to that heart pathology disruption of the metabolism that controls immune responses in the spleen and heart. Doxorubicin, a chemotherapy drug widely used in ovarian, bladder, lung, thyroid and stomach cancers carries a harmful side effect. The drug can disrupt the immune system, and cause a dose-dependent heart toxicity that can lead to congestive heart failure.

25. SUMMARY

26. BIBLIOGRAPHY: Black M. joyce , Hwks hokanson jane,medical surgical nursing.8 th edition. volume 2. New delhi ;Reed elsevier india private limited:2009.p1411-1426. Suddarth’s and brunner , Hinkle L.Janice , Cheever H.Kerry . text book of medical surgical nursing.13 th edition . volume 1.New delhi : wolters kluwer india Pvt ltd ;2014.p729-759. https://www.mayoclinic.org/diseases-conditions/heart-failure/diagnosis-treatment/drc-20373148 https://www.healthline.com/health/congestive-heart-failure https://ceufast.com/course/congestive-heart-failure-the-essence-of-heart-failure