34 hours ago Heart failure is commonly characterized by typical signs of fluid retention with symptoms of breathlessness, fatigue, paroxysmal nocturnal dyspnoea, and reduced exercise tolerance39. There are many causes of CHF but the most common underlying causes are heart attack, coronary heart disease, and high blood pressure. >> Go To The Portal
Heart failure is commonly characterized by typical signs of fluid retention with symptoms of breathlessness, fatigue, paroxysmal nocturnal dyspnoea, and reduced exercise tolerance39. CCF is a common disease which affects approximately 1-2% of the general population in developed countries1.
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CASE REPORT: Congestive Heart Failure? History: A 72-year-old male with a history of ESRD, CHF and DM presents to the hospital with 6 weeks of slowly progressive leg edema and 3 weeks of SOB/DOE that has become much worse over the past 24 hours and is associated with a new cough.
Heart failure is commonly characterized by typical signs of fluid retention with symptoms of breathlessness, fatigue, paroxysmal nocturnal dyspnoea, and reduced exercise tolerance39. CCF is a common disease which affects approximately 1-2% of the general population in developed countries1.
The severity of heart failure can be classified according to the New York Heart Association (NYHA) classification system. This system consists of four classes which relate patient’s symptoms to physical activities and quality of life.
Whereas in stable patients clinical identification or grading of the severity of heart failure is unreliable [1], recent studies suggest that in acute heart failure clinical diagnosis is much more secure [2]. Any abnormality of the ECG in a breathless patient is supportive evidence for a cardiac cause of dyspnoea.
Due to her cardiac failure, Martha is at risk of fluid overloadTo ensure that Martha receives adequate fluids and nutritionTo prevent complications of dehydrationTo ensure that there is effective communication within the multidisciplinary team.
Martha is tachycardic and attached to a cardiac monitor which is showing atrial fibrillation between 110 and 115 bpm. Urinary output is greater than 70 mL/hour. Martha is very distressed but knows where she is and why. She is unable to eat or drink at the moment due to her breathlessness. She is a life-long smoker.
Martha is breathless and on oxygen therapy 35% via the mask. She has peripheral oedema and is fluid overloaded. Furosemide is being administered intravenously. She is on stage 2 (see Fig. 13.1) of the heart failure care plan but is not receiving glyceryl trinitrate (GTN) due to hypotension.
The use of inotropic agents in heart failure has encountered many problems. In the 1980s and early 1990s many agents were developed with effects on the heart and vascular tree combining a central inotropic stimulus with peripheral arterial vasodilatation.
Radiological cardiomegaly is also supportive of a diagnosis of heart failure [4]. This is not the case for more subtle radiological signs, even in the hands of experienced radiological staff [5] where the clinical context can significantly affect the interpretation.
Side note: Systolic heart failure is when the heart doesn’t contract properly (indicating a pumping problem). While diastolic heart failure is when the heart fails to relax or fill fully how it should (indicating a filling problem).
Chronic respiratory failure can be divided into two types: hypercapnic respiratory failure and hypoxemic respiratory failure. Hypercapnic respiratory failure occurs when carbon dioxide is not exchanged out and accumulates in the blood (increased carbon dioxide in the blood).
Consequently, the heart has less blood to pump out to the body. This is caused by thickening of the ventricular walls, which leads to slower relaxation of the ventricle. The heart then increases pressure inside the ventricle to make up for the thickened walls. This manifests as fatigue and exertional dyspnea.