CONGESTIVE HEART FAILURE

ANGELES A. YAP, MD, FPCP, FPCC

Internist- Cardiologist
Congestive Heart Failure

 Heart failure, also called congestive heart

failure, is a condition in which the heart can
no longer pump enough blood to the rest of the
body.
 a chronic, long-term condition, but can
sometimes develop suddenly.
Congestive Heart Failure

Kinds:
 Right-sided
 Left sided
 Both
Congestive Heart Failure

Types:
Systolic heart failure – the heart muscle
cannot pump, or eject, the blood out
of the heart very well

Diastolic heart failure - the heart muscles

are stiff and do not fill up with blood
easily
Normal anatomy of the heart
Normal anatomy of the heart
Circulation
Congestive Heart Failure

Causes:
Coronary artery disease (CAD)
- most common cause
- a narrowing of the small blood vessels
that supply blood and oxygen to the heart

Cardiomyopathy
- abnormality in the heart muscles causing
ineffective pumping
Dilated
Hypertrophic
Restrictive
Coronary artery disease
Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy
Congestive Heart Failure

Causes:
Congenital heart disease
Heart attack
Valvular heart disease e.g. Rheumatic
Cardiac arrhythmias - abnormal heart rhythms
Others:
Emphysema
Severe anemia
Hyperthyroidismor hypothyroidism
Congenital Heart Disease
Mitral stenosis
Mitral stenosis
Congestive Heart Failure

Symptoms:

- most often begin slowly

- may begin suddenly after a heart attack or
other heart problem
Congestive Heart Failure

Common symptoms:
Shortness of breath with activity, or after
lying down for a while
Cough
Swelling of feet and ankles
Swelling liver
Weight gain
Congestive Heart Failure

New York Heart Association Classification

(NYHA)
- clinical classification of heart failure

I – SOB on more than ordinary activities

II- SOB on ordinary activities
III- SOB on less than ordinary activities
IV- SOB even at rest
Congestive Heart Failure

Common symptoms:
Irregular or rapid pulse
Sensation of feeling the heart beat
(palpitations)
Difficulty sleeping (orthopnea, paroxysmal
nocturnal dyspnea
Fatigue, weakness, faintness
Loss of appetite, indigestion
Congestive Heart Failure

Other symptoms :
Decreased alertnessor concentration
Decrease urine production
Nausea and vomiting
Need to urinate at night
Congestive Heart Failure
Other symptoms :
Infants may sweat during feeding (or other
activity).
Asymptomatic, the symptoms may develop
only with these conditions:
Abnormal heart rhythm (arrhtymias)
Anemia
Hyperthyroidism
Infections with high fever
Kidney disease
Congestive Heart Failure

Signs :
Physical examination :
Fluid around the lungs (pleural effusion)
Irregular heartbeat
Leg swelling (edema)
Neck veins distention
Hepatomegaly
Crackles
Abnormal heart sounds
Congestive Heart Failure

Diagnostic tests:
Chest x-ray
ECG
Echocardiogram
Cardiac stress tests
Heart CT scan
Heart catheterization
MRI of the heart
Nuclear heart scans
Chest Xray
Congestive Heart Failure

Diagnostic tests:
Blood chemistry
BUN
Complete blood count
Creatinine
Creatinine clearance
Liver function tests
Uric acid
Sodium
Urinalysis
Congestive Heart Failure

Treatment:
MONITORING AND SELF CARE
Regular check-up every 3 to 6 months
Weight gain monitoring
Taking medications as directed
Do not smoke
Stay active
Lose weight if you are overweight
Get enough rest
Limit salt intake
Congestive Heart Failure
Some tips to lower salt and sodium intake:
Look for foods that are labeled “low-sodium,” “sodium-free,” “no
salt added,” or “unsalted.”
Check the total sodium content on food labels. Be especially
careful of canned, packaged, and frozen foods
Don’t cook with salt or add salt to what you are eating. Try
pepper, garlic, lemon, or other spices for flavor instead. Be
careful of packaged spice blends as these often contain salt or
salt products (like monosodium glutamate, MSG).
Avoid foods that are naturally high in sodium, like anchovies,
meats (particularly cured meats, bacon, hot dogs, sausage,
bologna, ham, and salami), nuts, olives, pickles, sauerkraut,
soy and Worcestershire sauces, tomato and other vegetable
juices, and cheese.
Take care when eating out. Stick to steamed, grilled, baked,
boiled, and broiled foods with no added salt, sauce, or cheese.
Use oil and vinegar, rather than bottled dressings, on salads.
Eat fresh fruit or sorbet when having dessert.
Congestive Heart Failure

Medications:
ACE
Diuretics
Digitalis glycosides
Angiotensin receptor blockers (ARBs)
Beta-blockers
Congestive Heart Failure

Definitive treatment:
Coronary artery bypass grafting
Percutaneous transcoronary angioplasty
Valvular heart surgery
Pacemaker insertion
Heart transplantation
LOVE YOUR HEART