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Showing posts with label Congestive Heart Failure. Show all posts
Showing posts with label Congestive Heart Failure. Show all posts

Pathophysiology of CHF - Congestive Heart Failure

Congestive heart failure is a condition in which the heart becomes an inefficient or weak pump.

This heart condition is a long-term and chronic condition, which typically involves both sides of the heart. However, the condition may affect only the right side of the heart (right-sided heart failure) or the left side (left-sided heart failure). The condition occurs when your heart muscles are weak and cannot pump the blood out of the heart effectively (systolic heart failure) or when your heart muscles are stiff and do not fill up with blood easily (diastolic heart failure).

Pathophysiology of CHF - Congestive Heart Failure

Heart failure is often separated into two classifications: right sided or left-sided failure. In right-sided failure, the right ventricle is unable to pump blood into the pulmonary artery, resulting in less blood being oxygenated by the lungs and increased pressure in the right atrium and systemic venous circulation. Systemic venous hypertension causes edema on the extremities. In left-sided failure, the left ventricle is unstable to pump blood into the systemic circulation, resulting in increased pressure in the left atrium and pulmonary veins. The lungs become congested with blood, causing relevated pulmonary pressures and pulmonary edema.
Although, each type produces different systemic/pulmonary artery alterations, clinically it is unusual to observe solely right-or left-sided failure. Since both sides of the heart are dependent on adequate function of the other side, failure of one chamber causes a reciprocal change in the opposite chamber. For example, in left-sided failure increase in pulmonary vascular congestion will cause increased pressure in the right ventricle, resulting in right ventricular hypertrophy, decreased myocardial efficiency, and eventually pooling of blood in the systemic venous circulation.

Physical Examination for Congestive Heart Failure (CHF)

Congestive heart failureor Heart failure is inability of the heart to pump an adequate amount of blood to the systemic circulation to meet the body's metabolic demands.

In most cases, heart failure is a process that occurs over time, when an underlying condition damages the heart or makes it work too hard, weakening the organ. Heart failure is characterized by shortness of breath (dyspnea) and abnormal fluid retention, which usually results in swelling (edema) in the feet and legs.

Common symptoms of congestive heart failure include:
  • Shortness of breath with exertion or when lying down
  • Cough
  • Swelling in legs, feet and ankles (pooling of blood)
  • Swelling of the abdomen
  • Weight gain
  • Loss of appetite, indigestion
  • Irregular or rapid pulse
  • Low blood pressure
  • Weakness and fatigue
  • Heart palpitations (feeling the heart beat)
  • Difficulty sleeping
  • Other symptoms may include:
  • Decreased in alertness or ability to concentrate
  • Decreased urine production
  • Nighttime urination (the need to get out of bed to go to the bathroom)
  • Nausea and vomiting
Physical Examination for Congestive Heart Failure (CHF)

GENERAL SITUATION
Obtained good or composmentis awareness and change according to the level of perfusion disorders involving the central nervous system

Breathing
  • Visible shortness
  • Frequency of breathing exceeds the normal
Bleeding
  • Inspection: the scar, complaints of physical weakness, edema of the extremities.
  • Palpation: weak peripheral pulses, thrill
  • Percussion: Shifting boundaries of heart
  • Auscultation: decreased blood pressure, extra heart sounds
BRAIN
  • Awareness is usually composmentis
  • Peripheral cyanosis
  • The face grimacing, crying, moaning, stretched and stretched.
Bladder
  • Oliguria
  • Extremity edema
Bowel
  • Nausea
  • Vomiting
  • Decrease in appetite
  • Weight loss
BONE
  • Weaknesses
  • Fatigue
  • Unable to sleep
  • Sedentary lifestyle
  • Schedule regular exercise could not
PSYCHOSOCIAL
  • The integrity of the ego: denial, fear of dying, anger, worry.
  • Social interaction: stress due to family, work, difficulties of economic cost, difficulty coping.
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