Congestive Heart Failure

Pathophysiology of Congestive Heart Failure Congestive heart failure is: 1) inability of heart to deliver sufficient cardiac output to meet physiologic needs 2) both diastolic and systolic phases are abnormal 3) initially, compensatory mechanisms occur(increased catecholamines, increased atrial natriuretic factor, myocardial hypertrophy), but eventual failure of these ensues causing congestive heart failure 4) result is increase in venous pressure with congestion of liver, spleen, and kidney (“backward failure”) and sodium retention, peripheral edema, and pulmonary sequelae (“forward” failure”) 5) a “final common pathway” occurs with coronary artery disease (most common), valve dysfunction, and hypertension Signs and Symptoms 1) dypsnea 2) orthopnea 3) distended neck veins 4) pitting edema in dependent body parts 5) rales on lung auscultation 6) ascites 7) pleural effusions 8) cough 9) pulmonary edema 10) pulmonary hypertension 11) cyanosis of lips and nail beds 12) weakness and fatigue 13) confusion 14) memory loss 15) nocturia 16) failure of right ventricle 17) abnormally increased atrial filling pressure relative to stroke volume Characteristic Test Findings Laboratory 1) increased renin (owing to decreased glomerular filtration rate) 2) increased angiotensin 3) increased aldosterone 4) increased sodium resorption (which causes increased fluid retention) 5) increased catecholamines (to stimulate cardiac contractility) 6) increased...
Source: Inside Surgery - Category: Surgeons Authors: Tags: Cardiology backward failure enlarged heart foward failure myocardial hypertrophy nutmeg liver peripheral edema Source Type: blogs