Congestive heart failure.



Congestive heart failure (CHF) is a condition when abnormality of cardiac function is responsible for inability of heart to pump blood at a rate to meet the demands by peripheral tissues.

- Classification:
1. A. Systolic dysfunction: it is the consequence of progressive deterioration of myocardial contractile function as occurs with ischemic injury, volume overload, tachyarrhythmias, myocarditis and cardiomyopathy.
B. Diastolic dysfunction: it is the inability of ventricles to relax sufficiently during diastole due to thickened ventricular wall improper ventricular filling as in left ventricular hypertrophy, sustained HTN, aortic stenosis, congenital HD, AV shunts and myocardial fibrosis.
2. A. Forward failure: diminished cardiac output insufficient amount of blood pumped to the body, occur with disease of the heart.
B. Backward failure: decrease cardiac output stasis of blood behind the heart (in the venous system).

There are 2 types of CHF:

Left sided heart failure: caused by:

Ischemic heart disease.
Hypertension.
Valvular diseases except mitral stenosis.

Symptoms and signs:

Decreased output.

Backward failure.

Pulmonary oedema dyspnea and paroxysmal nocturnal dyspnea.

Haemoptysis.

Increased sodium-water retention and vasoconstriction increases workload on the heart.

Coma.

Right sided heart failure: caused by:

Left side failure.
Congenital heart diseases.
Valvular diseases except tricuspid stenosis.

Symptoms and signs:

Generalized edema.

Hepatomegaly.

Jugular venous distension

Chronic congestive splenomegaly.

Chronic hypoxic renal congestion.

GIT congestion.

Ascitis.


(CHF......Pharmacology Lecture.)

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