Heart Failure- A condition in which the heart is unable to generate sufficient cardiac output to ...
1. Right sided heart failure-The inability of the right ventricle (RV) to deliver sufficient blood flow into the pulmonary circulation while maintaining normal central venous pressure (McCane & Huether, 2019).
2. Left side heart failure
2.1. HFpEF- Diastolic. Heart failure with preserved ejection fraction (HFpEF), characterized by an ejection fraction greater than 50% (Chandra & Rajawat, 2023)
2.2. HFrEF- Systolic. Heart Failure with Reduced Ejection Fraction (HFrEF) is characterized by a left ventricular ejection fraction ≤ 40% (McCane & Huether, 2019)
2.2.1. PATHOPHYSIOLOGY (McCane & Huether, 2019)
2.2.1.1. Decreased Contractility
2.2.1.1.1. Increased preload
2.2.1.1.2. Increased afterload
2.2.1.1.3. Decreased renal perfusion
2.2.2. DIAGNOSIS (McCane & Huether, 2019)
2.2.2.1. Ejection Fraction ≤ 40% and left ventricular dysfunction. Reduced contractility and cardiac output.
2.2.3. SYMPTOMS (McCane & Huether, 2019)
2.2.3.1. Accessed by provider
2.2.3.1.1. S3 gallop
2.2.3.1.2. Pulmonary Edema
2.2.3.1.3. Hypotension or Hypertension
2.2.3.2. Experienced by patient
2.2.3.2.1. Dyspnea, orthopnea, frothy sputum, cough, fatigue,decreased urine output, edema
2.2.4. TREATMENT (McCane & Huether, 2019)
2.2.4.1. Loop Diuretics
2.2.4.1.1. Reduces preload
2.2.4.2. ACE inhibitor
2.2.4.2.1. Reduces preload and afterload
2.2.4.3. Beta-blocker
2.2.4.3.1. Decreases myocardial demand
2.2.4.4. Severe Systolic Failure
2.2.4.4.1. Percutaneous Coronary Intervention (PCI) or Acute Coronary Bypass
2.3. ETIOLOGY (Chandra & Rajawat, 2023)
2.3.1. The most common causes of left heart failure are coronary artery disease and hypertension. Hypertension contributes to left heart failure by causing left ventricular hypertrophy, which can lead to heart failure with preserved ejection fraction (HFpEF), and it also increases the risk of developing coronary artery disease.
2.3.1.1. Genetics
2.3.1.2. High-output States
2.3.1.3. Metabolic diseases
2.3.1.4. Myocarditis
2.3.1.5. Arrhythmias
2.3.1.6. Valvular heart disease
2.3.1.7. Non-ischemic Cardiomyopathies
2.3.1.8. Hypertension
2.3.1.9. Ischemic Heart disease
2.4. TESTS (Kang & Park, 2021; McCane & Huether, 2019)
2.4.1. ECG & Serum Troponin
2.4.1.1. Looking for Acute Ischemia
2.4.2. Chest X-ray
2.4.2.1. Access Heart size & pulmonary Congestion
2.4.3. Echocardiogram
2.4.3.1. Confirms cardiomegaly, decreased ejection fraction and decreased Cardiac output
2.4.4. Serum BNP
2.4.4.1. Severity of Heart Failure and response to treatment
2.5. RISK FACTORS (Chandra & Rajawat, 2023)
2.5.1. Diabetes, smoking, obesity, male gender, excessive alcohol and a sedentary lifestyle