Done by RN,BScNABDULLA KHAMIS NGWALI

Congestive heart failure

(CHF)

Objectives

After the presentation each student should be able to:

• Define congestive heart failure.

• Explain causes of CHF.

• Mention the risk factors of CHF.

• Describe pathophysiology of CHF

Objectives…..

• Explain signs and symptoms of CHF

• Describe different diagnostic measures of CHF

• Explain nursing managements of CHF

• Describe the treatment of CHF

• Describe the preventive measures of CHF

Definition

• Congestive Heart failure is a inability or failure of the heart to adequately meet the needs of organs and tissues for oxygen and nutrients.

• This decrease in cardiac output, the amount of blood that the heart pumps, is not adequate to circulate the blood returning to the heart from the body and lungs, causing fluid (mainly water) to leak from capillary blood vessels.

Cause of CHF

• There may be many potential reasons for a patient to develop congestive heart failure.

• More than one cause may be present at the same time.

Common causes of heart Failure including:

Coronary artery disease

Previous heart attack (myocardial infarction)

Causes…..

Valve disease

Congenital heart disease(condition born with)

Cardiomyopath (enlargement of heart)

High blood pressure(Hypertension)

Diabetic

Diagram shown normal and abnormal heart with CHF

Risk factors for CHF

• Congestive heart failure is often a consequence of atherosclerotic heart disease and therefore the risk factors are the same:

• Poorly controlled high blood pressure,

• High cholesterol, Diabetes, smoking

• And family history.

• Heart valve disease becomes a risk factor as the patient ages

Pathophysiology

• In congestive heart failure, the heart is unable to receive it’s normal flow of blood from venous return and to pump out the required amount through arterial circulation.

• The left ventricle does not empty into the aorta and the blood that will be normal inter right atrium from superior and inferior vena cover can’t do so.

Pathophysiology

• Pressure rise in the venous circulation and the organs and the tissues that are normal drained by the venous become congested with blood that is flowing slowly against increasing pressure.

• The left ventricles try to do extra work to pump blood and it become enlarged.

Signs and Symptoms

• In early stages the person will most not likely in his/her health. But, as the condition get worse, the person experiences gradual changes in his or her body.

Symptoms the person may notice first.

• Fatigue and weight gain

• Swelling in you ankles, feet and legs.

• Increase need to urinate especially at night.

Sign and symptoms….

Symptom that indicate person condition worsening.

• Irregular heartbeat

• A cough that develops from congested lung.

• wheezing

Sign and symptoms…

Symptoms indicate a severe heart condition need immediately medical attention.

• Chest pain that radiates through the upper body.

• Rapid breath

• Skin that appears blue(from lack of oxygen in lungs)

• Fainting.

Diagnostic Measure

1. Echocardiogram (cardiac echo)

• Is an ultrasound examination of the heart that produces detailed images of the organ.

• It can be used to detect abnormalities in the structure of the heart and to measure the ejection fraction.

Diagnostic Measures……..

• Electrocardiogram (ECG ) is a noninvasive test used to measure electrical activity in the heart.

• Electrical sensors called leads are attached to predetermined positions on the arms, legs, and chest to record electrical activity and help assess heart function.

Diagnostic Measures……..

• Cardiac computerized tomography (CT) scan.This test can be used to diagnose heart problems, including causes of heart failure.

• In a cardiac CT scan, the patient lie on a table inside a doughnut-shaped machine.

• An X-ray tube inside the machine rotates around on patient body and collects images of heart and chest.

Stress test:

• Stress tests measure how the heart and blood vessels respond to exertion. The patient may walk on a treadmill or pedal a stationary bike while attached to an ECG machine.

• Or may receive a drug intravenously that stimulates heart similar to exercise. Stress tests help if individual have an coronary artery disease.

Myocardial biopsy.

• In this test, a small flexible biopsy cord inserted into a vein in neck or groin, and small pieces of the heart muscle are taken.

• This test is performed to diagnose certain types of heart muscle diseases that cause heart failure.

Chest X-ray

• X-ray images help see the condition of lungs and heart. In heart failure, heart may appear enlarged and fluid buildup may be visible in lungs.

• Can also use an X-ray to diagnose conditions other than heart failure that may explain the patient signs and symptoms.

Blood tests.

• Is type of test in which a sample of blood taken to check the kidney and thyroid function and look for indicators of other diseases that affect the heart.

• A blood test to check for a chemical called N-terminal pro-B-type natriuretic peptide (NT-proBNP) can help in diagnosing heart failure.

Nursing Management of CHF

1.Reducing the workload of the heart

2. Achieve the desired clinical response

3. Limitation of physical activityi. Avoid strenuous workii. Stop the heavy exercise

4. Sodium restriction

Nursing Management of CHF…..

5. Take Vital signs including blood pressure, pulse rate, respiratory rate, oxygen saturation, and body weight.

6. Stopping smoking

Treatment for CHF

• The goal of treatment for congestive heart failure is to have the heart beat more efficiently so that it can meet the energy needs of the body.

Medication:

• Diuretic medications (water pills) may be prescribed if appropriate. Common diuretics include furosemide, bumetanide, and hydrochlorothiazide

Treatment for CHF…..

• Angiotensin converting enzyme inhibitors) and ARBs (angiotension receptor blockers) are medicines that are also shown to increase survival by decreasing hypertension; they are often used with other drugs

• Beta blockers may control heart rate and increase cardiac output and ejection fraction.

• Digoxin is an older medicine that may help increase cardiac output and control symptoms.

Treatment for CHF…..

• Surgery:

• If medication are not effective on their own, surgery may be required.

• Angioplasty, a procedure to open up blocked arteries, is one option.

• Heart valve repair surgery are done to help valves open and close properly

Prevention

• Congestive heart failure is prevented for controlling those risk factors These include:

• lifelong control of high blood pressure, high cholesterol, and diabetes and smoking cessation.

• High blood pressure and diabetes are independent risks for congestive heart failure. Alcohol and drug abuse may be a cause of heart failure

Smoking…!!!!!!!!!!!

References.

• Roger, Veronique L., et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. "Heart disease and stroke statistics -- 2011

• "The epidemiology of heart failure: the Framingham Study." Journal of the American College of Cardiology 22.4 Suppl A (1993): 6A-13A