Heart failure is when the heart cannot pump enough blood to meet the body's needs. It can be caused by conditions that damage the heart like heart attacks or heart valve disorders. Left-sided heart failure causes symptoms like shortness of breath, cough, and fatigue due to fluid buildup in the lungs. Right-sided heart failure causes fluid buildup in the legs and abdomen due to the right ventricle failing. Both types are treated with medications like diuretics, ACE inhibitors, and beta-blockers to help the heart pump more effectively and relieve symptoms.

1. HEART FAILURE

2. Heart Failure
– is inability of the heart to pump sufficient to blood to meet the needs
of the tissues of the oxygen & nutrients.
- HF was often referred to as CHF, because many pt’s experience
pulmonary or peripheral congestion.
Chronic Heart Failure
-
The increase incidence of HF reflects not only the
increased number of elderly people but also
improvements in treatment of cardiac diseases (MI),
resulting in increased survival rates.

3. Clinical Manifestations
May be produced by the different types of
HF (systolic, diastolic or both) are similar
and therefore do not assist in
differentiating the types of HF.
 The S/S of HF can be r/t which ventricle is
affected.

LSHF causes different manifestations than
RSHF .

4. LEFT-SIDED HEART
FAILURE

Pulmonary congestion occurs when the left
ventricle cannot effectively pump blood out of the
ventricle into the aorta and the systemic circulation.
CM of pulmonary congestion:

Dyspnea or SOB
 Cough
 Pulmonary crackles
 Low oxygen saturation level

5. CAUSES:
 CAD
 MI
 Myocarditis or endocarditis
 Heart valve disorders
 Arrthyhmias
 Pulmonary HPN
 Pulmonary embolism
 Hyper & Hypothyroidism
 Anemia
 Kidney Failure

6. S/S of LSHF:
 Crackles
 Dsypnea
 Nonproductive cough
 Blood tinged, frothy sputum
 Restlessness
 Tachycardia
 S3 & S4
 Orthopnea
 Nocturnal dyspnea
 Cool, pale skin

7. Tests:




Electrocardiography (EKG)
CXR
Echocardiogram
Pulmonary Artery pressure monitoring
Tx:




Diuretics
ACE inhibitors
Angiotensin II receptor blockers
Beta-blockers

8. RIGHT-SIDED HEART FAILURE
- The right ventricles fails, congestion in the
peripheral tissues & the viscera
predominates.
Causes:
 LSHF
 HPN
 Age, infiltration, Infections that cause
cardiac wall stiffness
 Heart valve disorders
 Lung disorders: COPD & PE

9. S/S:

Hepatomegaly & splenomegaly

Epigastric tenderness

Ascites

Edema

Anorexia, fullness, edema

JVD

Nocturia
Tests:

EKG

CXR

Echocardiogram

PA pressure monitoring

10. Tx:

Diuretics
→ Loop Diuretics: Furosemide (Lasix)

ACE inhibitors
→ lisonopril (prinivil), captopril (capoten), perindropil (aceon), ramipril (altace)

Angiotensin II receptor blockers
→ valsartan (diovan), eprosartan (teveten), telmisartan (micardis), losartan (cozaar)

Beta-blockers
→ metropolol (lopressor, toprol), atenolol (tenormin), carvedilol (coreg)

Calcium Channel Blockers
→ dihydropyrimides : amlodipine (norvasc), felodipine (plendil)