Wednesday, January 25, 2023

Complications Of Congestive Heart Failure

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Myocytes And Myocardial Remodeling

Pathophysiology of Congestive Heart Failure (CHF)

In the failing heart, increased myocardial volume is characterized by larger myocytes approaching the end of their life cycle. As more myocytes drop out, an increased load is placed on the remaining myocardium, and this unfavorable environment is transmitted to the progenitor cells responsible for replacing lost myocytes.

Progenitor cells become progressively less effective as the underlying pathologic process worsens and myocardial failure accelerates. These featuresnamely, the increased myocardial volume and mass, along with a net loss of myocytesare the hallmark of myocardial remodeling. This remodeling process leads to early adaptive mechanisms, such as augmentation of stroke volume and decreased wall stress and, later, to maladaptive mechanisms such as increased myocardial oxygen demand, myocardial ischemia, impaired contractility, and arrhythmogenesis.

As heart failure advances, there is a relative decline in the counterregulatory effects of endogenous vasodilators, including nitric oxide , prostaglandins , bradykinin , atrial natriuretic peptide , and B-type natriuretic peptide . This decline occurs simultaneously with the increase in vasoconstrictor substances from the RAAS and the adrenergic system, which fosters further increases in vasoconstriction and thus preload and afterload. This results in cellular proliferation, adverse myocardial remodeling, and antinatriuresis, with total body fluid excess and worsening of heart failure symptoms.

Complications Of Heart Disease

Overview

Heart disease is an umbrella term, meaning it describes many conditions that affect a persons heart health. Heart disease describes conditions that affect a persons heart muscle, heart valves, coronary arteries, or heart rhythm. Each of these components plays an important part in a persons overall heart health. When a person learns they have heart disease, its important for them to make lifestyle changes to slow the progression of the disease. Heart disease can cause many potentially fatal complications if left untreated. According to the

Can Heart Failure Be Prevented

You may be able to prevent or delay heart failure if you:

  • Work with your provider to manage any health conditions that increase your risk of developing heart failure
  • Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

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Take Care Of Your Heart

These lifestyle changes can help lower your risk for heart disease or keep it from getting worse, as well as help you manage diabetes:

  • Follow a healthy diet. Eat more fresh fruits and vegetables, lean protein, and whole grains. Eat fewer processed foods and avoid trans fat. Drink more water, fewer sugary drinks, and less alcohol.
  • Aim for a healthy weight. If youre overweight, losing even a modest amount of weight can lower your triglycerides and blood sugar. Modest weight loss means 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person.
  • Get active. Being physically active makes your body more sensitive to insulin , which helps manage your diabetes. Physical activity also helps control blood sugar levels and lowers your risk of heart disease. Try to get at least 150 minutes per week of moderate-intensity physical activity, such as brisk walking.
  • Manage your ABCs:
  • A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months aim to stay in your target range as much as possible.
  • B: Try to keep your blood pressure below 140/90 mm Hg .
  • C: Manage your cholesterol levels.
  • s: Stop smoking or dont start.
  • Manage stress. Stress can raise your blood pressure and can also lead to unhealthy behaviors, such as drinking too much alcohol or overeating. Instead, visit a mental health counselor, try meditation or deep breathing, get some physical activity, or get support from friends and family.
  • Symptoms Of Reduced Pumping Capability

    Congestive Heart Failure #cardiovascularinfographic

    The most prominent symptoms are:

    • Extreme weakness and fatigue
    • Muscle weakness and muscle wasting
    • Lethargy and inanition
    • Extreme weight loss

    Obviously, symptoms like this are not compatible with a long life. Unless the cardiac function can be improved, or unless cardiac transplantation or a ventricular assist device can be used, once a person with heart failure develops these kinds of symptoms, death usually follows relatively soon.

    Recommended Reading: Which Side Of The Heart Has Oxygenated Blood

    Our Favorite Online Support Groups

    Sponsored by the American Association of Heart Failure Nurses, this online support community for anyone who has been affected by heart failure allows you to connect with others and to hear from real medical experts. There is also a resource section that has information on things like low-salt cookbooks and patient tips for getting through the holidays.

    This network has tracks for various heart conditions, where you can post questions, share your story, and learn more about your condition. Once you sign up to become a part of the community, you will receive personalized content based on your condition and concerns.

    How Does Heart Failure Affect The Quality Of Life And Lifestyle

    With the right care and treatment plan, many adults still enjoy life even though heart failure limits their activities. How well you feel depends on:

    • How well your heart muscle is working.
    • How well you respond to your treatment plan.
    • How well you follow your treatment plan.

    This includes caring for yourself by:

    • Taking your medications.

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    Edema And Heart Failure

    Edema is swelling that is caused by excess fluid trapped in the bodys tissue.

    The condition often occurs as the result of congestive heart failure. It can also be the result of medication, pregnancy, or another underlying condition, such as kidney disease or cirrhosis of the liver.

    Signs that you have edema include:

    • Swelling or puffiness of the tissue directly under the skin, especially in the legs or arms
    • Arms or legs start to feel full or heavy
    • Shiny or stretched skin
    • Skin that retains pits, or dimples, after being pressed for several seconds
    • Clothing or jewelry starts to feel tight and uncomfortable
    • Skin near the swelling feels tight or warm
    • It becomes more difficult to move the joints that are affected
    • Increased abdominal size

    When To See A Doctor

    Congestive Heart Failure (CHF) Pathophysiology, Nursing, Treatment, Symptoms | Heart Failure Part 1

    If you notice that you are more tired than usual even with a good night’s sleep or you are having trouble completing your normal activities, you should visit your doctor.

    Heart failure can be a slow-moving process, or it can develop as a result of an acute event like a heart attack. You should immediately go to the emergency department or call 911 if you have the following:

    • New chest pain, or chest pain that lasts longer than 15 minutes and is not improved with medications or rest
    • Severe chest pain, especially if it comes with sweating, nausea, weakness, or shortness of breath
    • A heart rate over 120 beats per minute
    • Sudden weakness or paralysis

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    Sensitivity Specificity And Predictive Value Of Symptoms Signs And Chest X Ray Findings For Presence Of Heart Failure In 1306 Patients With Coronary Artery Disease Undergoing Cardiac Catheterisation

    Clinical features
    32

    Oedema

    Swelling of ankles and feet is another common presenting feature, although there are numerous non-cardiac causes of this symptom. Right heart failure may manifest as oedema, right hypochondrial pain , abdominal swelling , loss of appetite, and, rarely, malabsorption . An increase in weight may be associated with fluid retention, although cardiac cachexia and weight loss are important markers of disease severity in some patients.

    Cardiac Rehabilitation And Physical Activity

    Attending a cardiac rehabilitation program is one of the best things you can do for heart failure. Many people can benefit from cardiac rehabilitation – it can improve your quality of life, keep you out of hospital and have a positive impact on your mental health and wellbeing.

    Cardiac rehabilitation combines exercise and education sessions to help you make healthy changes. This includes exercise to help increase your strength, fitness and confidence levels. Exercise includes activities that make you slightly out of breath, while still being able to hold a conversation. For example, walking or riding a stationary bike. It might also include exercises that use light weights or other equipment. Youll get a tailored exercise program to suit you and you will be able to go at your own pace. Many cardiac rehabilitation service now offer home-based services via telephone and/or over the internet.

    Visit the Heart Foundations cardiac services directory to find a cardiac rehabilitation program near you.

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    Congestive Heart Failure: Prevention Treatment And Research

    Congestive heart failure is a serious condition in which the heart doesnt pump blood as efficiently as it should. Despite its name, heart failure doesnt mean that the heart has literally failed or is about to stop working. Rather, it means that the heart muscle has become less able to contract over time or has a mechanical problem that limits its ability to fill with blood. As a result, it cant keep up with the bodys demand, and blood returns to the heart faster than it can be pumped outit becomes congested, or backed up. This pumping problem means that not enough oxygen-rich blood can get to the bodys other organs.

    The body tries to compensate in different ways. The heart beats faster to take less time for refilling after it contractsbut over the long run, less blood circulates, and the extra effort can cause heart palpitations. The heart also enlarges a bit to make room for the blood. The lungs fill with fluid, causing shortness of breath. The kidneys, when they dont receive enough blood, begin to retain water and sodium, which can lead to kidney failure. With or without treatment, heart failure is often and typically progressive, meaning it gradually gets worse.

    More than 5 million people in the United States have congestive heart failure. Its the most common diagnosis in hospitalized patients over age 65. One in nine deaths has heart failure as a contributing cause.

    How Is Congestive Heart Failure Treated

    Pin by Laurie Freeman on nursing

    Doctors will assess the current health status of the patient to establish a baseline, and develop a long-term health plan. This may involve the optimization of medicines and therapies, adding new medication, or possibly enrollment in a clinical trial.

    Stabilizing and/or reversing a patients condition often involves long-term, collaborative follow-up with a referring cardiologist or physician.

    In serious situations, advanced therapies, which include mechanical solutions, a heart transplant, or hospice, may be offered.

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    Symptoms And Complications Of Heart Failure

    If you have heart failure, it is important for you to know what kinds of symptoms you can experience. By paying close attention to your symptoms, you can help your healthcare provider optimize your therapy, both to keep your symptoms at bay and to reduce your chances of having some of the more serious complications of heart failure.

    Most symptoms caused by heart failure can be divided into three general categories:

    • Symptoms due to fluid overload and congestion
    • Symptoms due to reduced cardiac pumping
    • Symptoms due to cardiac arrhythmias

    Surgery For Heart Failure

    Your doctor may recommend surgery to implant a medical device that helps the heart function more effectively:

    • Pacemaker, which maintains a steady heart beat in people with a slow or irregular heartbeat
    • Implantable cardioverter defibrillator , which monitors the heart for fast rhythm and delivers an electrical shock to reset normal rhythm
    • Left ventricular assist device , which takes over the pumping action of the heart

    People with advanced heart failure may be candidates for heart transplantation. A heart transplant replaces the diseased heart with a donated heart from a person who has died.

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    Complications Of Congestive Heart Failure

    To call your heart hard-working is a big understatement. Each day, your heart pumps about 100,000 times, circulating the 5.6 quarts of blood throughout your body three times every minute. When you have congestive heart failure, your heart isnt pumping blood as efficiently as it should, which can lead to some serious complications.

    If youre one of the six million people living with congestive heart failure, the team of cardiology experts here at Advanced Cardiovascular Specialists feels that education is a great start for avoiding these serious complications.

    Though our goal here isnt to unnecessarily scare you, its important that you appreciate the far-reaching impact that congestive heart failure can have on your health.

    Survival Time To Complications Of Congestive Heart Failure Patients At Felege Hiwot Comprehensive Specialized Referral Hospital Bahir Dar Ethiopia

    “Management of Congestive Heart Failure” by Christina VanderPluym, MD, for OPENPediatrics
    • Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing original draft, Writing review & editing

      Affiliation Department of Statistics, Samara University, Samara, Ethiopia

    • Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing original draft, Writing review & editing

      Affiliation Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia

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    Living Well With Heart Failure

    The Heart Foundation has developed a range of resources for people living with heart failure, and their families and carers.

    • Living well with heart failure booklet, which includes information about what to do when you feel sick, managing symptoms, and monitoring your fluid and salt intake.
    • Living well with heart failure video series, which includes seven videos covering topics to help you manage your condition. The series is available in a range of languages.
    • Heart failure fact sheet, which includes questions to ask your health professional and what changes you might need to make to your daily life.
    • Heart failure action plan, which helps you to identify the most important parts of your heart failure management to focus on right now.

    Access these resources on the Heart Foundation website.

    Nurse Teaching On Complications Of Congestive Heart Failure

    Effectively contracting and optimally functioning heart muscle is needed to pump blood from one chamber in the heart to the next in orderly fashion, pump blood into the lungs for oxygen pick-up, and pump oxygen rich blood to the vital organs and tissues in the body. Congestive heart failure is an abnormal condition of the heart, in which the heart muscle is damaged. The signs and symptoms could slightly vary depending on the severity of damage and the chambers affected. Overall, damaged heart muscle cannot contract effectively, contributing to poor contractions and inadequate pumping activity of the involved heart chambers. This post discussed complications of congestive heart failure if this situation is not controlled and the damage continues further.

    In summary, complications of congestive heart failure can be listed as below

    Hypotension:

    Reduced output of blood from the heart due to congestive heart failure, can result in low blood volume in circulation, low blood pressure, and hypotensive symptoms of dizziness and lightheadedness. Also, reduced blood supply to brain, secondary to hypotension and reduced output from heart, can contribute to altered level of consciousness. Eventually, this increase risk for falls and accidents.

    Compromised end organ function:

    Exacerbation of SOB:

    Chest pain and discomfort:

    Worsening of heart failure:

    Increased weakness and fatigue:

    Arrhythmia:

    Blood clot formation:

    Acute weight gain:

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    Medications For Heart Failure

    Certain medications can help treat heart failure and its underlying cause:

    • Aldosterone blockers block the effects of the hormone aldosterone, encouraging the body to release sodium and water. They also help prevent scarring in the heart.
    • Angiotensin receptor-neprilysin inhibitor : Treatment with sacubitril-valsartan reduces excess fluid in the body and relaxes blood vessels. This makes it easier for your heart to pump blood. Alternatives to ARNIs include angiotensin-converting enzyme inhibitors andangiotensin receptor blockers .
    • Beta blockers make the heart beat more slowly and with less force. They also help keep heart rhythm regular.
    • Sodium-glucose transport protein 2 inhibitors are diabetes drugs that have recently been found to be very beneficial in heart failure. They help remove glucose via the kidneys into the urine.

    Other medications can relieve the heart failure symptoms:

    • Diuretics reduce the amount of fluid in the body.
    • Vasodilators dilate the blood vessels and reduce the hearts workload.
    • Digoxin helps the heart beat stronger with a more regular rhythm.
    • Anti-arrhythmics control arrhythmia and maintain normal heart rhythm.

    European Society Of Cardiology’s Guidelines For Diagnosis Of Heart Failure

    Is Fluid In The Lungs The Same As Congestive Heart Failure?

    Essential features

    • ArrhythmiasAtrial fibrillation ventricular arrhythmias bradyarrhythmias
    • ThromboembolismStroke peripheral embolism deep venous thrombosis pulmonary embolism
    • GastrointestinalHepatic congestion and hepatic dysfunction malabsorption
    • MusculoskeletalMuscle wasting
    • RespiratoryPulmonary congestion respiratory muscle weakness pulmonary hypertension

    Recent observational data from the studies of left ventricular dysfunction and vasodilator heart failure trials indicate that mild to moderate heart failure is associated with an annual risk of stroke of about 1.5% , rising to 4% in patients with severe heart failure. In addition, the survival and ventricular enlargement study recently reported an inverse relation between risk of stroke and left ventricular ejection fraction, with an 18% increase in risk for every 5% reduction in left ventricular ejection fraction this clearly relates thromboembolism to severe cardiac impairment and the severity of heart failure. As thromboembolic risk seems to be related to left atrial and left ventricular dilatation, echocardiography may have some role in the risk stratification of thromboembolism in patients with chronic heart failure.

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    What Are The Complications Of Heart Failure

    Some of the complications from heart failure include:

    • Irregular heartbeat.
    • History of taking drugs that can damage your heart muscle, such as some cancer drugs.

    Stage B

    Stage B is considered pre-heart failure. It means your healthcare provider has given you a diagnosis of systolic left ventricular dysfunction but youve never had symptoms of heart failure. Most people with Stage B heart failure have an echocardiogram that shows an ejection fraction of 40% or less. This category includes people who have heart failure and reduced EF due to any cause.

    Stage C

    People with Stage C heart failure have a heart failure diagnosis and currently have or previously had signs and symptoms of the condition.

    There are many possible symptoms of heart failure. The most common are:

    • Shortness of breath.
    • Need to urinate while resting at night.
    • Rapid or irregular heartbeats .
    • A dry, hacking cough.
    • A full or hard stomach, loss of appetite or upset stomach .

    There may be times that your symptoms are mild or you may not have any symptoms at all. This doesn’t mean you no longer have heart failure. Symptoms of heart failure can range from mild to severe and may come and go.

    Unfortunately, heart failure usually gets worse over time. As it worsens, you may have more or different signs or symptoms.Its important to let your doctor know if you have new symptoms or if your symptoms get worse.

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