Congestive Heart failure

Definition:

Congestive heart failure occurs when the heart is unable to pump sufficient blood to meet the metabolic needs of the body. The result
of inadequate cardiac output is poor organ perfusion and vascular congestion in the pulmonary or systemic circulation.

Pathophysiology:

CHF may be described as backward or forward failure, high or low output failure, or right or left- sided failure. In backward failure,
the ventricle fails to eject it’s contents, resulting in pulmonary edema in the left side of the heart. In forward failure, an inadequate
cardiac output(CO) leads to decreased organ perfusion. High-output failure is the inability of the heart to meet the increased metabolic
demands of the body despite a normal or high CO. Low-output failure occurs when the right ventricle is unable to maintain an
adequate CO and systemic congestion occurs. When the left ventricle is unable to produce a CO sufficient to prevent pulmonary
congestion, left-sided heart failure occurs.

Signs & symptoms:

 Shortness of breath on exertion or rest

 Orthopnea (using 2-3 pillows to sleep)
 Nocturnal dyspnea
 Cough with frothy sputum
 Nocturia
 Weight gain
 Anorexia
 N/V
 In right-side failure- JVD
 Peripheral edema
 Upon auscultation: inspiratory crackles or expiratory wheezing
 Tachypnea and tachycardia
 Gallop heart rhythms (s3 or s 4)
 Collaborative Problems w/ S/S:

 Liver failure ( jaundice, darkened urine, loss of appetite, fatique, N/V, chills, headache, Temperature 100.F-104.F)
 Thrombus formation and emboli ( edema, cyanosis, redness and/or tenderness over affected area, may have fever or Homan’s
sign, feeling of tightness, a dull ache then worsens when walking)
 Pleural effusion ( empyema, hydrothorax, hemothorax or chylothorax- atelectasis possibly, dyspnea, pleuritic chest pain,
malaise, activity intolerance, dullness with tactile fermitus, decreased lung sounds heard over thorax)
 Unstable angina ( pain, discomfort not relieved by rest

CHRONIC PULMONARY CARDIAC DISEASE:

A complication of lung disorders where the blood flow into the lungs is slowed or blocked causing increased lung pressure. The right side of the heart
has to pump harder to push against the increased pressure and this can lead to enlargement of the heart muscle and other problems. Ultimately,
congestive heart failure of the right side of the heart can result. Other chronic lung conditions that can cause pulmonary heart disease are pulmonary
hypertension, cystic fibrosis and advanced emphysema.