Adult health - Week 3 - Ch 30 Heart failure and other complications from heart disease

may be on either left or right side, usually biventricular, but is called left or right depending on which is worse

systolic heart failure = ineffective contraction, resulting in low CO and low tissure perfusion

diastolic heart failure = ineffective filling of heart (stiff), low CO and low tissue perfusion

systolic heart failure

Ejection fraction

systolic - very low EF

diastolic - normal EF (55-65%)

patient's severity of symptoms

two classification systems:

Class 1-4 - NYHA

Class A-D AHA

NYHA

Class1 - asymptomatic, no constrain on ADL.
Class2 - slight constrain on ADL. Slight symptoms on activity, but no symptoms on rest.
Class3 - moderate limitation on ADL. Comfortable at rest, but less than ordinart activity causes symptoms.
Class4 - symptoms at rest

AHA

ClassA - high risk for heart disease
ClassB - with heart disease, no symptoms of heart failure
CLassC - with heart disease, current or prior symptoms of HF
ClassD - refractory end stage heart failure

Left - pulmonary congestion --> dyspnea, cough, crackles, low oxygen sat, S3. Fluid accumulation in alveoli disrupts oxygen-co2 exchange, resulting in orthopnea and PND. cough initially dry, progressively pink frothy mucus.

Dominant feature: inadequate tissue perfusion --> oliguria --> stim RAAS --> FVE. Decreased workload of heart during sleep improves perfusion, causing nocturia. Anxiety due to dec blood flow to brain

low urine outoput

increased venous pressure --> JVD, edema, ascites

--> hepatomegaly and RUQ tenderness ---> inc portal tension --> ascities --> GI/ respiratory distress

venous engorgement of abdominal organs --> anorexia and nausea

reduced CO --< weakness imparied ciurculation

symptoms similar to renal failure and COPD, -->

echocardiogrm, CXR, ECG, BNP*

high levels of BNP - indicates high cardiac filling pressure