Congestive Heart Failure I. Definition: A.

condition in which the heart's function as a pump is inadequate to meet the body's needs B. the heart does not pump as well as it should to meet the bodys oxygen demands, often due to heart diseases such as cardiomyopathy or cardiovascular disease Epidemiology: A. estimated B. that 5.8 million people in the United States have CHF C. one of the most common reasons those aged 65 and over are hospitalized D. over one million hospitalizations in the US Signs & Symptoms: A. Common Signs: 1. Cough 2. Fatigue, weakness, faintness 3. Loss of appetite 4. Need to urinate at night 5. Pulse that feels fast or irregular, or a sensation of feeling the heartbeat (palpitations) 6. Shortness of breath when you are active or after you lie down (dyspnea) 7. Swollen (enlarged) liver or abdomen 8. Swollen feet and ankles 9. Waking up from sleep after a couple of hours due to shortness of breath 10. Weight gain
B. Signs Health Care Provider Will Check For:

II.

III.

1. Leg swelling (edema) 2. Neck veins that stick out (distended) 3. Sounds ("crackles") from fluid buildup in your lungs, heard through a stethoscope 4. Swelling of the liver or abdomen 5. Uneven or fast heartbeat and abnormal heart sounds IV. How it is diagnosed? A. Chest X-rays may be taken to determine the hearts size and shape, as well as the presence of congestion in the lungs B. Electrocardiogram (ECG) 1. records the electrical activity of your heart through electrodes attached to your skin

2. impulses are recorded as waves and displayed on a monitor or printed on paper C. Echocardiogram 1. helps distinguish systolic heart failure from diastolic heart failure in which the heart is stiff and can't fill properly D. Stress Test 1. measures how the heart and blood vessels respond to exertion E. Coronary angiography 1. evaluates pressures in the heart chambers and the pumping function F. Myocardial Biopsy 1. doctor inserts a small flexible biopsy cord into a vein in your neck or groin, and small pieces of the heart muscle are taken 2. performed to diagnose certain types of heart muscle diseases that cause heart failure G. Not a curable condition V. Treatment A. chronic disease needing lifelong management B. lifestyle changes: 1. reducing salt intake 2. eating smaller meals 3. more frequent meals (less effort needed to digest smaller meals) 4. avoid caffeine C. wearing support stockings 1. reduce leg swelling D. vasodilators 1. medication to dilate the blood vessels, reducing blood pressure & easing blood flow E. Weigh yourself daily: sudden gain in weight is usually due to fluid retention and may require an increase in your water pill (diuretic) F. Digitalis glycosides 1. strengthen the hearts contractions, helping to improve circulation G. Anticoagulants 1. help prevent blood clots H. Beta Blockers 1. slows heart rate, reduces blood pressure, & limits/reverses damage done to

heart VI. Prognosis A. can be controlled by taking medicine & changing your lifestyle B. mostly a chronic illness that will get worse over time VII. Prevention A. Dont smoke B. Controlling certain conditions, such as high blood pressure, high cholesterol and diabetes C. Staying physically active D. Eating healthy foods E. Maintaining a healthy weight F. Reducing and managing stress G. Do not consume more than two alcoholic beverages a day H. If diabetic, maintain control of blood sugar VIII. Psychosocial Issues A. Worried: 1. what if something happens while theyre out causing their heart to give out on the B. Stressed: 1. their condition is a continuously worsening disease, therefore they will be stressed about their health C. Depressed: 1. extremely upset that they have this condition, although its common, no one wants to have CHF D. Feeling of being a burden: 1. Due to their weakened heart, they cant do all the activities their friends and family would do, resulting in them as a person feeling as though they're holding everyone back E. Questionable: 1. Continuously wondering what life will bring them, the disease can be a slowly worsening or quickly worsening condition therefore they may not know how long to plan their life or how far their outlook should be.

Links: http://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/index.html http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/definition/con-20029801 http://www.nlm.nih.gov/medlineplus/ency/article/000158.htm http://www.cdc.gov/nchs/data/databriefs/db108.htm