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Flashcards in Congestive Heart Failure Deck (11):

What is congestive heart failure (CHF)?

A clinical syndrome that occurs in pateints with an inherited or acquired abnormality of cardiac structure or function. Essentially a pump failure


What is the most common cause of R sided CHF?

L sided heart failure


What is the most common cause of isolated R sided CHF?

Cor Pulmonale (lung disease leading to R sided CHF)


What are the clinical features of R sided CHF?

  • Jugular vein distension 
    • Due to increased venous pressure
  • Painful hepatosplenomegaly
    • Characteristic nutmeg liver
    • Increased central venous pressure causes increased resistance to portal flow 
    • Rarely but may lead to cardiac cirrhosis
  • Pitting edema
    • Increased venous pressure causes fluid transudation


What are the common features of CHF?

  • Cardiac dilation
    • Greater ventricular end diastolic volume
  • Dyspnea on exertion
    • Failure of CO to increased during exercise


What are the causes of L sided CHF?

  • Ischemia
  • HTN
  • Dilated Cardiomyopathy
  • Myocardial infarction
  • Restrictive cardiomyopathy


What leads to the clnical features of L sided CHF?

  • Decreased forward perfusion
  • Pulmonary congestion


What are the pulmonary symptoms of L sided CHF?

  • Pulmonary edem
  • Dyspnea
  • Paroxysmal nocturnal dyspnea
  • Orthopnea
  • Increased venous return in supine position exacerbates pulmonary vascular congestion
  • Crackles


What is a histological feature in the lung is indicative of L sided CHF?

  • Hemosidirin laden macrophages
    • Small congested pulmonary capillaries may burst leading to intraalveolar hemorrhage
    • MAcrophages then come in and consume the RBCs filling them up with hemoglobin


How do the kidneys exacerbate L sided CHF?

  • Decreased perfusion to the kidneys cause it to activate the renin-angiotensin system
  • This system increases BP and icnreases fluid retention which are both detrimental
    • Increased BP increases afterload
    • Increased fluid retention exacerbates pulmonary dysfunction