Congestive Heart Failure

Congestive heart failure is the lack of ability of the heart to pump blood to supply the demands of tissues for oxygen and other nutrients. It is more likely to occur on the left side of the heart because that part takes a greater work load of pumping blood compares on the right side. The result of the dysfunction is associated with various cardiovascular diseases such as coronary artery disease, hypertension, cardiomyopathy or valvular disorders.
Most of the affected patients with congestive heart failure resulted from coronary artery disease in which one of the blood vessels carrying oxygen-rich blood that connects the aorta to the heart muscle is obstructed by the fat deposits and other substances forming a plaque, the condition called atherosclerosis. The signs and symptoms of congestive heart failure depend on which side of the heart is affected.
The following signs and symptoms of congestive heart failure are divided into two categories which refer to the left and right side of the heart.

Left-Sided Heart Failure

Pulmonary Congestion. This is a common sign of congestive heart failure in which the ventricle fails to pump out the blood from the ventricle to the rest of the body. With this condition, the pressure and blood volume of the left ventricle increases which then decreases the blood flow from the pulmonary vessels. As a result, there will be a backward failure happens impairing the gas exchange between the pulmonary capillaries and alveoli.

Shortness of Breath (Dyspnea). This will likely occurs when the pulmonary gas exchange is impaired resulting to lack of oxygen supply in the lungs. The patient may even have shortness of breath at rest or when exerting moderate effort. To alleviate dyspnea, the patient may lie with 2-3 pillows to elevate the head and chest. Another measure also is to sit on the bed on high-back rest or sleep with a sitting position.

Cough. A non-productive cough may produce during exertion. The cough is usually mistaken as asthma or chronic obstructive pulmonary disease. A frothy pink (blood tinged) sputum may also happen when the cough becomes moist.

Right-sided Heart Failure

Edema. Because the right-sided of the heart fails to eject blood, the blood that returns from the rest of the body cannot be accommodated resulting to swelling of the lower part of the body. Usually the ankles and the feet are swollen but later progress up to the legs, thighs or lower trunk.

Hepatomegaly. The liver is swollen because of the high pressure from the veins that engorged the organ. The patient with right-sided heart failure may experience pain on the upper quadrant of the abdomen in which the liver is located.

Ascites. This is the accumulation of fluid in the peritoneal cavity. The abdominal girth is increased due to the fluid that is being forced from the portal vessels’ high pressure, as the liver dysfunction progresses. 

Other signs and symptoms of right-sided heart failure are loss of appetite, nausea, abdominal pain and distended neck veins. Most of the signs are related to swelling and distending of body parts because of the dysfunction of the right ventricle to accommodate the blood that returns to the heart for oxygenation.

The severity of congestive heart failure may trigger from other underlying conditions such as anemia and increase metabolic rate. If the symptoms are getting worse, a prompt consultation to the physician is needed to treat the disease.


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