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Congestive Heart Failure

Congestive Heart Failure. And Diabetes. Definition:. Also called “Left Ventricular Dysfunction (LVD): The failure of the heart to meet the circulatory demands of the body Results in fluid “congestion” in venous system. CHF Causes:. CAD: Chronic ischemia

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Congestive Heart Failure

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  1. Congestive Heart Failure And Diabetes

  2. Definition: • Also called “Left Ventricular Dysfunction (LVD): The failure of the heart to meet the circulatory demands of the body • Results in fluid “congestion” in venous system

  3. CHF Causes: • CAD: Chronic ischemia • Past MI: Impaired cardiac function • Chronic HTN: • Valve disorders • Congenital Defects • Myocarditis/Endocarditis: Infection of the heart muscle or valves

  4. CHF Impact: • Reduced functional capacity: • Pulmonary Edema • Peripheral Edema • Na+ and H2O handling problems

  5. Associated Complications: • Pulmonary Edema (Pneumonia) • Ventricular Dysrrhythmias • Atrial Fibrillation

  6. Treatment: • Rest: Give the heart a break “to recover”** • Diet: AHA guidelines, Na+ restrictions • Drugs: • Diuretics • Vasodilators • Digitalis • ACE-Inhibitors Reduce the work Of the heart Increase the Strength of the heart * Does Both

  7. Digitalis: Lanoxin • Fox Glove Plants • Inhibit Na+/K+ ATPases • Dig Toxicity: • Can induce fatal arrhythmias • Cause Hypokalemia • Requires constant monitoring of levels because of long elimination time (t1/2 = 5-6 days)

  8. ACE Inhibitors: • Increase Na+/ H2O excretion • Causes vasodilation reducing both the preload and afterload of the heart • Increases Cardiac Output • Becoming more important in CHF treatment – sometimes used with Dig

  9. Diabetes Type I: IDDM Type II: NIDDM

  10. Common to Both: • Chronic Hyperglycemia • Polydipsia: Excessive Thirst • Polyuria: Excessive Urination • Polyphagia: Excessive Hunger • Long Term Complications: • Vasculopathies: CAD, PVD, other • Neuropathies: Limbs, ANS • GI, urinary and reproductive dysfunctions

  11. Insulin deficiency Ketoacidosis Requiring Insulin Younger Onset* Insulin Receptor Problem Non-ketoacidosis May need insulin Older Onset** Different Pathogenesis:IDDM: NIDDM:

  12. Exercise Benefits: • IDDM: • Overall Health: Reduces complications • Self-Esteem • Requires careful monitoring • NIDDM: • Cornerstone in treatment plan • Reduces complications • Self-Esteem

  13. Exercise Guidelines: IDDM: • Exercise > 1 hour post insulin • Decrease Insulin dose if necessary • Exercise within 1-3 hours of meals • Pre-exercise glucose: 100-250 • Monitor before / after / later to avoid hypoglycemia

  14. Let’s Call That A Wrap!

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