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Heart Failure. Definition: It represents the failure of the heart to supply adequate blood flow and, hence, nutrients and oxygen to metabolizing tissues. Types of heart failure. 1. High output vs low output failure: High output heart failure in: Anaemia Hyperthyroidism
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Heart Failure Definition: It represents the failure of the heart to supply adequate blood flow and, hence, nutrients and oxygen to metabolizing tissues
Types of heart failure 1. High output vs low output failure: • High output heart failure in: Anaemia Hyperthyroidism • Low output failure in: Hypertension CHD Cardiomyopathies
2. Right-sided vs left-sided heart failure Important causes of left and right heart failure: * Left heart failure: • Ischaemic heart disease • Rheumatic heart disease (MR – AS - AR) • Hypertension • Cardiomyopathy • Congenital heart disease ( VSD – PDA)
* Right heart failure: • Secondary to lung disease • Multiple pulmonary emboli • Rheumatic tricuspid valve disease (rarely) • Congenital heart disease (ASD – Any cyanotic heart disease with right to left shunt)
Congestive heart failure (right heart failure 2ry to left heart failure) must be distinguished from cor-pulmonale ( right heart failure 2ry to lung disease) • The symptoms and signs in these 2 conditions can be very similar, and the 2 may co-exist.
Symptoms and signs of left heart failure • Dyspnea • Orthopnea • Paroxysmal nocturnal dyspnea • Signs of pulmonary congestion (basal lung crepitations – pink frothy sputum) • Cardiac asthma (wheezy chest) • Pulmonary oedema (Bubbling crepitations)
Symptoms and signs of right heart failure • Congested neck veins • Hepatomegaly (tender enlarged liver – dyspepsia) • Peripheral oedema • Pleural effusion & ascites in advanced cases