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Cardiac Failure

Cardiac Failure. Adie Andrea & Emma. What is Cardiac Failure?. Definition “ A chronic or acute state that results when the heart is not capable of supplying the oxygen demands of the body” (Tortora & Anagnostakos 1990). Classification of Cardiac Failure (Nicolas 2004).

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Cardiac Failure

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  1. Cardiac Failure Adie Andrea & Emma

  2. What is Cardiac Failure? • Definition “ A chronic or acute state that results when the heart is not capable of supplying the oxygen demands of the body” (Tortora & Anagnostakos 1990)

  3. Classification of Cardiac Failure (Nicolas 2004) • Class 1: Patient asymptomatic, ordinary physical activity does not cause SOB or palpitation • Class 2: Patient comfortable at rest ordinary physical activity causes fatigue, palpitations or SOB • Class 3: Patient has marked limitation of physical activity though comfortable at rest • Class 4: Patient unable to carry out any physical activity without causing discomfort

  4. Types of Cardiac Failure (Waugh & Grant 2002) • Acute Cardiac Failure Sudden Decrease in output of blood from both ventricles resulting in acute reduction in blood supply • Chronic Cardiac Failure Develops gradually and there may be no symptoms because of compensatory changes – if compensation no longer possible there is a decline in myocardial efficiency

  5. Right Sided (Congestive) Cardiac Failure Pressure developed within right ventricle is less than the force to push it through the lungs Right atrium and venae cavae become congested with blood congestion through venous system Left Sided Ventricular failure Pressure in Left ventricle is less than the pressure in the aorta Incomplete emptying of the ventricle Results in dilation of the atrium and an increase in the pulmonary blood system eventually resulting in systemic venous congestion Manifestations of cardiac failure (Waugh & Grant 2002)

  6. Manifestations of Cardiac Failure (Swearing & Keen 2001) • Bi-Ventricular Failure Left Ventricular MI combined with a right Ventricular MI

  7. Primary causes Ischaemia Myocardial infarction Cardiac tamponade/pericardial effusion Hypertensive heart disease Valve disease Drugs e.g. Tricylic antidepressants Electrolytes Hypothermia Electrocution Cardiomyopathy Pericarditis Rheumatic Heart Disease Septal defect Secondary Causes Asphyxia Airway obstruction Apnoea Tension pneumothorax Severe blood loss Hypoxaemia Septic Shock Pregnancy Severe Anaemia Systemic Lupus Thyrotoxcsis Alcohol Causes of Cardiac Failure (Puttaroo 2004)

  8. Management of Cardiac Failure(Ayers 2005) Nurse led MDT intervention has resulted in substantial benefits (Alexander et al 2000) • Clinical management – Angiotensin-converting enzyme (ACE) Inibitors; Beta-blockers, digoxin and diuretics • Education – explanation of diagnosis home monitoring pharmacokinetics & early symtom recognition • Palliative care – access to palliation services for patients with end stage cardiac failure • Supplementary Support Services – new conditions may present such as diabetes, renal failure & anaemia – appropriate referral service

  9. References • ALEXANDER, M.F., FAWCETT, M.F. & RUNCIMAN, P.J (2000) Nursing Practice: Hospital and Home; The Adult. 2nd Edition Edinburgh: Churchill Livingstone • AYERS, N. (2005) Evaluating the effect of setting up a nurse-led heart failure service Nursing Times Vol 101(2) 34-36 • NICHOLAS, M. (2004) Heart failure: pathophysiology, treatment and nursing care. Nursing Standard Vol 19(11) 46-51 • PUTTAROO, M. (2004) Cardio-Respiratory Failure Lecture Notes Thames Valley University • SWEARINGEN, P.L. & KEEN, J.H. (2001) Manual Care Nursing: Nursing Interventions & Collaborative Management. 4th Edition St Louis: Mosby • TORTORA, G.J. & ANAGNOSTAKOS, N.P.(1990) Principles of Anatomy and Physiology. 6th Edition. New York: Harper Collins • WAUGH, A. & GRANT, A. (2002) Ross and Wilson: Anatomy and Physiology in Health and Illness. 9th Edition. Edinburgh: Churchill Livingstone

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