Congestive heart failure history and symptoms: Difference between revisions
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(/* 2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Ass...) |
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==Symptoms== | ==Symptoms== | ||
* [[ | * Table bellow shows [[Symptoms]] and [[sign]]s of [[heart failure]]: | ||
* [[ | {| style="border: 2px solid #4479BA; align="left" | ||
* [[ | ! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Typical symptoms}} | ||
* [[ | ! style="width: 300px; background: #4479BA;" | {{fontcolor|#FFF|More specific signs}} | ||
* [[ | |- | ||
* [[ | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Breathlessness]] | ||
* [[ | *[[Orthopnoea]] | ||
* [[ | *[[Paroxysmal nocturnal dyspnoea]] | ||
* [[ | *Reduced [[exercise tolerance]] | ||
* [[ | *[[Fatigue]] | ||
* [[ | *[[Tiredness]] | ||
* [[ | * Increased time to recover after [[exercise]] | ||
* [[ | *[[Ankle swelling]] | ||
* [[ | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Elevated [[jugular venous pressure]] | ||
* [[ | *[[Hepatojugular reflux]] | ||
* [[ | *[[Third heart sound]] ([[gallop rhythm]]) | ||
* [[ | *Laterally displaced [[apical impulse]] | ||
* [[ | |||
* [[ | |- | ||
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Less typical symptoms}} | |||
! style="width: 300px; background: #4479BA;" | {{fontcolor|#FFF|Less specific signs}} | |||
|- | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Nocturnal cough]] | |||
*[[Wheezing]] | |||
*[[Bloated]] feeling | |||
*Loss of [[appetite]] | |||
*[[Confusion]] (especially in the [[elderly]]) | |||
*[[Depression]] | |||
*[[Palpitation]] | |||
*[[Dizziness]] | |||
*[[Syncope]] | |||
*[[Bendopnea]] | |||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Weight gain]] (>2 kg/week) | |||
*[[Weight loss]] (in advanced [[HF]]) | |||
*Tissue [[wasting]] ([[cachexia]]) | |||
*[[Cardiac murmur]] | |||
*[[Peripheral oedema]] ([[ankle]], [[sacral]], [[scrotal]]) | |||
*[[Pulmonary crepitations]] | |||
*[[Pleural effusion]] | |||
*[[Tachycardia]] | |||
*[[Irregular pulse]] | |||
*[[Tachypnoea]] | |||
*[[Cheyne-Stokes respiration]] | |||
*[[Hepatomegaly]] | |||
*[[Ascites]] | |||
*[[Cold extremities]] | |||
*[[Oliguria]] | |||
*Narrow [[pulse pressure]] | |||
|- | |||
|} | |||
{| | |||
! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2021 ESC Guideline | |||
|- | |||
|}<ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref> | |||
===Symptoms of Left Sided Congestive Heart Failure=== | ===Symptoms of Left Sided Congestive Heart Failure=== | ||
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*'''[[New york heart association functional classification#New York Heart Association Functional Classification (NYHA)|NYHA IV]]:''' Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency present at rest. | *'''[[New york heart association functional classification#New York Heart Association Functional Classification (NYHA)|NYHA IV]]:''' Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency present at rest. | ||
==References== | ==References== | ||
Latest revision as of 04:10, 10 February 2022
 |
Resident Survival Guide |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
The classic symptoms of heart failure include dyspnea, fatigue, and fluid retention. Patients with heart failure present in different ways. Some patients present with exercise intolerance but show little evidence of congestion or edema. Other patients present with mild symptoms of edema and pulmonary congestion. The ejection fraction is usually below 35% in patients who are symptomatic with systolic heart failure.
Symptoms
- Table bellow shows Symptoms and signs of heart failure:
| Typical symptoms | More specific signs |
|---|---|
Breathlessness
|
Elevated jugular venous pressure
|
| Less typical symptoms | Less specific signs |
Nocturnal cough
|
Weight gain (>2 kg/week) |
| The above table adopted from 2021 ESC Guideline |
|---|
Symptoms of Left Sided Congestive Heart Failure
The left side pumps blood into the systemic circulation, while the right side pumps blood into the pulmonary circulation. Although left-sided heart failure will reduce forward cardiac output to the systemic circulation, the initial symptoms are often due to pulmonary congestion. In systolic dysfunction, the ejection fraction is decreased, leaving an abnormally elevated volume of blood in the left ventricle. In diastolic dysfunction, left ventricular end-diastolic pressure will be high. This increase in volume or pressure backs up to the left atrium and then into the pulmonary veins. Increased volume or pressure in the pulmonary veins impairs the normal drainage of the alveoli and favors the flow of fluid from the capillaries to the lung parenchyma, causing pulmonary edema. This impairs gas exchange and results in hypoxemia. Thus, left-sided heart failure often presents with respiratory symptoms including:
- Dyspnea
- Frothy sputum
- Nocturnal cough
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Shortness of breath
- Wheezing
New York Heart Association Criteria (NYHA)
The following criteria are often used to gauge the severity of heart failure:
- NYHA I: No symptoms with ordinary activity.
- NYHA II: Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, dyspnea, or angina.
- NYHA III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain.
- NYHA IV: Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency present at rest.
References
- ↑ McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check
|pmid=value (help). Vancouver style error: initials (help)