Congestive heart failure causes: Difference between revisions

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{{congestive heart failure}}
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| [[Heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{{Congestive heart failure}}
{{CMG}}
{{CMG}}


==Overview==
==Overview==
There are several general causes of heart failure. Heart failure may be of pericardial origin such as [[tamponade]] and [[pericardial constriction]], of valvular origin such as aortic or [[mitral regurgitation]]; of myocardial origin such as [[idiopathic dilated cardiomyopathy]], [[familial dilated cardiomyopathy]], [[ischemic cardiomyopathy]], [[valvular heart disease]]; or of coronary vascular origin such as acute ischemic episodes, and rhythm disturbances such as [[tachycardia-induced heart failure]].
There are several classification schemes used to characterize the pathophysiology of heart failure as either [[systolic dysfunction|systolic]] vs [[diastolic dysfunction|diastolic]]; left vs right; or low output vs [[High output failure|high output]]. The anatomic structure underlying the disease process is often characterized as well.  The causes of heart failure are also often characterized by their chronicity (acute/decompensated or chronic).
Other common secondary causes include [[anemia]], [[obesity]],[[drugs]] [(such as first generation [[calcium channel blockers]], [[disopyramide]], and [[sotalol]], [[NSAIDs]] (may cause [[fluid retention]]), [[beta blockers]] (may cause heart failure with their negative inotropic effects)].


==Causes of Acute or Decompensated Heart Failure==
==Causes==
Chronic stable heart failure may easily decompensate. This most commonly results from an intercurrent illness (such as [[pneumonia]]), [[myocardial infarction]] (a heart attack), [[cardiac arrhythmia|arrhythmias]], uncontrolled [[hypertension]], or a patient's failure to maintain a fluid restriction, diet, or medication.<ref name="OPTIMIZE-HF">{{cite journal |author=Fonarow GC, Abraham WT, Albert NM, ''et al.'' |title=Factors Identified as Precipitating Hospital Admissions for Heart Failure and Clinical Outcomes: Findings From OPTIMIZE-HF |journal=Arch. Intern. Med. |volume=168 |issue=8 |pages=847–854 |year=2008 |month=April |pmid=18443260 |doi=10.1001/archinte.168.8.847}}</ref> Other well recognized precipitating factors include [[anemia]] and [[hyperthyroidism]] which place additional strain on the heart muscle. Excessive fluid or salt intake, and medication that causes fluid retention such as [[Non-steroidal anti-inflammatory drug|NSAIDs]] and [[thiazolidinedione]]s, may also precipitate decompensation.<ref>{{cite journal |author=Nieminen MS, Böhm M, Cowie MR, ''et al.'' |title=Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology |journal=Eur. Heart J. |volume=26 |issue=4 |pages=384–416 |year=2005 |month=February |pmid=15681577 |doi=10.1093/eurheartj/ehi044 |url=http://eurheartj.oxfordjournals.org/cgi/content/full/26/4/384}}</ref>
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Congestive heart failure is life threatening and should be treated as such irrespective of the underlying cause.


==Differential Diagnosis of the Underlying Causes of Heart Failure==
===Common Causes===
*[[Arrhythmias]]
*[[Cardiomyopathy|Cardiomyopathies]]
*[[Cardiotoxicity|Cardiotoxins (e.g., alcohol, cocaine, aprotinin)]]
*[[Congenital heart disease]]
*[[Hypertension]]
*[[Ischemic heart disease]]
*[[Pericarditis]]
*[[Pulmonary embolism]]
*[[Valvular heart disease]]
*[[Viral myocarditis]]


===Cardiomyopathies and Inflammatory Diseases===
===Causes by Organ System===
{|style="width:75%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Aortic regurgitation]], [[aortic stenosis]], [[arrhythmias]], [[arrhythmogenic right ventricular dysplasia]], [[arteriovenous fistula]], [[atrial fibrillation]], [[atrial septal defect]], [[cardiac amyloidosis]], [[aneurysm|cardiac aneurysm]], [[congenital heart disease]], [[constrictive pericarditis]], [[dilated cardiomyopathy]], [[Eisenmenger syndrome]], [[endocarditis]], [[hypertension]], [[hypertrophic cardiomyopathy]], [[hypoplastic left heart syndrome]], [[interferon gamma]], [[ischemic heart disease]], [[malignant hypertension]], [[mitral regurgitation]], [[mitral stenosis]], [[myocardial infarction]], [[oxaprozin]], [[patent ductus arteriosus]], [[pericardial effusion]], [[pericardial tamponade]], [[pericarditis]], [[peripartum cardiomyopathy]], [[pertuzumab]], [[restrictive cardiomyopathy]], [[rheumatic fever|rheumatic carditis]], [[rupture of the papillary muscles]], [[Takotsubo cardiomyopathy]], [[tricuspid insufficiency]], [[valvular heart disease]], [[ventricular aneurysm]], [[ventricular septal defect]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Ethylene glycol]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|  [[Ado-trastuzumab emtansine]], [[bicalutamide]],[[bicisate dihydrochloride]], [[carfilzomib]], [[certolizumab pegol]], [[cidofovir]], [[cinacalcet]], [[cyclophosphamide]], [[dexamethasone]], [[diclofenac (patch)]], [[disulfiram]],[[dornase alfa]], [[doxorubicin hydrochloride]], [[epirubicin ]],  [[epoetin alfa]], [[felbamate]], [[ferumoxytol]], [[flurbiprofen]], [[goserelin]], [[hydroxyethyl starch]], [[ibuprofen lysine]], [[idarubicin hydrochloride]], [[idursulfase]], [[imatinib]], [[ixabepilone]], [[levothyroxine]], [[mefenamic acid]], [[meloxicam]], [[meropenem]], [[methoxy polyethylene glycol-epoetin beta]], [[methylprednisolone]], [[metoclopramide]], [[mitomycin]], [[mitoxantrone]], [[muromonab-CD3]], [[nilutamide]], [[nitroglycerin]],[[oprelvekin]], [[oxcarbazepine]], [[Peginterferon Beta-1a]],[[pergolide]], [[phenylbutazone]], [[piroxicam]],  [[ponatinib hydrochloride]], [[pramipexole]], [[prednisone]], [[prednisolone]], [[rubidium Rb 82]], [[sorafenib]], [[sulindac]], [[sunitinib malate]], [[tolmetin]], [[trastuzumab]], [[valdecoxib]], [[vandetanib]]


=====[[Restrictive Cardiomyopathies]]=====
|-
*Primary (idiopathic)
|-bgcolor="LightSteelBlue"
*Tumor infiltration
| '''Ear Nose Throat'''
*[[Amyloidosis]]  
|bgcolor="Beige"| No underlying causes
*Storage diseases
|-
*Endocardial fibrosis
|-bgcolor="LightSteelBlue"
*[[Anthracyclines]]  
| '''Endocrine'''
*Eosinophilic heart disease
|bgcolor="Beige"| [[Diabetes mellitus]], [[hyperthyroidism]], [[hypothyroidism]], [[thyrotoxicosis]]
*Radiation
|-
*[[Hemochromatosis]]  
|-bgcolor="LightSteelBlue"
*Cardiac transplant
| '''Environmental'''
*[[Sarcoidosis]]  
|bgcolor="Beige"| [[Coalworker's pneumoconiosis]], [[silicosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Atrial septal defect]], [[congenital heart disease]], [[Friedreich's ataxia]], [[glycogen storage disease]], [[Marfan's syndrome]], [[Mulibrey nanism|Mulibrey nanism syndrome]], [[muscular dystrophy]], [[Noonan syndrome]], [[ventricular septal defect]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Anemia|Severe anemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|[[Endocarditis]], [[human immunodeficiency virus]], [[Lyme disease]], [[pericarditis]], [[rheumatic fever|rheumatic carditis]], [[rheumatic fever]], [[sepsis]], [[viral myocarditis]], [[Whipple's disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Ascorbic acid deficiency]], [[beriberi]], [[carnitine deficiency]], [[glycogen storage disease]], [[hemochromatosis]], [[metabolic acidosis]], [[Paget's disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Pancoast tumor]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Alcohol]], [[atenolol]], [[dronedarone]], [[imatinib mesylate]], [[propranolol]], [[verapamil]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Coalworker's pneumoconiosis]], [[cor pulmonale]], [[hypoxia]], [[Pickwickian syndrome]], [[pulmonary artery stenosis]], [[pulmonary embolism]], [[pulmonary fibrosis]], [[pulmonary hypertension]], [[pulmonary valve stenosis]], [[pulmonary vein stenosis]], [[pulmonic regurgitation]], [[silicosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum/Immune/Allergy'''
|bgcolor="Beige"| [[Cardiac amyloidosis]], [[sarcoidosis]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


=====[[Dilated Cardiomyopathies]]=====
===Causes in Alphabetical Order===
*[[Duchenne muscular dystrophy]]
{{columns-list|
*[[Becker's muscular dystrophy]]
*[[Ado-trastuzumab emtansine]]
*[[Limb-girdle muscular dystrophy]]
*[[Alcoholism]]
*[[Mitochondrial myopathy]]
*[[Anemia]]
*:*[[Kearns-Sayre syndrome]]
*[[Aortic insufficiency]]
*[[Aortic stenosis]]
*[[Arrhythmias]]
*[[Arrhythmogenic right ventricular dysplasia]]
*[[Arrhythmogenic right ventricular dysplasia]]
*[[Alcohol-Induced cardiomyopathy]]
*[[Arteriovenous fistula]]
*[[Cocaine related cardiomyopathy]]
*[[Ascorbic acid deficiency]]
*[[Diabetic cardiomyopathy]]
*[[Atenolol]]
*[[Atrial fibrillation]]
*[[Atrial septal defect]]
*[[Beriberi]]
*[[Bicalutamide]]
*[[Bicisate dihydrochloride]]
*[[Cardiac amyloidosis]]
*[[Aneurysm|Cardiac aneurysm]]
*[[Carfilzomib]]
*[[Carnitine deficiency]]
*[[Certolizumab pegol]]
*[[Cidofovir]]
*[[Cinacalcet]]
*[[Coalworker's pneumoconiosis]]
*[[Congenital heart disease]]
*[[Constrictive pericarditis]]
*[[Cor pulmonale]]
*[[Cyclophosphamide]]
*[[Dexamethasone]]
*[[Diabetes mellitus]]
*[[Diclofenac (patch)]]
*[[Dilated cardiomyopathy]]
*[[Disulfiram]]
*[[Dornase alfa]]
*[[Doxorubicin Hydrochloride]]
*[[Dronedarone]]
*[[Eisenmenger syndrome]]
*[[Endocarditis]]
*[[Epirubicin]]
*[[Epoetin alfa]]
*[[Ethylene glycol]]
*[[Felbamate]]
*[[Ferumoxytol]]
*[[Flurbiprofen]]
*[[Friedreich's ataxia]]
*[[Glycogen storage disease]]
*[[Goserelin]]
*[[Hemochromatosis]]
*[[Human immunodeficiency virus]]
*[[Hydroxyethyl starch]]
*[[Hypertension]]
*[[Hyperthyroidism]]
*[[Hypertrophic cardiomyopathy]]
*[[Hypoplastic left heart syndrome]]
*[[Hypothyroidism]]
*[[Hypoxia]]
*[[Idarubicin hydrochloride]]
*[[Ibuprofen lysine]]
*[[Idursulfase]]
*[[Imatinib mesylate]]
*[[Interferon gamma]]
*[[Ischemic heart disease]]
*[[Ixabepilone]]
*[[Levothyroxine]]
*[[Lyme disease]]
*[[Malignant hypertension]]
*[[Marfan's syndrome]]
*[[Mefenamic acid]]
*[[Meloxicam]]
*[[Meropenem]]
*[[Metabolic acidosis]]
*[[Methoxy polyethylene glycol-epoetin beta]]
*[[Methylprednisolone]]
*[[Metoclopramide]]
*[[Mitomycin]]
*[[Mitoxantrone]]
*[[Mitral regurgitation]]
*[[Mitral stenosis]]
*[[Mulibrey nanism|Mulibrey nanism syndrome]]
*[[Muromonab-CD3]]
*[[Muscular dystrophy]]
*[[Myocardial infarction]]
*[[Nilutamide]]
*[[Nitroglycerin]]
*[[Noonan syndrome]]
*[[Oprelvekin]]
*[[Oxaprozin]]
*[[Paget's disease]]
*[[Pancoast's tumor]]
*[[Patent ductus arteriosus]]
*[[Peginterferon Beta-1a]]
*[[Pergolide]]
*[[Pericardial effusion]]
*[[Pericardial tamponade]]
*[[Pericarditis]]
*[[Peripartum cardiomyopathy]]
*[[Peripartum cardiomyopathy]]
*[[Anthracycline induced cardiomyopathy]]
*[[Phenylbutazone]]
*[[Trastuzumab]] [[Herceptin-lnduced Cardiomyopathy]]
*[[Pickwickian syndrome]]
 
*[[Piroxicam]]
=====Inflammations=====
*[[Ponatinib hydrochloride]]
*[[Viral Myocarditis]]
*[[Pneumococcal Vaccine 13-Valent]] ([[Prevnar 13]])
*[[Rickettsial Myocarditis]]
*[[Pramipexole]]
*[[Bacterial Myocarditis]]
*[[Propranolol]]
*Spirochetal Infections
*[[Prednisone]]
*[[Myocarditis|Protozoal Myocarditis]]: [[Trypanosomiasis]] ([[Chagas Disease]])
*[[Prednisolone]]
*[[Fungal myocarditis]]
*[[Pulmonary artery stenosis]]
*[[Giant Cell Myocarditis]]
*[[Pulmonary embolism]]
*[[Pulmonary fibrosis]]
*[[Pulmonary hypertension]]
*[[Pulmonary valve stenosis]]
*[[Pulmonary vein stenosis]]
*[[Pulmonic regurgitation]]
*[[Restrictive cardiomyopathy]]
*[[Rheumatic fever|Rheumatic carditis]]
*[[Rheumatic fever]]
*[[Rubidium Rb 82]]
*[[Rupture of the papillary muscles]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
 
*[[Sepsis]]
===Congestive Heart Failure as a Consequence of Valvular Heart Disease===
*[[Silicosis]]
*[[Aortic stenosis with Left Ventricular Systolic Dysfunction]]
*[[Sorafenib]]
*[[Chronic aortic regurgitation]]
*[[Sulindac]]
*[[Mitral Stenosis]]
*[[Sunitinib malate]]
*[[Chronic mitral regurgitation]]
*[[Systemic lupus erythematosus]]
*[[Acute aortic regurgitation]]
*[[Takotsubo cardiomyopathy]]
*[[Acute mitral regurgitation]]
*[[Thyrotoxicosis]]
 
*[[Tolmetin]]
===Congestive Hert Failure Secondary to Congenital Heart Disease===
*[[Trastuzumab]]
 
*[[Tricuspid insufficiency]]
'''A. Causes of Congestive Heart Failure in Adults with Unoperated Congenital Heart Diseases'''
*[[Valdecoxib]]
*[[Eisenmenger's syndrome]]
*[[Vandetanib]]
*Fibrocalcific degeneration of abnormal [[aortic valve]]  
*[[Valvular heart disease]]
*Systemic ventricular dysfunction and/or [[tricuspid regurgitation]] in congenitally corrected transposition of the great arteries
*[[Ventricular aneurysm]]
*[[Atrial septal defect]] with [[mitral regurgitation]]] secondary to myxomatous mitral valve
*[[Ventricular septal defect]]
*[[Congenital mitral regurgitation]]  
*[[Verapamil]]
*[[Arrhythmia]]
*[[Viral myocarditis]]
*[[Endocarditis]]  
*[[Whipple's disease]]
*Other degenerative diseases ([[coronary artery disease]], [[hypertension]])
}}
*[[Drug abuse]], [[alcohol abuse]]  
*[[Pregnancy]]
 
'''B. Causes of Congestive Heart Failure in Adults with Operated Congenital Heart Diseases'''
*Myocardial dysfunction
*Valvular regurgitation
*Persistent left-to-right shunt
*Pulmonary vascular disease  
*Prosthetic valve dysfunction
*Status post [[Fontan operation]]
*[[Arrhythmia]]  
*[[Endocarditis]]
*Other degenerative diseases ([[coronary artery disease]], [[hypertension]])
 
=== Right Ventricular Failure ===
Factors affected right ventricle and to be eliminated during management of congestive heart failure.
A. Right ventricular myocardial dysfunction
#[[Right ventricular myocardial infarction]]
#[[Dilated cardiomyopathy]]
#[[Arrhythmogenic right ventricular dysplasia|Right ventricular dysplasia]]
B. Primary right ventricular pressure overload
#[[Left ventricular failure]]
#[[Mitral valve]] disease
#[[Atrial myxoma]]
#[[Pulmonary veno-occlusive disease]]
#[[Cor pulmonale]]
#:*[[Chronic obstructive pulmonary disease]]
#:*[[Primary pulmonary hypertension]]
#:*[[Pulmonary embolism]]
#[[Pulmonic stenosis]]
#:*[[Supravalvular pulmonic stenosis]]  
#:*[[Valvular pulmonic stenosis]]
#:*[[Subvalvular pulmonic stenosis]]
#[[Ventricular septal defect]]  
#Aortopulmonary communication
C. Primary right ventricular volume overload
#[[Pulmonic regurgitation]]
#[[Tricuspid regurgitation]]
#[[Atrial septal defect]]
#[[Partial anomalous pulmonary venous return]]
D. Impediment to right ventricular inflow
#[[Tricuspid stenosis]]
#[[Cardiac tamponade]]
#[[pericarditis |Constrictive pericarditis]]
#[[cardiomyopathy|Restrictive cardiomyopathy]]
 
== Differential Diagnosis of Causes of Heart Failure==
 
===A. Left Ventricular Failure===
 
====Most Common Causes:====
* [[Aortic Regurgitation|Aortic regurgitation]]
* [[Aortic Stenosis|Aortic stenosis]]
* [[Hypertension]]
* [[Mitral Regurgitation|Mitral regurgitation]]
* [[Myocardial ischemia]]
 
====Expanded List of Causes:====
* [[Atrial fibrillation]]
* [[Alcoholism]]
* [[Anemia]]
* [[Angina]]
* [[Aortic Regurgitation|Aortic regurgitation]]
* [[Aortic Stenosis]]
* [[Arteriovenous fistula]]
* [[Beriberi]]
* [[aneurysm|Cardiac aneurysm]]
* [[Cardiomyopathy]]
* [[pericarditis|Constrictive pericarditis]]
* [[Drugs]], [[toxin]]s
* [[Hypertension]]
* [[Hyperthyroidism]]
* [[Hypovolemia]]
* [[Hypoxia]]
* Mediastinal tumors
* [[Mitral Regurgitation]]
* [[Myocardial Infarction]]
* [[Paget's Disease]]
* [[Pancoast's Tumor]]
* [[Pericardial effusion]]
* [[Pericardial tamponade]]
* [[Perimyocarditis]]
* [[Protein deficiency]]
* [[Restrictive cardiomyopathy]]
* [[Papillary muscle rupture|Rupture of the papillary muscles]]
* [[Sepsis]]
* Vena Cava Superior Thrombosis
 
===B. Right Ventricular Failure ===
 
====Most Common Causes:====
* [[Cardiomyopathy]]
* [[Cor pulmonale]]
* [[myocarditis|Diffuse myocarditis]]
* Left heart failure
 
====Other Causes:====
* After [[left ventricular failure]]
* After pulmonary resection
* [[Alveolitis|Allergic alveolitis]]
* [[asthma|Bronchial asthma]]
* [[bronchitis|Chronic bronchitis]]
* [[Alveolitis|Honeycomb lung]]
* [[Hyperglobulia]]
* [[Emphysema]]
* [[Mitral Stenosis]]
* [[Right ventricular myocardial infarction]]
* [[Pickwickian Syndrome]]
* Pleural fibrosis
* [[Pneumoconiosis]]
* [[Pulmonary fibrosis]]
* [[Pulmonic regurgitation]]
* [[Pulmonic stenosis]]
* [[Sarcoidosis]]
* [[pulmonary emboli|Severe relapsing pulmonary emboli]]
* [[Silicosis]]
* [[Tachycardia]]
* [[Tricuspid insufficiency]]
 
===C. Others ===
* [[Ascorbic acid deficiency]]
* [[Cardiac amyloidosis]]
* [[Carnitine deficiency]]
* Cervical vein stasis of non-cardiac genesis
* [[Congenital heart disease]]
* [[Cyanosis]] of non-cardiac genesis
* [[Diabetes Mellitus]]
* [[Ddx:Dyspnea|Dyspnea]] of non-cardiac genesis
* [[Edema]] of non-cardiac genesis
* [[Hemochromatosis]]
* [[Pleural effusion]] of non-cardiac genesis
* [[Pulmonary edema]] of non-cardiac genesis
* [[Thiamine deficiency]]
* [[Thyroid disease]]
 


==References==
==References==
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Latest revision as of 21:05, 29 July 2020
Resident
Survival
Guide
Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure causes On the Web

Most recent articles

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Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

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FDA on Congestive heart failure causes

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Congestive heart failure causes in the news

Blogs on Congestive heart failure causes

Directions to Hospitals Treating Congestive heart failure causes

Risk calculators and risk factors for Congestive heart failure causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There are several classification schemes used to characterize the pathophysiology of heart failure as either systolic vs diastolic; left vs right; or low output vs high output. The anatomic structure underlying the disease process is often characterized as well. The causes of heart failure are also often characterized by their chronicity (acute/decompensated or chronic).

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Congestive heart failure is life threatening and should be treated as such irrespective of the underlying cause.

Common Causes

Causes by Organ System

Cardiovascular Aortic regurgitation, aortic stenosis, arrhythmias, arrhythmogenic right ventricular dysplasia, arteriovenous fistula, atrial fibrillation, atrial septal defect, cardiac amyloidosis, cardiac aneurysm, congenital heart disease, constrictive pericarditis, dilated cardiomyopathy, Eisenmenger syndrome, endocarditis, hypertension, hypertrophic cardiomyopathy, hypoplastic left heart syndrome, interferon gamma, ischemic heart disease, malignant hypertension, mitral regurgitation, mitral stenosis, myocardial infarction, oxaprozin, patent ductus arteriosus, pericardial effusion, pericardial tamponade, pericarditis, peripartum cardiomyopathy, pertuzumab, restrictive cardiomyopathy, rheumatic carditis, rupture of the papillary muscles, Takotsubo cardiomyopathy, tricuspid insufficiency, valvular heart disease, ventricular aneurysm, ventricular septal defect
Chemical/Poisoning Ethylene glycol
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Ado-trastuzumab emtansine, bicalutamide,bicisate dihydrochloride, carfilzomib, certolizumab pegol, cidofovir, cinacalcet, cyclophosphamide, dexamethasone, diclofenac (patch), disulfiram,dornase alfa, doxorubicin hydrochloride, epirubicin , epoetin alfa, felbamate, ferumoxytol, flurbiprofen, goserelin, hydroxyethyl starch, ibuprofen lysine, idarubicin hydrochloride, idursulfase, imatinib, ixabepilone, levothyroxine, mefenamic acid, meloxicam, meropenem, methoxy polyethylene glycol-epoetin beta, methylprednisolone, metoclopramide, mitomycin, mitoxantrone, muromonab-CD3, nilutamide, nitroglycerin,oprelvekin, oxcarbazepine, Peginterferon Beta-1a,pergolide, phenylbutazone, piroxicam, ponatinib hydrochloride, pramipexole, prednisone, prednisolone, rubidium Rb 82, sorafenib, sulindac, sunitinib malate, tolmetin, trastuzumab, valdecoxib, vandetanib
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus, hyperthyroidism, hypothyroidism, thyrotoxicosis
Environmental Coalworker's pneumoconiosis, silicosis
Gastroenterologic No underlying causes
Genetic Atrial septal defect, congenital heart disease, Friedreich's ataxia, glycogen storage disease, Marfan's syndrome, Mulibrey nanism syndrome, muscular dystrophy, Noonan syndrome, ventricular septal defect
Hematologic Severe anemia
Iatrogenic No underlying causes
Infectious Disease Endocarditis, human immunodeficiency virus, Lyme disease, pericarditis, rheumatic carditis, rheumatic fever, sepsis, viral myocarditis, Whipple's disease
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Ascorbic acid deficiency, beriberi, carnitine deficiency, glycogen storage disease, hemochromatosis, metabolic acidosis, Paget's disease
Obstetric/Gynecologic No underlying causes
Oncologic Pancoast tumor
Ophthalmologic No underlying causes
Overdose/Toxicity Alcohol, atenolol, dronedarone, imatinib mesylate, propranolol, verapamil
Psychiatric No underlying causes
Pulmonary Coalworker's pneumoconiosis, cor pulmonale, hypoxia, Pickwickian syndrome, pulmonary artery stenosis, pulmonary embolism, pulmonary fibrosis, pulmonary hypertension, pulmonary valve stenosis, pulmonary vein stenosis, pulmonic regurgitation, silicosis
Renal/Electrolyte No underlying causes
Rheum/Immune/Allergy Cardiac amyloidosis, sarcoidosis, systemic lupus erythematosus
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

Template:WikiDoc Sources

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