Congestive heart failure natural history: Difference between revisions
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==Overview== | ==Overview== | ||
Congestive heart failure is associated with a poor prognosis. In the Framingham experience, 80% of men and 70% of women with heart failure had died within 8 years of the diagnosis. | Congestive heart failure is associated with a poor prognosis. In the Framingham experience, 80% of men and 70% of women with heart failure who were under 65 years of age had died within 8 years of the diagnosis. | ||
==Complications== | ==Complications== | ||
Revision as of 15:14, 2 April 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Saleh El Dassouki, M.D. [3], Atif Mohammad, M.D.
Overview
Congestive heart failure is associated with a poor prognosis. In the Framingham experience, 80% of men and 70% of women with heart failure who were under 65 years of age had died within 8 years of the diagnosis.
Complications
1. Cardiac Arrhythmias:
- Ventricular tachycardia and ventricular fibrillation can occur as serious complications of heart failure when its pump function is severely impaired. This further worsens the cardiac output and even possible death.
- Atrial fibrillation which is rapid beating of atrium without optimal forward pumping of blood is another complication of heart failure which occurs as a result of resistance to blood flow from atrium to ventricles. These patients are at increased risk of stroke.
- Left bundle branch block is an abnormality in electrical conduction in the heart.
2. Pulmonary Congestion:
- Pulmonary congestion which occur in left ventricular failure can cause pulmonary edema.
- Venous stasis and pedal edema can occur as a complication of right heart failure. These conditions predispose patients to venous ulcers, infections and cellulites.
- Cardiac cirrhosis occurs as a result of hepatic venous congestion. This can lead to coma and even death [1].
3. Angina and myocardial infarction: Cardiac ischemia and infarction can also occur when heart failure patients undergo exertion. With LV dilation, LV wall stress increases, and this increases the risk of angina.
4. Renal failure: Renal impairment can occur secondary to decreased renal perfusion. This further worsens heart failure by fluid retention.
5. Cardiac cachexia: Unintentional rapid weight loss (a loss of at least 7.5% of normal weight within 6 months) can occur in chronic heart failure[2]. This is a bad prognostic factor.
Prognosis
Mortality Associated with Heart Failure
Based on the 44-year follow-up of the NHLBI’s Framingham Heart Study:
- 80% of men and 70% of women under age 65 who have heart failure will die within following 8 years.
- In people diagnosed with heart failure, sudden cardiac death occurs at 6 to 9 times the rate of the general population.
- One in eight deaths has heart failure mentioned on the death certificate.
References
- ↑ Moussavian SN, Dincsoy HP, Goodman S, Helm RA, Bozian RC (1982). "Severe hyperbilirubinemia and coma in chronic congestive heart failure". Digestive Diseases and Sciences. 27 (2): 175–80. PMID 7075414. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Freeman LM (2009). "The pathophysiology of cardiac cachexia". Current Opinion in Supportive and Palliative Care. 3 (4): 276–81. doi:10.1097/SPC.0b013e32833237f1. PMID 19797959. Retrieved 2011-04-30. Unknown parameter
|month=ignored (help)