Heart failure resident survival guide
Congestive Heart Failure Microchapters |
Pathophysiology |
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Differentiating Congestive heart failure from other Diseases |
Diagnosis |
Treatment |
Medical Therapy: |
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ACC/AHA Guideline Recommendations
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]
Definition
Heart failure is a complex syndrome whereby there is inadequate output of the heart to meet the metabolic demands of the body. Abnormal function of different anatomic parts of the heart cause heart failure including the pericardium, the myocardium, the endocardium, the heart valves and the great vessels. Symptoms of heart failure are due to a lack of both forward blood flow to the body, and backward flow into the lungs. Heart failure is a clinical syndrome characterized by symptoms of dyspnea, edema and fatigue and signs such as rales on physical examination.
Causes
Life Threatening Causes
Acute decompensated heart failure is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated.
- Accelerated hypertension
- Acute kidney injury
- Acute myocardial ischemia
- Acute or progressive valvular disease (e.g. acute mitral regurgitation)
- Acute or subacute valve disease endocarditis
- Aortic dissection
- Cardiac arrhythmias, specially ventricular arrhythmias
- Cardiotoxic agents (e.g. alcohol, cocaine, and certain chemotherapy drugs)
- Diabetic emergencies (e.g. ketoacidosis)
- Myopericarditis
- Pulmonary embolus
- Severe anemia (e.g. acute hemolysis or blood loss)
- Systemic Inflammatory response syndrome
- Thyrotoxicosis
Common Causes
- Accelerated hypertension
- Acute kidney injury
- Acute myocardial ischemia
- Acute or progressive valvular disease (e.g. acute mitral regurgitation)
- Cardiac arrhythmias
- Excessive alcohol or illicit drug use (e.g. cocaine)
- Hypertension
- Myocardial ischemia
- Pulmonary embolus
- Systemic Inflammatory response syndrome
Management
- Acute decompensated HF will most likely fall in the stage C or stage D of the ACC/AHA HF classification. see figure 1
Figure 1: Stages in the development of HF:[1]
Determine ACC/AHA stage of HF | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
STAGE A At high risk for HF but without structural heart disease or symptoms of HF | STAGE B Structural heart disease but without signs or symptoms of HF | STAGE C Structural heart disease with prior or current symptoms of HF | STAGE D Refractory HF | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Do's
Don'ts
References
- ↑ Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.