Congestive Cardiac Failure

Nearly 5.1 million people in the United States have been diagnosed with heart failure. Yet so many people don’t have a clue what it is until they have been diagnosed with it. Congestive Heart Failure, or CHF, is a disease that has many symptoms, can be tested and treated, has several causes, and can be avoided.

Heart failure, HF, is a result of one’s heart inefficiently pumping blood out to the body (Lewis, Dirksen, Heitkemper and Bucher, 2014, p.766). A healthy heart will pump blood out of the left and right ventricles rhythmically and simultaneously, creating an even flow of blood from the heart to the pulmonary arteries and the aorta (Lewis et al., 2014, p.769). Someone with heart failure has a ventricular dysfunction in either one or both ventricles; the ventricles are not filling or contracting properly. The failure of one ventricle to properly function leads to an overcompensation of the opposite ventricle as well as a disruption in normal blood flow that leads

Congestive heart failure is an older name for heart failure. Congestive heart failure takes place when the heart is unable to maintain an adequate circulation of blood in the bodily tissues or to pump out the venous blood returned to it by the veins (Merriam-Webster). The heart is split into two distinct pumping structures, the right side of the heart and the left side of the heart. Appropriate cardiac performance involves each ventricle to extract even quantities of blood over intervals. If the volume of blood reimbursed to the heart develops more than both ventricles can manage, the heart can no longer be an efficient pump.

A low partial pressure of oxygen (PaO2) suggests that a person is not getting enough oxygen; Metabolic acidosis->Kidney failure, shock, diabetic ketoacidosis

The Canadian Heart and Stroke Foundation defines heart failure (HF) as “a common condition that develops after the heart becomes damaged or weakened by diseases of the heart including heart attacks and other medical conditions. (Heart Failure, 2013)” HF is a chronic medical condition causing the body’s heart to weaken and become unable to pump and supply enough blood and nutrients to the meet the body’s needs. There are four different types of HF: left-side, right-side, systolic and diastolic heart failure (Heart Failure, 2015). Left-side heart failure causes shortness of breath due to fluid backing up in the lungs. Right-side heart failure causes fluid retention in abdomen, legs and feet causing swelling. Systolic heart failure is when the left ventricle can’t contract fast enough, indicating a pumping issue and diastolic heart failure is when the left ventricle can’t relax enough to fill properly, indicating a filling problem (Heart Failure, 2015). These abnormalities in heart function can result a homeostatic imbalance in the kidneys responding by causing the body to retain fluid and salt. The term congestive heart failure (CHF) is used when the heart failure has worsened causing a backup of fluid and congesting extremities and other organs (Heart Failure, 2015). Often, you can control heart failure by taking medicine, changing your lifestyle, and treating the condition that caused it but there is no cure at this time.

Congestive Heart failure: Congestive Heart Failure (CHF) is a cardiac disease associated with the decreasing capacity of the cardiac output. It has been shown that the CHF is the main cause of cardiac death around the world (Lucena, Barros, & Ohnishi, 2016). Congestive heart failure is the inability of the left side of the heart to pump an adequate amount of blood due to certain conditions. Because of these conditions, the heart become weak and unable to pump all of the blood forward and some of

CHF stands for congestive heart failure. There are several types of congestive heart failure. There is left sided heart failure which may cause fluid to back up into your lungs which will cause shortness of breath. Right sided heart failure may cause fluid to back up into your abdomen, and other body parts. Systolic heart failure causes the left ventricle can’t contract vigorously, which causes problems with the heart pumping blood. The final type is diastolic heart failure means the left ventricle can’t relax or fill up adequately.

Congestive Heart Failure is when the heart's pumping power is weaker than normal. It does not mean the heart has stopped working. The blood moves through the heart and body at a slower rate, and pressure in the heart increases. This means; the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up with fluids, it becomes congested. Many conditions can cause heart

Contractility is the pumping of the heart muscle. It is measured as the ejection fraction. Contractility directly influences stroke volume. Increased contractility will increase stroke volume with any amount of preload. Diseases that disrupt myocyte activity reduce contractility. Myocardial infarction is the most common. Others include, but are not limited to, cardiomyopathies, degenerative valve disease, and myocarditis (Francis & Tang, 2003). Secondary causes of decreased contractility, such as myocardial ischemia and increased myocardial workload, contribute to neurohumoral , immune, and inflammatory changes and can cause ventricular remodeling. Ventricular remodeling occurs when the size, shape, and function of the affected chamber is distorted. Ventricular remodeling causes hypertrophy and dilation of the heart muscle and causes progressive myocyte contractile dysfunction over a period of time. When contractility is decreased, stroke

The heart tries to make up for loss of pumping capacity in three ways enlarging, developing more muscle mass, and pumping faster. By enlarging, the heart contracts more strongly and pumps more blood. When the contracting cells of the heart increase in size, an increase in muscle mass also occurs. Pumping faster helps to increase the heart’s output.

When the heart begins to fail, mechanisms are activated to compensate for the impaired function and maintain the cardiac output. The primary compensatory mechanisms are Frank –Starling mechanism, neuroendocrine responses including activation of the sympathetic nervous system and the renin- angiotensin-aldosterone system, and ventricular hypertrophy. Decreased cardiac output initially stimulates aortic baroreceptors, which in turn stimulate the SNS. SNS stimulation produces both cardiac and vascular responses through the release of norepinephrine. Norepinephrine increases heart rate and contractility by stimulating cardiac beta- receptors. Cardiac output improves as both heart rate and stroke volume increase. Norepinephrine also causes arterial

The cardiac muscle cells can be affected by heart disease through the inability to maintain its homeostasis through the calcium pump. If there is excess calcium within the heart it results in the in ability of the heart muscle to relax. As a result, the ADP/ATP ratio increases, phosphocreatine decreases, and energy stores are depleted. Furthermore, this imbalance affects the energy needed to relax the left ventricle. Secondly, diastolic heart failure can occur from changes in preload, afterload, renin-angiotension-aldosterone system, and the sympathetic nervous system. These changes affect the fibrillar collagen within the extracellular matrix that affects the ability of the ventricular to relax. These changes along with those compensatory mechanisms results in continuous resistance that results in increased in left ventricular end-diastolic pressure (McCance & Huether, 2010).

The major causes of diastolic heart failure are hypertension-induced myocardial hypertrophy and myocardial ischemia-induced ventricular transformation (coronary artery disease). Hypertrophy and ischemia cause a decreased ability of the myocytes to actively pump calcium from the cytosol, resulting in impaired relaxation. Some of the other causes are aortic valvular disease and cardiomyopathies. Diabetes can also lead to diastolic heart failure (Huether and McCune 2012). Other risk factors for this disease are chronic kidney disease, obstructive sleep apnea, and older age. There are two types of the heart failure: systolic heart failure and diastolic heart failure. In systolic heart failure, the left ventricle has difficulty contracting and ejecting blood into the circulation, which causes reduced left ventricular fraction. On the other hand, diastolic heart failure has a slow and delayed relaxation and increased chamber rigidity, which then causes inadequate filling of blood and

The body needs a certain amount of cardiac output to maintain its basic functions. In congestive heart failure the body needs more output than the heart can put out. To make up for the lack of cardiac output, the heart sends all of its output to the essential organs such as the brain and lungs. It neglects to send as much blood to the extremities. This is why in congestive heart failure patents, edema is usually present. Fatigue results from the heart having to work extra hard to send blood to only a few essential organs. This is why fatigue is considered the first symptom of congestive heart failure. Congestive Heart Disease can happen on either side of the heart, or it can effect both sides. When the heart cannot keep up with what the body needs capillary pressure increases. When this capillary pressure increases it causes sodium to build up, and the body does not excrete the

As this disease progresses and the workload of the heart is consistently increased, ventricular hypertrophy occurs. At first, the hypertrophied heart muscles will increase contractility, thus increasing cardiac output; however, as hypertrophy of the ventricular myocardial cells continues, it begins to have poor contractility, requires more oxygen to perform, and has poor circulation from the coronary arteries. This can result in heart tissue ischemia and lead into cardiac dysrhythmias (Lewis et al. 2014, 768).