CHF

Risk Factors

• CAD
• Advancing Age
• HTN
• DIabetes
• Cigarette smoking
• Obesity
• Hypercholesterolemia

Low Output:

• Right sided
• Left sided - acute vs. chronic, systolic or diastolic

High Output

Causes:

• Conditions that restrict blood flow to the lungs (pulmonary HTN); heart pumping hard to overcome pressure in pulmonary bed
• RV MI - damage to RV itself
• L. heart failur because blood backs up to pulmonary bed causing R side to work harder

S/S:

• JVD
• Ascites
• Wt gain
• Hepatic spleen enlargement
• Gastric distress, distention
• Peripheral edema

Cor Pulmonale - R sided heart failure from a pulmonary disorder

Causes:

• CAD
• HTN (increased afterload)
• MItral and aortic valve disease - stenosis

S/S:

• Increased L. atrial pressures
• Pulmonary congestion (increased fluid = pulmonary edema)
• Crackles
• Decreased O2, Increased CO2
• Fatigue
• Activity Intolerance
• Dyspnea
• Cough (fluid in alveoli)
• Wheezing

• Acute - abrupt, common after massive MI
• manifests itself as pulmonary edema and requires hospitalization
• SOB, rale and wheezes, wt gain, fluid overload
• Require - diuretics, vasodilators, and meds that improve heart's effectiveness as a pump
• Chronic - progressive deterioration over time