Heart Failure is one of the most important conditions to include lifestyle counseilng. Counseling such as?

Restrict Sodium Intake

Monitor weight on a daily basis (a sudden water-weight gain can indicate that the condition has acutely "decompensated", or worsened)

Discontinue tobacco use

Limit alcohol

Improve nutrition and physical activity

Hypertension: the heart has to pump against a high pressure - this results in an enlarged ventricle and eventually reduced cardiac output.

The heart has four chambers: a right atrium and ventricle and a left atrium and ventricle. Describe the movement of blood throughout the heart

Right atrium (oxygen-poor blood) ---> right ventricle ---> pulmonary artery into the lungs for oxygen replenishment ---> left atrium (back into the heart) ---> left ventricle ---> aorta and into systemic circulation

The heart beat sounds (if healthy) sound like "lub-dub, lub dub". What does the "lub" represent?

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S1 heart sound. The sound of the tricuspid and mitral valves closing in the right atrium and ventricle

The heart beat sounds (if healthy) sound like "lub-dub, lub dub". What does the "dub" represent?

S2 sound. The sound of the aortic and pulmonary valves closing in the left atrium and ventricle.

CO = SV x HR [writter in mL or L (of blood volume) per minute]

SV: stroke volume

HR: heart rate

When the left ventricle (and sometimes the right, or both ventricles) does not fill with or eject blood properly. Consequently, the heart fails to pump sufficient blodd to meet the body's metabolic (oxygen and nutrient) needs.

Heart responds to diminshed output by stretching (to hold more blood) or by growing thicker muscular walls in order to pump harder. This will improve the situation short-term, but eventually the chamber inside the left ventricle becomes smaller due to expanding muscle, and the muscle walls weaken. This results in a decreased CO.

What happens when the body compensates for early stages of heart failure?

In an attempt to compensate, the body tries to maintain normal arterial pressure through constricting arterial vessels by activation of the sympathetic (adrenergic) nervous system (SNS). SNS activation causes the kidneys to release renin, which activates the renin-angiotensin-aldosterone system (RAAS), resulting in increased systemic vascular resistance via increased aniotensin II and increased aldosterone, which results in increased renal reabsorption of sodium and water. Therefore, blood volume increases and helps maintain CO, but it is harmful because it raises vesnous pressure and causes pulmonary and systemic edema. The excess fluid causes the body to become "congested" and classic symptoms of "congestive" heart failure appear, including dyspnea (shortness of breath, or SOB), fatigure, pulmonary congestion (fluid back-up into the lungs - which contributes to the SOB) and peripheral edema.