Heart failure: Pathology review
Osmosis from Elsevier・12 minutes read
Both Lydia and Richard suffer from heart failure, with Lydia exhibiting symptoms of systolic heart failure with left heart involvement, while Richard has signs of right-sided heart failure possibly due to pulmonary causes. Treatment includes medication to decrease mortality and relieve symptoms, tailored to the type and underlying causes of heart failure.
Insights
- Heart failure can be categorized as systolic or diastolic, with systolic heart failure characterized by decreased left ventricle contractility, low ejection fraction, and high end-diastolic pressure, while diastolic heart failure results from reduced ventricle stretch during filling due to hypertrophy.
- Treatment for heart failure involves various medications targeting different mechanisms to decrease mortality and alleviate symptoms, including ACE inhibitors, ARBs, beta blockers, diuretics, and vasodilators, tailored to the specific type and symptoms of heart failure in each patient.
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Recent questions
What is heart failure?
Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs, categorized as systolic or diastolic.
What are the symptoms of left heart failure?
Symptoms of left heart failure include pulmonary congestion, orthopnea, paroxysmal nocturnal dyspnea, and crackles on auscultation.
What are the causes of systolic heart failure?
Causes of systolic heart failure include myocardial infarction and dilated cardiomyopathy.
How is heart failure treated?
Treatment for heart failure includes medications like ACE inhibitors, ARBs, beta blockers, diuretics, and vasodilators to decrease mortality and relieve symptoms.
How is right-sided heart failure diagnosed?
Further diagnostic steps for right-sided heart failure may involve a chest x-ray and spirometry to investigate potential pulmonary causes.
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Summary
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Heart Failure: Causes, Symptoms, and Treatment Options
- Two patients on the Cardiology Ward: Lydia, 70 years old, had a myocardial infarction 3 years ago, presents with fatigue, dyspnea, and pitting edema in legs, and an S3 sound on osculation. Richard, 81 years old, a smoker for 50 years, also has fatigue, pitting edema, jugular Venus distension, and hepatomegaly.
- Both Lydia and Richard suffer from heart failure, a condition where the heart can't pump enough blood to meet the body's demands, categorized as systolic or diastolic heart failure.
- Systolic heart failure is characterized by decreased contractility of the left ventricle, leading to decreased cardiac output and ejection fraction, with high end-diastolic pressure and volume.
- Causes of systolic heart failure include myocardial infarction and dilated cardiomyopathy, while diastolic heart failure results from ventricular hypertrophy, reducing the ventricle's ability to stretch during filling.
- Heart failure can affect the right or left ventricle, or both, with right heart failure often stemming from left heart failure or pulmonary causes like chronic lung disease.
- Symptoms of left heart failure include pulmonary congestion, leading to pulmonary edema, orthopnea, paroxysmal nocturnal dyspnea, and crackles on auscultation.
- Treatment for heart failure includes medications like ACE inhibitors, ARBs, aldosterone receptor antagonists, beta blockers, diuretics, and vasodilators, aiming to decrease mortality and relieve symptoms.
- Lydia's symptoms and low ejection fraction indicate systolic heart failure with left heart involvement, while Richard's normal ejection fraction and right ventricular hypertrophy suggest right-sided heart failure possibly due to pulmonary causes.
- Further diagnostic steps for Richard may involve a chest x-ray and spirometry to investigate potential pulmonary causes of his right-sided heart failure.
