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Heart Failure:

condition in which the heart is unable to meet the metabolic needs of the body, or can do so only in the presence of pathophysiological adaptive mechanisms.

Clinical Manifestations:

Left-sided failure	Right-sided failure
-fatigue, weakness -shortness of breath -orthopnea -paroxysmal nocturnal dyspnea -exercise intolerance -edema -pulmonary edema -crackles in lungs -hemoptysis	-fatigue, weakness -shortness of breath -edema -“dependent” edema -exercise intolerance -ascites -fluid in peritoneum -distended neck veins -elevated central venous pressure

In the presence of ongoing Heart Failure:

dilation (ventricular cavity enlarges)
in response to chronic volume overload of the ventricles
may initially be beneficial (Frank-Starling Curve)
detrimental if severely dilated
hypertrophy (ventricular muscle thickens)
in response to ongoing pressure overload
initially may be beneficial (ventricles able to squeeze harder)
may become detrimental (decreased ventricular compliance)

Common precipitants of Heart Failure:

-ischemia/infarction
-anemia
-arrhythmias
-myocarditis
-thyrotoxicosis

-pregnancy
-hypertensive crisis
-dietary changes
-pulmonary embolus
- excessive physical activity

Treatment for acute Heart Failure

Treatment for chronic Heart Falure

-look for and treat the precipitant
-O2, diuretics
-vasodilators (nitrates, narcotics)

-digitalis (increase force of ventricular contraction)
-diuretics (furosemide, etc.)
-spironolactone*
-afterload reducers (ACE-I*, ARBs*)
-beta receptor-blockers*

* shown to decrease mortality