Heart Failure

Research By: Dr. Ritta Baena

Visual Effects By: John Baena

The Function of the Heart

• The heart is a pump that pumps blood to the whole body.

• The heart is divided into a right side and left side. • Each side is further divided into two parts, the

artrium ( at the top) and ventricle ( at the bottom)

• The right side of the heart pumps the deoxygenated blood to the lungs to pick up oxygen and remove the carbon dioxide from the blood.

• The oxygenated blood is returned from the lungs to the left part of the heart which pumps the oxygen rich blood to the whole body.

Normal Heart Function

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The Function of the Heart

• Heart is a muscular organ with 4 chambers pumping blood as required by the body.

• The contraction of the muscles fibers of the heart is controlled by electricity that flows in distinct pathways.

The Electrical Impulse of the Heart

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Locations of the Heart Sounds

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Heart Rate

• Normal Adult Heart Rate is 60-100beats/min

• A normal person’s heart rate may vary in response to exercise, and stimuli such as pain or anger.

• Abnormal heart rate is when it is inappropriately fast called Tachycardia or slow called bradycardia or when electrical impulse travel an abnormal pathway.

Heart Performance

A Normal heart performance during exercise

B Normal heart performance at rest

C Heart Failure

D Cardiogenic shock

What is heart failure?

• Heart failure is when the heart can not meet the bodies requirements, thus the heart fails due to many causes.

• Heart failure ranges from stage 1-4. • Stage 1 there is no limitation on the

heart during exercises, any metabolic demand or other forms of stress. This is the mildest form of heart failure.

• Severe heart failure is at rest

Stages of Hear Failure

Class Patient Symptoms

Class I (Mild) No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or

dyspnea (shortness of breath).

Class II (Mild) Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue,

palpitation, or dyspnea.

Class III (Moderate)

Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue,

palpitation, or dyspnea.

Class IV (Severe)

Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at

rest. If any physical activity is undertaken, discomfort is increased.

Common Cause of Heart Failure

The most common cause of heart failure

• In adults is due to coronary artery diseases. The coronary artery is the artery that supplies the heart with oxygen and glucose in order to function as a pump from the left side of the heart.

• In children it can be from a variety of conditions from congenital to infection etc

Symptoms of Heart Failure

The patients normal come in with:• difficulty breathing at rest or with exercise

this is mostly to be right heart failure due to fluid in the lungs and the lungs are unable to expand to normal requirements and

• fluid in their legs( worst towards the end of the day due to gravity and in the mornings it mostly settles horizontally ie the back) mostly due to left side heart failure.

Types of heart failure

• Acute- sudden

• Chronic- gradual impairment of the heart.

• This can further be divided into Right heart failure, left heart failure and biventricular heart failure

Symptoms of heart failure • Shortness of breath called dyspnea:

– from walking stair or simple activities. – Trouble breathing at rest.– Breathless at night that wakes you up (Paroxymal Nocturnal

Dyspnea)– Unable to lie flat and require two or more pillow. (Orthopnea)

• Fluid in the ankles called edema• Weakness and fatigue• Palpitation• Coughing-fequent coughing

– drycough– cough with production of a mucus or

pink, blood-tinged sputum• Exercise intolerance

Causes of heart failure

• High blood pressure • Damage heart• Valves are damage• Illicit Drugs• Cardiomyopathy• Infects Bacterial or

viral• Congenital

Test

• Echocardiogram

• ECG

• Blood test for sodium, creatnine, urea, liver function and Thyroid functions-TSH

• Chest x-ray

Treatment

• It depends on the cause of the heart failure. It is always advisable to talk to your doctor. It may vary from simple restrictions of salt, nutritional food to heart implants and or replacement.– Salt restriction– Regular exercise with doctors advise– Fluid restriction– Regular weight checks to see if you are retaining fluid– Medication normal combination treatment of pills such as

ACE Inhibitors, Diuretics, Beta Blocker, Digitalis– Surgery- Pacers( for stage III/IV NYHA)– Ventricular Assist Device:

• RVAD ( Right ventricular assist device)• LVAD (Left Ventricular assist device )• BiVAD (Biventriculat assist device)

– Heart transplant

Heart Pace Maker

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Ventricular Assist Device

Heart Transplant