Heart Failure

Congestive heart failure (CHF) or congestive cardiac failure (CCF) or just plain heart failure is a condition that may result from functional or structural cardiac disorder that impairs the heart’s ability to pump a sufficient amount of blood for the whole body.

The symptom for heart failure is dependent on two factors. The first is basing on the side of the heart that is involved. The second factor can be based on the type of failure; it can either be diastolic or systolic.

Left Sided Failure
The failure of the heart’s left ventricle is the cause of congestion of the pulmonary capillaries. Patient with this condition have dyspnea (shortness of breath), and is easily tired. If left the function of the left ventricle is severely compromised, symptoms of poor system circulation manifest which lead to dizziness, confusion and diaphoresis.

On physical exam, left ventricular failure manifest a displaced apex beat and gallop rhythm in case of decompensation.

Right Sided Failure
The heart’s right side pumps blood returned from the tissues to the lungs and where CO2 is exchanged for O2. A failure on the right ventricle of the heart leads to congestion of systemic capillaries which leads to peripheral edema or anasarca and nocturia.

On physical exam, right sided ventricular failure reveal edema, ascites and hepatomegaly.

In systolic heart failure the pumping action of the heart is reduced or weakened. A common clinical measurement for this is the ejection fraction (EF), this calculates how much blood is ejected out of the left ventricle stroke volume) and is divided by the maximum volume remaining in the left ventricle at the end of diastole or relaxation phase. A normal ejection fraction is greater than 50% but in a systolic heart failure ejection fraction is less than 50%

In a diastolic heart failure, the heart’s contracting is normal but is stiff, or less compliant, when it is relaxing and is filling in blood. This obstructs blood filling into the heart and produces backup into the lungs and CHF symptoms. This heart failure is more common in patients older than 75 years, especially in women with high blood pressure. In this hart failure, the ejection fraction is normal.

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