Heart Failure often referred to as congestive heart failure (CHF), is the inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients. The term CHF is misleading, because it indicates that patients must experience pulmonary or peripheral congestion to have Heart Failure, and it implies that patients with congestion have Heart Failure

Classifications of Heart Failure-:Heart Failure, what is Heart Failure

Class I: no undue symptoms associated with ordinary activity and no limitation of physical activity

Class II: slight limitation of physical activity; patient comfortable at rest

Class III: marked limitation of physical activity; patient comfortable at rest

Class IV: inability to carry on any physical activity without discomfort; symptoms of cardiac insufficiency or chest pain possible even at rest

Etiology-: Heart Failure, what is Heart Failure

1. Coronary artery disease and heart attack-:
2. High blood pressure (hypertension)
3. Faulty heart valves
4. Damage to the heart muscle (cardiomyopathy)
5. Myocarditis
6. Heart defects from born with (congenital heart defects).
7. Abnormal heart rhythms (heart arrhythmias).

Risk factors of Heart Failure-: Heart Failure, what is Heart Failure

1. High blood pressure.Heart works harder than it has to if blood pressure is high.
2. Coronary artery disease.Narrowed arteries may limit heart’s supply of oxygen-rich blood, resulting in weakened heart muscle.
3. Heart attack.Damage to heart muscle from a heart attack may mean heart can no longer pump as well as it should.
4. Having diabetes increases risk of high blood pressure and coronary artery disease.
5. Sleep apnea.The inability to breathe properly while sleep at night results in low blood oxygen levels and increased risk of abnormal heart rhythms. Both of these problems can weaken the heart.
6. Congenital heart defects.Some people who develop heart failure were born with structural heart defects.
7. Valvular heart disease.People with valvular heart disease have a higher risk of heart failure.
8. A viral infection may have damaged heart muscle.
9. Alcohol use.Drinking too much alcohol can weaken heart muscle and lead to heart failure.
10. Tobacco use.Using tobacco can increase risk of heart failure.
11. People who are obese have a higher risk of developing heart failure.
12. Irregular heartbeats-: These abnormal rhythms, especially if they are very frequent and fast, can weaken the heart muscle and cause heart failure

Type of heart failure-: Heart Failure, what is Heart Failure

1. LEFT-SIDED HEART FAILURE
2. RIGHT-SIDED HEART FAILURE

Assessment and Diagnostic Findings -: Heart Failure, what is Heart Failure

• History of the present illness and past illness.
• Physical examination ( general physical examination and systemic examination)
• Blood tests-: Check the Complete hemoglobin test kidney function test, liver function test and thyroid function
• Chest X-ray X-ray images help to see the condition of lungs and heart. In heart failure, heart may appear enlarged and fluid build-up.
• Electrocardiogram (ECG) ECG helps diagnose heart rhythm problems and damage to heart from a heart attack that may be underlying heart failure.
• Echocardiogram An important test for diagnosing heart failure is the echocardiogram. An echocardiogram helps distinguish systolic heart failure from diastolic heart failure in which the heart is stiff and can’t fill properly.
• Stress test-: Stress tests measure heart and blood vessels respond to exertion. Patient may walk on a treadmill or pedal a stationary bike while attached to an ECG machine. Stress tests help to see if patient has coronary artery disease. Stress tests also determine how well body is responding to heart’s decreased pumping effectiveness and can help guide longterm treatment decisions.
• Cardiac computerized tomography (CT) scan or magnetic resonance imaging (MRI)
• Coronary angiogram-: In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at femoral or radial side and guided through the aorta into coronary arteries. A dye injected through the catheter makes the arteries supplying heart visible on an X-ray. This test helps identify narrowed arteries to heart (coronary artery disease) that can be a cause of heart failure. The test may include a ventriculogram a procedure to determine the strength of the heart’s main pumping chamber (left ventricle) and the health of the heart valves.
• Myocardial biopsy-: In this test, Inserts a small, flexible biopsy cord into a vein in neck or groin, and small pieces of the heart muscle are taken. This test may be performed to diagnose certain types of heart muscle diseases that cause heart failure.

 Medical Management-: Heart Failure, what is Heart Failure

The basic objectives in treating patients with HF are the following:

• Eliminate or reduce any etiologic contributory factors, especially those that may be reversible, such as arterial fibrillation or excessive alcohol ingestion.
• Reduce the workload on the heart by reducing after load and preload.

PHARMACOLOGIC THERAPY-:Heart Failure, what is Heart Failure

• Angiotensin-converting enzyme (ACE) inhibitors -: enalapril (Vasotec), lisinopril (Zestril) and captopril (Capoten).
• Angiotensin II receptor blockers-: losartan (Cozaar) and valsartan (Diovan),
• Beta blocker-: carvedilol (Coreg), metoprolol (Lopressor) and bisoprolol (Zebeta).
• Diuretics-: furosemide (Lasix),
• Aldosterone antagonist: spironolactone (Aldactone) and eplerenone (Inspra).
• Digoxin (Lanoxin)