Congestive Heart Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
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About this ebook
Heart failure happens when the heart muscle cannot push or eject the blood out of the heart
This is termed systolic heart failure.
The heart muscles are stiff and can not fill up with blood readily.
This is termed diastolic heart failure.
When the heart's pumping becomes less effective, blood may accumulate in other parts of the body.
Fluid may collect in the lungs, liver, gastrointestinal tract, and the arms and legs.
This is termed congestive heart failure.
Causes of Congestive Heart failure are:
1. Coronary artery disease (CAD)
2. Cardiomyopathy
3. Congenital heart disease
4. High blood pressure
5. Heart valve disease
6. Infection that weakens the heart muscle and its pumping action
7. Abnormal heart rhythms
Diagnosis is by :
a. Fast or difficult breathing
b. Leg swelling (edema)
c. Neck veins that are distended
d. Sounds (crepitations) from fluid buildup in your lungs, heard through a stethoscope
e. Swelling of the liver or abdomen
f. Uneven or fast heartbeat and abnormal heart sounds
An echocardiogram (ultrasound) is the best test to diagnose, determine the cause of, and monitor the heart failure because it can check on the blood flow through the heart.
The purposes of heart treatment are to:
1. Relieve symptoms and improve quality of life
2. Slow disease progression
3. Reduce the need for emergency room visits and hospitalization
4. Help people live longer
Treatment methods are dependent on the form, cause, symptoms and category of the heart failure.
Normally more than one treatment is given.
Get sufficient rest
Take a heart-healthy diet that is low in sodium and fat
Do not smoke and drink
The forms of medicine given are:
1. Angiotensive converting enzyme (ACE) inhibitors, which dilate, or widen, the arteries, increasing blood flow and making it so that the heart does not have to pump as hard.
2. Beta-blockers reduce blood pressure and decrease and block the effect of harmful hormones that can induce disease progression.
3. Diuretics or water pills help the kidneys produce more urine and excrete the body of excess fluid which can over load the heart.
4. Spironolactone is a diuretic that preserves potassium and has been found to reduce hospitalization and prolong life when given to treat advanced heart failure.
5. Potassium and magnesium supplements are often given with diuretics to replace these minerals, which are passed out in urine.
6. Digoxin makes the heart beat stronger and slower, and controls the rhythm of its contractions.
8. Anti-arrhythmic drugs can treat abnormal heart rhythms
Surgical methods to treat underlying causes of heart failure are:
1. Coronary artery bypass graft (CABG) or angioplasty to treat and prevent heart failure caused by blocked arteries.
2. Angioplasty
3. Implantation of pacemakers
4. Heart Transplantation as last resort
TABLE OF CONTENT
Introduction
Chapter 1 Congestive Heart failure
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Coronary Heart Disease
Chapter 8 Hypertension
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Congestive Heart Failure, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Congestive Heart
Failure,
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2016 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes the Congestive Heart Failure, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What You Need to Treat Congestive Heart Failure)
This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Conditions
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Congestive Heart Failure
What is Congestive Heart failure?
Congestive Heart failure is a medical disorder that happens when the heart can not push enough blood to the rest of the body.
This disorder may involve either the right side or the left side of the heart.
Frequently both sides of the heart are affected.
Congestive Heart failure is frequently a chronic disorder but it may start suddenly.
It can be produced by many different heart disorders.
Heart failure happens when:
a. The heart muscle cannot push or eject the blood out of the heart very well.
This is termed systolic heart failure.
b. The heart muscles are stiff and can not fill up with blood readily.
This is termed diastolic heart failure.
c. When the heart's pumping becomes less effective, blood may accumulate in other parts of the body.
Fluid may collect in the lungs, liver, gastrointestinal tract, and the arms and legs.
This is termed congestive heart failure.
What is the Cause of Congestive Heart failure?
When the heart is not able to eject enough oxygen-rich blood out to the other parts of the body, the blood may collect in the lungs, liver, gastrointestinal tract, and the arms and legs.
1. Coronary artery disease (CAD) is the narrowing of the small blood vessels that supply blood and oxygen to the heart weakening the heart and its pumping action.
2. Cardiomyopathy - Heart failure can also happen when an infection weakens the heart muscle and the heart muscle becomes bigger to compensate.
3. Congenital heart disease -defects in the heart of the newborn decrease the pumping effect of the heart
4. High blood pressure that is not properly controlled, resulting in problems with stiffness or ultimately resulting in muscle weakening.
5. Heart valve disease - abnormal valves that are narrowed or leaks affects the blood flow through the heart
6. Infection that weakens the heart muscle and its pumping action
7. Some types of abnormal heart rhythms (arrhythmias) causes the effectiveness of blood flow through the heart
8. Emphysema – the chronic lung disease involves the heart lung circulation
9. Overactive thyroid – the fast heart beats involve the heart pumping action
10. Severe anemia -insufficient blood involves the blood flow in the heart
11. Under active thyroid - slow heart beats also involves the heart
12. Other diseases that can produce or contribute to heart failure:
a. Amyloidosis
b. Sarcoidosis
c. Too much iron in the body
What are the symptoms of Congestive Heart failure?
Symptoms of heart failure often start slowly.
At first they may only happen when the person is very active.
Over time, the patient may observe breathing problems and other symptoms even when he or she is resting.
Symptoms may also happen suddenly after the heart is injured from a heart attack or other disorder.
1. Breathing problems happen even while resting.
2. Coughing that is worse at night
3. Weakness, fatigue, faintness
4. Loss of appetite
5. Need to urinate at night
6. Pulse that is irregular or fast and palpitations (feeling of fast heart beats)
7. Shortness of breath when active or lying down
8. Enlarged (Swollen) liver or abdomen
9. Feet and ankles swelling
10. Waking up from sleep from shortness of breath
11. Weight gain
Heart failure symptoms can also start suddenly for example after a heart attack or other heart disorder.
Signs
1. Difficulty in breathing or fast breathing
2. Fast or irregular heartbeat and abnormal heart sounds
3. Leg swelling (edema)
4. Neck veins that swell out (distended)
5. Sounds (crepitations) from fluid buildup in lower areas of the lungs
6. Swelling of the liver or abdomen
How is the diagnosis of Congestive Heart failure made?
Diagnosis:
The doctor will examine you for signs of heart failure:
a. Fast or difficult breathing
b. Leg swelling (edema)
c. Neck veins that are distended
d. Sounds (crepitations) from fluid buildup in your lungs, heard through a stethoscope
e. Swelling of the liver or abdomen
f. Uneven or fast heartbeat and abnormal heart sounds
Many tests are done to diagnose and monitor heart failure.
A. An echocardiogram (ultrasound) is the best test to diagnose, determine the cause of, and monitor the heart failure because it can check on the blood flow through the heart.
The doctor can make use of it to help the treatment.
B. Imaging tests are helpful
They can observe at how well the heart is able to pump blood and how much the heart muscle is injured:
1. Heart stress tests
2. Cardiac catheterization
3. MRI of the heart
4. Nuclear heart scans
C. Laboratory blood tests are done to:
i. Diagnose and monitor heart failure
ii. Identify risks for heart disease
iii. Check for other causes of heart failure, or disorder that may make the heart failure worse
iv. Monitor for side effects of medicines the patient may be taking
1. Kidneys condition (BUN, creatinine, creatinine clearance, and urinalysis)
2 .Low blood count or anemia -- full blood count (FBC)
3. Test for brain natriuretic peptide (BNP)
4. Sodium and potassium levels in your blood
What is the classification of Heart Failure?
The most commonly used classification system is called the New York Heart Association Functional Classification.
Patients are classified in one of 4 categories that are dependent on the extent their disorder involves the function of normal physical activities.
The 4 categories are:
Class I
Patients in this category feel no symptoms and can do ordinary physical activities without any restrictions.
They form about 35 percent of patients