Heart Failure
CHF or Heart Failure is defined as the inability of the
heart to maintain adequate circulation to meet the tissues
need for oxygen and nutrients.
There are two types of heart failure: diastolic heart
failure and systolic heart failure.
Diastolic HF Systolic HF
(Alteration in ventricular filling) (Alteration in ventricular contraction)
Assessment Findings:
Assessment Findings:
Jugular vein distention
Dyspnea, orthopnea,
Anorexia, nausea, vomiting
nocturnal dyspnea, tachypnea
Abdominal distention, ascites
Crackles, wheezes, rhonchi,
Hepatomegaly
cough
Liver and spleen enlargement
Hemoptysis
Dependent edema, peripheral
Gallop rhythm: S3, S4
edema
Palpitations, arrhythmias,
Weight gain
disrhythmias, tachycardia
Signs of left-sided heart failure
Fatigue
Tachycardia, fatigue, nocturia
Anxiety
Elevated CVP
Diaphoresis
nocturia
Forthy sputum (blood-tinged)
Anorexia
Left Side HF Right Side HF
Diagnostic Tests:
History and physical examination
BNP (a test to determine an increase in cardiac hormone
production
indicating heart failure)
Chest x-ray will show left ventricular hypertrophy & increase
pulmonary congestion.
ABG, CBC, serum electrolytes (decreased potassium)
ECG
Echocardiogram will show increased
size of cardiac chambers and decreased wall motion.
Hemodynamic monitoring
Pharmacologic Therapy:
Digitalis
myocardial contraction and left ventricular output
increased CO
conduction through the AV node
Caution: check for apical pulses before administration,
watch out for toxicity that can cause dangerous
dysrhymias
Medications:
Digoxin (Lanoxin)
Pharmacologic Therapy cont. :
Calcium Channel Blockers
Interfere with the ability of muscles to contract, leading to
vasodilation & reducing systemic vascular resistance
Medications:
Amlodipine (Norvasc)
Nifedipine (Procardia)
Diltiazem (Cardizem)