Do you know? that many percentage of people has give up the ghost because of heart failure.

    This infirmity occurs often in men than that of women. And it is most common in aged people from 45 above. Human being do interact with his environment and the heart react to these interaction with a dynamic response. Efficient heart functions (contraction) provides vital organ worth needed oxygen and nutrients to carry out their unique functions. When changes occurs in the contractile ability of the heart it attempts to cope with the  disruption by developing mechanism to handle alterations in muscles contractility. When this mechanism fails, cardiac output diminished and heart failure occurs. The underlying mechanism of cardiac failure involves impairment of the  contractile properties of the heart, which leads to a lower than normal cardiac output.
  We shall be discussing about heart failure in this post but on our next post we shall discuss the remedies and good for heart failure.

 Definition of heart failure: it's regarded as a general term that refers to the inability of the cardiovascular system to perform the functions of delivery of nutrients to the removal of waste from the cells.
 Heart failure is not a disease but a syndrome resulting from a variety of pathophysiological disruptions that place increased demands on the heart.
 Type of heart failure. 
This are two; → left ventricular failure.
→ right sided heart failure or congestion cardiac failure.
♣ The left ventricular failure is inability of the left ventricle to pump blood from the left sided aorta of the heart.
♣  the congestive cardiac failure is a condition of stasis of blood in the Venous system due to the ability of the right ventricular to function properly,  or as a result of the failure of the right ventricle to pump blood into the pulmonary artery.

 Cause of left heart failure (LHF)

Coronary artery occultation (myocardial infraction)
Valvular defects
Arrhythmia
Pericarditis
Hypertension
Septicaemia
Anaemia
Pregnancy with underlying heart disease
Rheumatic fever
Obesity
Hyperthyroidism
Transfusion and infusion overloading.
The causes of congestive heart failure is similar to LHF.


Pathophysiology of heart failure. 

The heart beats average 70 times per minute under favorable conditions and a total of 4.9 litters of blood delivered into the systemic circulation in a minute (cardiac out-put).
 Any pathophysiological disruption tends to increase the heart rate but cardiac output is maintained at a rate consistent with body requirements. This is due to certain compensatory mechanism which include dilatation and or hypertrophy or the characteristics enlargement often referred to as cardiomegaly. Initially the dilating process within the cardiac chambers causes the myocardium to stretch thus increasing stroke volume and cardiac output.  However the persistence of the stressor (pathophysiological disruption) over a long period of time causes reduction in the contractile tension of the myocardium and failure in it's ability to provide adequate cardiac output. The resultant effect of this is accumulation (stasis) of blood within the left ventricle and left atrium.

 Back flow occurs through the pulmonary veins unto the lungs resulting  in pulmonary congestion thereby reducing lung vital capacity. Subsequently fluid extravasate into the instertitial space of thje lungs and eventually in the alveloi both of which impairs gaseous exchange resulting in dyspnoea. The fluid serves as an irritant, and the lungs attempt to rid themselves of excess secretions by initiating the cough mechanism with resultant cough.  Decrease cardiac output resulting from hypertrophied myocardium and stasis of blood within the chambers causes diminished circulation to vital organs in the body. Mostly affected are the kidneys, brains, gastrointestinal tract, lungs, muscles, and the heart. Respectively oliguria, sodium, and water retention, mental confusion, anorexia, dyspnoea, cough, pulmonary rales, fatigue, rapid and irregular pulse are manifested. These are the clinical manifestation of left ventricular failure.
  The congestion of the lungs serves as resistant to pulmonary circulation.  In the same sequence as occurred in the left ventricular failure, the right sided of the heart fails. There is resultant stasis of blood within the chambers and consequent back flow of blood onto the the superior and inferior venacavae.
 Ultimately, systemic venous congestion or stasis occurs. There is increased central venous pressure and engorged jugular vein.  Extravasation of fluid from the veins into the interstitial spaces accounts for the independent oedema, and ascites that characterize congestive cardiac failure. The congestion of the haemorrhoidial plexuses predisposes the patient to hemorrhoids.

Clinical manifestation of L.H.F

Orthopnea
Coughing
Dyspnoea on exertion
Fatigue
Mental confusion
Anorexia

Clinical manifestation of congestive cardiac failure. 

Hepatomegally
Aching abdominal pain
Dependent oedema
Ascites (anasarca)
Increased venous pressure

Diagnosis: heart failure are diagnosed in the following mentioned below.
The clinical manifestation are diagnosed
Radiotherapy: chest x-ray reveals cardiomegaly
Blood electrolyte analysis
The central venous pressure (CVP) is elevated
Urinalysis will usually show albuminuria.

Chemotherapy

  The underlying cause of heart failure must be treated accordingly with the appropriate chemotherapy.
 Diuretics: e.g Chlorothiazide 0.5gm-2gm daily.  Diuretics are given to rid the body of its excess fluid and sodium stored in the cells.
 Cardiac glycosides: e.g digoxin 0.5mg start then 0.25mg tds orally.  Digitalis enables the ventricles empty themselves more completely after each systolic contraction. There action is to increase the force of myocardial contraction. Digitalis helps to restore circulation function.
 Electrolyte supplement- potassium chloride is given to prevent the development of hypokalemia a side effect of potassium-depleting diuretics. A liquid potassium supplement maybe order. Since potassium solution can cause gastric irritation, they should be diluted in water or juice before being swallowed.  Always stay healthy... share with your friends and keep them fit.

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