Cardiac Failure

Cardiac Failure (CF) Congestive Heart Failure (CHF) The HEART

Cannot maintain an adequate cardiac output Cannot pump enough blood to supply

the bodys needs leading to: Reduced blood flow Back-up of blood in the veins and lungs Becomes weak, or stiff Cardiac failure Is Not a heart attack . The heart has not: stopped working about to stop working

What is really happening? Not enough blood circulates Fluid builds up, creating congestion

Statistics of heart failure Very common but under recognized No 1 cause of death in the Philippines (2010)

Classification of HF 1. Acute heart failure occurs suddenly

2. Chronic heart failure develops over time, however: a client with chronic HF can develop an acute episode Causes of heart failure 1. Coronary artery disease 2. Heart attack 3. High blood pressure 4. Heart valves disorder 5. Inflammation of heart muscle Causes of heart failure 1. Severe lung disease 2. Severe anemia 3. Overactive thyroid gland 4. Underactive thyroid gland 5. Abnormal heart rhythms Atrial fibrillation Myocarditis Cardiomyopathy

6. Kidney failure Types of HF 1. Right ventricular failure Left ventricular failure 1. Forward failure, Backward failure 1. Low output, High output 1. Systolic failure,

Diastolic failure Symptoms of HF Think FACES Classifications of HF Diagnostic Examination Treatment No cure Early diagnosis and proper treatment can: Slow the progression of disease Treatment 1. Help control symptoms: Diuretics often called water pills decrease fluid retention and reduce swelling Frequent Urination Keep fluid from collecting in the body Treatment 1. Help control symptoms: Echocardiogram (echo) Electrocardiogram Chest X-Ray Fatigue Activities Limited Chest congestion Edema or Ankle Swelling Shortness of Breath

Digoxin improves blood circulation Increases the strength of the

heart muscle contractions Slows the heartbeat Treatment 2. Can slow disease progression ACE Inhibitors dilate or widen blood vessels, increase blood flow A vasodilator Treatment 2. Can slow disease progression ARBs Angiotensin II receptor blockers Same benefits as ACE Inhibitors Treatment 2. Can slow disease progression ACE Inhibitors dilate or widen blood vessels, increase blood flow Beta Blockers help strengthen the hearts pumping ability, block the bodys response to substances which can damage the heart Treatment 3. Surgery and Medical Devices Coronary Bypass Surgery A vein in the clients leg, arm, or chest replaces the blocked vein in the heart Heart valve repair or replacement Treatment ACE angiotensin converting enzyme

3. Surgery and Medical Devices Implantable Cardioverter - Defibrillators (ICDs) Implanted under the skin Attached through the veins in the chest to the heart with small wires Monitor the heart rhythm Shocks the rhythm back to normal: In events of dangerous rhythm If the heart stops Treatment 3. Surgery and Medical Devices Cardiac Resynchronization Therapy (CRT) or Biventricular Pacing Sends timed electrical impulses to both of the hearts lower chambers Pump in a more efficient, coordinated manner Combined with an ICD for patients with HF Treatment 3. Surgery and Medical Devices Heart Pumps Also termed as left ventricular assist devices (LVADs) Implanted into the abdomen or chest , and attached to the weakened heart to help it pump Sometimes used as an alternative to transplantation. Temporarily used on patients for heart transplant Treatment 3. Surgery and Medical Devices Heart Transplant

 For clients with severe heart failure that surgery or medications cannot help. Nursing Management 1. Maintain in high fowlers position 2. Elevate extremities except when the patient is in acute distress 3. Monitor vital signs 4. Change position frequently 5. Monitor: Intake & output Daily weight

6. Restrict fluids as ordered 7. Teach patient and family about lifestyle change and provide emotional support 8. Explain the side effects of medications being taken 9. Observe aseptic technique when caring for invasive lines 10. Meticulous skin care 11. Measure abdominal girth 12. Monitor V/S, I & O, breathsounds 13. Institute bloodless phlebotomy