CASE STUDY: HEART FAILURE

Case Study: Heart Failure



Case Study: Heart Failure

Alternative Names

CHF; Congestive heart failure; Left-sided heart failure; Right-sided heart failure - Cor pulmonale; Cardiomyopathy - heart failure

Causes

Heart failure is a long-term (chronic) condition, but it can sometimes develop suddenly.

The condition may affect only the right side or only the left side of the heart. These are called right-sided heart failure or left-sided heart failure. More often, both sides of the heart are involved. Heart failure is present when:

Your heart muscle cannot pump (eject) the blood out of the heart very well. This is called systolic heart failure.

Your heart muscles are stiff and do not fill up with blood easily. This is called diastolic heart failure.

Both of these problems mean the heart is no longer able to pump enough oxygen-rich blood out to the rest of your body, especially when you exercise or are active.

As the heart's pumping action is lost, blood may back up in other areas of the body. Fluid builds up in the lungs, liver, gastrointestinal tract, and the arms and legs. This is called congestive heart failure.

The most common cause of heart failure is coronary artery disease(CAD), a narrowing of the small blood vessels that supply blood and oxygen to the heart. For information on this condition and its risk factors.

Heart failure can also occur when an infection weakens the heart muscle. This condition is called cardiomyopathy.

Other heart problems that may cause heart failure are:

Congenital heart disease

Heart attack

Heart valve disease

Some types of abnormal heart rhythms (arrhythmias)

Other diseases that can cause or contribute to heart failure:

Emphysema

Overactive thyroid

Severe anemia

Underactive thyroid

In-Depth Causes »

Symptoms

Symptoms of heart failure often begin slowly. At first, they may only occur when you are very active. Over time, you may notice breathing problems and other symptoms even when you are resting. Heart failure symptoms may also begin suddenly; for example, after a heart attack or other heart problem.

Common symptoms are:

Cough

Fatigue, Weakness, faintness

Loss of appetite

Need to urinate at night

Pulse that feels fast or irregular, or a sensation of feeling the heart beat (palpitations)

Shortness of breath when you are active or after you lie down

Swollen (enlarged) liver or abdomen

Swollen feet and ankles

Waking up from sleep after a couple of hours due to shortness of breath

Weight gain

Exams and Tests

Your health care provider will examine you for signs of heart failure:

Fast or difficult breathing

Irregular or fast heartbeat and abnormal heart sounds

Leg swelling (edema)

Neck veins that stick out (are distended)

Sounds ("crackles") from fluid buildup in your lungs, heard through a stethoscope

Swelling of the liver or abdomen

An echocardiogram (echo) is often the best test to diagnose, learn the cause of, and monitor your heart failure. Your doctor will use it to guide your treatment.

Other imaging tests are:

Cardiac stress tests

Heart catheterization

MRI of the heart

Nuclear heart scans

Lab tests are done to help your doctor:

Check how well your kidneys are working (BUN, creatinine,creatinine clearance, urinalysis)

Look for a low blood count or anemia -- complete blood count (CBC)

Test for brain natriuretic peptide (BNP)

Watch sodium and potassium levels in your blood

References

Emanuel LL, Bonow RO. Care of patients with end-stage heart ...