Congestive Heart Failure Signs & Symptoms (& Why They Occur)

In this system we are talking about the

signs

and

symptoms

of

congestive

heart

failure

before we talk about those

signs

and

symptoms

, let's talk about what

congestive

heart

failure

is so that we can better understand why the signs and symptoms

occur

, so congestive heart failure Congestive heart disease is a condition. which involves an inability of the heart to pump blood effectively, generally speaking, is due to damage to the heart muscle, which is also known as the myocardium. You can imagine that if there is damage to the heart muscle, it will not be able to contract and pump blood effectively, so it will not be able to push blood to the places it is supposed to go.

Now there are a variety of risk factors for getting congestive heart failure, we'll talk about them here very quickly, but if you want to learn more. See my full lesson on congestive heart failure, as some of the risk factors for congestive heart failure include coronary artery disease, previous myocardial infarction, which is a heart attack, diabetes, valvular heart disease, alcoholism, etc. that often this will be chronic excessive alcohol consumption, hypertension, which is high blood pressure, so often there will again be a chronic history of high blood pressure and then breathing disorders during sleep, so conditions such as sleep apnea, to understand the signs and symptoms of congestive heart failure, we actually break down the heart into the right side. heart in the left heart, so we'll talk quickly about the anatomy of the heart here, so in the right heart, if we look directly at the patient, this is the right side and this is the left side, so the right side of the heart will bring blood from the rest of the body, it will be deoxygenated blood from the superior vena cava to the inferior vena cava into the right atrium, which will not carry that blood to the right ventricle and the right ventricle is will contract and push blood through the pulmonary valve into the pulmonary arteries, these are actually called arteries although

they

still carry deoxygenated blood and that blood will go to the lungs and then become oxygenated and then return to the left heart through four pulmonary arteries. veins into the left atrium, the left atrium will then bring blood to the left ventricle and then that left ventricle will contract and push that blood through the aortic valve into the aorta and supply the rest of the body with oxygenated blood to know that Anatomy, if we said that there is right heart failure, so the right side of the heart does not contract properly, for example, there may be some damage.

The myocardium on the right side of the herd blood continually returns to the right. atrium in the right ventricle, but if it is not pushed through the pulmonary valve into the pulmonary arteries, it begins to retreat into the inferior superior vena cava and into other parts of the venous system on the other side, if it is left heart failure, that means that blood is coming from those pulmonary veins and if that left side of the heart is not pumping blood effectively, what that means is that blood is continuing to come in but it is not being pushed through the aortic valve into the aorta to supply the rest. of the body so that the blood really starts to return to those pulmonary veins and eventually to the lungs and that's why we're going to look at the signs and symptoms that we're going to talk about in this lesson, so if it's positive Heart failure, the body will show signs and symptoms, whereas if it is left-sided heart failure, what that means is that blood will build up in the pulmonary veins and in the lungs, so it will mainly be lung involvement.

If there is now left-sided heart failure, even if you divide it into right-sided heart failure and left-sided heart failure, often patients will have both sides of the heart affected, so because of the two effects that we talk about here, We will have a variety of signs, symptoms and clinical findings that

occur

in congestive heart failure. I want to talk about them and why

they

occur as we go through this lesson, so first we're going to talk about left-sided heart failure, so... Lateral heart failure will have three very characteristic and distinctive findings that are often mentioned and discussed in clinical practice, so these will include exertional dyspnea, so dyspnea is simply shortness of breath and effort will be made during such short physical activity. your breath with exertion or activity and will be compared to baseline, so it will be compared to what it was before congestive heart failure.

A classic example is if they have trouble breathing when walking up a flight of stairs when they used to do so. I don't have this problem and it can start with dyspnea on exertion, but it can progress and worsen to the point where there is dyspnea at rest or shortness of breath at rest. Another classic finding of left heart failure is orthomnia, so orthopnea will disappear. There will be difficulty breathing when lying down. This will be the key. Lying down will be the problem and what you will often notice is that the patient will need to shoot up multiple pillows to catch their breath so if you have multiple pillows they push the patient up at an angle and the reason this is important is because if the patient is lying down there will be fluid in the lungs due to the backflow of blood into the lungs, so the backflow of blood into the lungs due to that left-sided heart failure will cause pulmonary edema, so there will be fluid that will begin to move back into some of the other structures of the lungs, and if you're lying down, gravity will flatten out.

That fluid covers most of the lung surface and, in the case of using multiple pillows, the patient's head is raised at an angle and gravity will bring that fluid down where there is another surface of the lungs that is not affected, so This is why the use of multiple pillows is helpful for these patients. Another important clinical finding with left heart failure is something called proximal nocturnal dyspnea or pnd and this is where the patient wakes up in the middle of the night gasping for air then they are sleeping and suddenly they wake up and are short of breath, they can't catch their breath. breath in a classic story for a patient with proximal nocturnal dysmia would be that they wake up suddenly in the middle of the night, gasp for air and run to a window and open it to breathe or catch their breath.

Some other signs and symptoms of left-sided heart failure include coughing, so coughing will occur in addition to shortness of breath. and often it will be persistent and productive so they may cough up a little bit of mucus and this is due to pulmonary edema like all of these findings that we see with left sided heart failure and then some other pulmonary findings that we can find include crackles. on auscultation, so if you were to auscultate or use your stethoscope and check the areas of the lungs, you will hear crackling noises and that is due to pulmonary edema from all that fluid built up from the buildup of blood that is not being pumped effectively from the side. left side of the heart, so those are some of the pulmonary findings that we will see with left sided heart failure.

Now let's talk about right-sided heart failure, so right-sided heart failure again. The right side of the heart does not pump blood effectively and this will cause a backflow of deoxygenated blood into the superior and inferior vena cava and other parts of the venous system. This will cause peripheral edema, so peripheral edema is It will look like this, swelling of the extremities and again this will occur with the right heart failure cited and another important finding with right heart failure is the distension of the jugular veins and this is what which we call jvp or jugular venous pressure.

This is where again the jugular veins fill with blood and this is actually a very important clinical measure, so there are methods where you get the patient to sit at a certain angle, when they sit at a higher angle , we see a reduction in the jvp if you sit at a lower angle, you see an elevation in the jvp and then you can use other clinical assessments like the hepatojugular reflex to see whether or not the jvp increases and how quickly it actually decreases to where it should be again. very important clinical findings regarding right sided heart failure and then some difficult findings that we can see include tachycardia, so the tachycardia will be an increase in heart rate and we can see what we call an S3 gallop, some other findings with with respect to the right side.

Unilateral heart failure includes hepatomegaly, so hepatomegaly will be an enlarged liver and the reason we can see a large liver is because there is a backup of blood back into the inferior vena cava and ultimately into the hepatic veins and other liver vessels and that can actually lead to inflammation of the liver and in some cases if left for a long enough period of time it can lead to liver damage and ultimately lead to liver failure and then we can also see ascites, so cities It will be a swollen abdomen. It will look like this, so it will be full of liquid.

It will be peritoneal fluid. This is due to an increase in pressure within the liver vessels that causes fluid to exude into the abdomen. cavity, this is why we can see ascites and ascites can also occur if there is also liver failure and then some other findings that we can see with congestive heart failure that can occur in both left and right heart failure include fatigue , so Excessive fatigue and feeling tired will be common symptoms of congestive heart failure, so you can imagine that if blood does not pump effectively to the brain and other parts of the body, you will not feel like you have much energy, so that your energy levels are going to be quite low and then we can also see cognitive deficits, so cognitive deficits can include memory problems, confusion, anxiety, sleep disturbances and this again is due to a reduction in blood supply to the brain and other parts of the central system. nervous system and then we can also see chest pain so chest pain can be pain or pressure and this chest pain can be secondary to underlying coronary artery disease or problems with hypertension due to that ineffective pumping of blood, which will lead to problems. with blood passing through the aortic valve into the coronary arteries of the heart and/or hypoxia, which would also be due to the same mechanism, if we don't pump enough blood through the heart, we're not going to get enough blood to the heart. coronary vessels and that will cause some anginal pain in the chest, so if you want to learn more about congestive heart failure, check out my full lesson on this topic and if you haven't already, like and subscribe for more lessons like this, thank you.

Much to see and I hope to see you next time.