Congestive Heart Failure : Etiology, Symptoms, Causes, Types, Treatment And MCQs for NEET, GPAT, CSIR NET JRF

” Heart failure is defined as the pathophysiologic state in which impaired cardiac function is unable to maintain an adequate circulation for the metabolic needs of the tissues of the body.”

A.] Chronic heart failure occurs either because of decreased myocardial capacity to contract or because of an inability to fill the cardiac chambers with blood.

B.] CHF is an end result of various forms of serious heart diseases.

ETIOLOGY :-

Heart failure may be caused by one of the following factors :-

• Intrinsic pump failure : The most common and most important cause of heart failure is the weakening of the ventricular muscles because of the disease that result in, heart stop working as an efficient pump.
• Increased workload on the heart : Increased mechanical load on the heart result in increased myocardial demand resulting in myocardial failure.
• Impaired filling of cardiac chambers : Decreased cardiac output and cardiac failure may result from extra – cardiac cause or defect in filing of the heart.

SYMPTOMS :-

• The hallmark and the most common symptom of left heart failure is the shortness of breath.
• Chest pain or angina may be associated, especially if the underlying cause of the failure is coronary heart disease.
• It may also lead to the accumulation of fluid in the liver causing hepatomegaly.
• Fatigue.
• Weight gain.
• Wheezing.
• Cheat pain that radiates through the upper body.
• Skin that appears blue, which is due to the lack of oxygen in your lungs.

CAUSES :-

The most common cause of congestive hart failure is :-

• Coronary artery disease.
• High blood pressure (hypertension).
• Longstanding alcohol abuse.
• Disorder of the heart valves.
• Viral infection of the stiffing of the heart muscles.
• Thyroid disorders.
• Heart rhythm abnormalities.

Pathogenesis

TYPES OF CONGESTIVE HEART FAILURE :-

1.] Left – sided CHF is the common type of CHF. In this condition filled can build up in lungs, which make breathing difficult.

2.] There are two kind of left – sided heart failure :-

• Systolic heart failure : Occurs when the left ventricle fails to contract normally. This reduces the level of forces available to push blood into the circulation. Without this force, the heart can’t pump properly.
• Diastolic failure : It happens when the muscles in the left ventricle become stiff. Because it can no longer relax, the heart can’t quite fill with blood between beats.

3.] Right – sided CHF occurs when the right ventricle has difficulty pumping blood to your lungs. Blood backs up in your blood vessels, which causes fluid retention in your lower extremities, abdomen and other vital organ.

TREATMENT :-

1.] Common diuretic medication (water pills) include :-

• Furosemide (Lasix).
• Bumetanide (Bumex).
• Hydrochlorothiazide.

2.] ACE (angiotensin converting enzymes) inhibitors.

3.] Beta blockers.

4.] Digoxin (Lanoxin) that may help to increase cardiac output.

5.] A very mild never diuretic, spironolactone, have been shown to be of long -term benefit.

MULTIPLE CHOICE QUESTIONS :-

1.] What is heart failure ?

a. A condition in which the heart stop beating

b. A heart attack

c. A condition in which the heart cannot pump enough body’s need

d. A condition in which a patient experiences chest pain

2.] Which is not one of the three types of heart failure ?

a. Right sided heart failure

b. Left sided heart failure

c. Congestive heart failure

d. Myocardial heart failure

3.] What are the common sign and symptoms of heart failure ?

a. Shortness of breath or trouble breathing

b. Fatigue

c. Swelling

d. All of the above

4.] What are the risk factor of heart failure ?

a. Medical history of heart related disease

b. Weight

c. Age

d. All of the above

5.] How many adults in the U.S. have been diagnosed with heart failure ?

a. 1.3 million

b. 2.4 million

c. 6.5 million

d. 9.6 million

6.] A patient can have heart failure without being aware of it ?

a. True

b. False

7.] Congestive heart failure and heart failure are the same ?

a. True

b. False

8.] What does the ECG show in prizmetals angina ?

a. ST segment elevation

b. ST segment depression

c. Absent P waves

d. Prolonged PR interval

9.] What is the most common cause of right sided heart failure ?

a. Left side heart failure

b. Chronic lung disease

c. Hypothyroidism

d. None of the these

10.] Which is the most common cause of heart failure ?

a. Ischemic heart failure

b. Hypertension

c. Sarcoidosis

d. Aortic stenosis

SOLUTIONS :-

1.] (c) A condition in which the heart cannot pump enough body’s need

2.] (d) Myocardial heart failure

3.] (d)

4.] (d)

5.] (c) 6.5 million

6.] (a)

7.] (b)

8.] (a) ST segment elevation

9.] (a) Left side heart failure

10.] (b) Hypertension

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REFERENCES :-

1.] Textbook Of Pathology By Harsh Mohan; 7th edition; Page no. 399 – 402.

2.] Robbin’s Basic Pathology; 5th edition; Page no. 520 – 523.