HEART FAILURE

1. There are various definitions of heart failure, however. They all centre around the inability of the heart to meet oxygen and nutrient requirements of the body.
2. Heart failure/circulatory failure/pump failure can be defined as "The heart's inability to pump blood, oxygen, and nutrients to the body in proportion to its metabolic needs."
3. It can also be regarded as a general term that refers to the inability of the cardiovascular system to perform the functions of delivery of nutrients to and removal of wastes from the cell.
4. Heart failure is not a disease but a syndrome resulting from a variety of pathophysiological disruptions that place increased demands on the heart.

Types of Heart Failure

There are basically two types of heart failure

• Left ventricular failure
• Right sided heart failure or congestive cardiac failure.

Left Heart Failure: This is the failure of the left ventricle to pump blood from the left side of the heart to the aorta.

Congestive Cardiac Failure: This is a condition of stasis of blood in the venous system due to the inability of the right ventricle to function normally, or as a result of the failure of the right ventricle to pump blood into pulmonary artery.

Causes of Left Heart Failure (LHF)

1. Coronary artery occlusion (myocardial infarction)
2. Valvular defects
3. Arrhythmias
4. Pericarditis
5. Hypertension
6. Septicaemia
7. Anaemia
8. Pregnancy with underlying heart disease
9. Rheumatic fever
10. Pulmonary heart disease secondary to disorders of lungs such as chronic obstructive pulmonary disease.
11. Hyperthyroidism
12. Obesity
13. Transfusion and infusion overloading
14. Prolonged dietary deficiency e.g. Beriberi
15. Paget's disease.
16. Arteriovenous fistulas
17. Environmental emotional stress
18. Syphilitic heart disease

 Causes of congestive Heart Failure

• Congestive cardiac failure often occur as a complication of left ventricular failure
• As for the previously listed causes of LHF, Asthma, emphysema, chronic bronchitis are other possible causes.

Management

The goals of management in congestive heart failure are to minimize, eradicate or prevent those factors which precipitate and or perpetuate the disease process, and strengthen the heart so that it can cope with its burden more effectively, to reduce venous congestion, to decrease sodium and water retention.

Chemotherapy:

The underlying cause of heart failure must be treated accordingly with the appropriate chemotherapy.

However, the following are beneficial in the management of cardiac failure.

1. Diuretics
2. Cardiac glycosides
3. Mild hypnotics 
4. Expectorants 
5. Electrolyte supplement - mixture of potassium chloride
6. Bronchodilators e.g. Aminophylline

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