When The left side of the heart cannot pump blood around the body effectively and this causes the blood pressure to be applied back to the lungs, the blood vessels in the capillaries leak into the alveoli (where gas exchange takes place of oxygen and carbon dioxide) making that process less effective and thus causing symptoms.
Also this pressure causes too much blood (artery) pressure in the lungs and this then can affect the right hand side of the heart, because the right hand side of the heart needs to pump blood to the lungs to remove carbon dioxide. If the heart is pumping against a resistance (in this case high lung blood pressure), the heart has to work harder and this can damage the pump and muscles on the left hand side of the heart.
Classification
The severity of heart failure is classified using the New York Heart Association (NYHA) classification.
This system grades the severity of symptoms and functional capacity of patients with heart failure.
Box 4: New York Heart Association classification
Class I
No limitation of physical activity. Ordinary physical activity does not cause undue breathlessness, fatigue or palpitations
Class II
Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in undue breathlessness, fatigue or palpitations
Class III
Marked limitation of physical activity. Comfortable at rest, but less than ordinary physical activity results in undue breathlessness, fatigue or palpitations
Class IV
Unable to carry on any physical activity without discomfort. Symptoms at rest can be present. If any physical activity is undertaken, discomfort is increased
European Society of Cardiology. Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal 2012;33:1787–847.
Diagnosis test
There are many tests that are conducted diagnosing and during heart failure:
Echocardiography is the primary cardiac imaging technique used for assessing heart failure. It uses ultrasound to evaluate the structure and function of the cardiac chambers, valves and pericardium.
Natriuretic peptides are hormones that are secreted as a result of myocardial (heart muscle) damage or excessive strain on the cardiac chambers.1 B-type natriuretic peptide (BNP) and the N-terminal pro-B-type natriuretic peptide (NT-proBNP) can both be used for diagnostic purposes.
Renal (kidney) function, serum electrolytes, full blood count (anaemia), thyroid function (hypothyroidism and/or hypothyroidism), blood glucose (diabetes), liver function, and fasting lipids (cholesterol) to check for any underlying causes.
Chest X-rays
Measuring oxygen levels especially if breathing is of concern.
Pulmonary function tests ,such as spirometry and peak flow to measure ones lung function.
Urinalysis can used to rule out urinary tract infections and detect abnormal amounts of protein or glucose, which might indicate nephropathy (kidney dysfunction) or diabetes.
Clinical Pharmacist, CP, June 2014, Vol 6, No 5;6(5):DOI:10.1211/PJ.2014.11138783
This condition can lead to:
Ascites
An increased or high level of fluid collection within the peritoneum (the sac that contains the intestines within the abdominal cavity- the outside lining of the organs- this space has peritoneal fluid which helps to reduce friction between the belly and the organs during digestion).
The blood volume is reduced and the kidney then responds and try to retain salt and water in the body, this causes further swelling.
Ascites can also be caused by cancer, heart failure, kidney failure, inflammation of the pancreas (pancreatitis), and tuberculosis affecting the lining of the abdomen.
Symptoms include:
Increased abdominal swelling and belly size
Ankle swelling
Shortness of breath
Feeling full after eating small amounts of food
Appetite loss
Varices
Described as enlarged veins. Blood that is meant for the portal system, is diverted to and gathers in other veins as it makes its way to the heart these include along the oesophagus, stomach, intestines, rectum and/or anus.
This can put pressure on blood vessels and they can rupture and bleed.
Anyone with the above condition and bleeds from any orifice and/or patient’s sputum is pink and frothy must seek urgent medical attention
Dyspnoea (short of breath and/or breathing difficulties)?
Orthopnoea (the sensation of breathlessness in the recumbent position, relieved by sitting or standing)?
Paroxysmal nocturnal dyspnoea (a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position)?
History of oedema (ankle, feet and/or hand swelling or just general swelling)?
Raised jugular venous pressure (bulging jugular vein, on the neck below the chin)?
Third heart sound?
Tachycardia (fast beating of the heart)?
Crepitations (cracking sound in the lungs , when using a stethoscope)?
Non-adherence to treatment hence condition is worsening
Drug interactions or concurrent use of contraindicated medicines (using medication not allowed/or in caution in heart failure i.e. over the counter decongestants, NSAID’s anti-inflammatory painkillers).
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
Please copy and paste any key words from the title: Heart Failure in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).
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