Congestive Heart Failure

Course overview

Objectives Explain the pathophysiology of CHF and current treatment options Describe the common cardiovascular disorders affecting the elderly Content Information Covered Past medical history Coronary artery disease Atherosclerotic heart disease Abnormal lipid metabolism or excessive intake of saturated fats and cholesterol Subendothelial accumulation of fatty streaks Altered endothelial function Disruption of endothelium Formation of mature fibrous plaque Resultant diseases angina previous MI hypertension congestive heart failure Related terminology Preload Afterload Congestive heart failure Left to right shunt Coarctation of the aorta CoA Atrial septal defect ASD Ventricular septal defect VSD Patent ductus arteriosus PDA Truncus arteriosus Congestive heart failure Congestive heart failure Myocarditis Cardiomyopathy Congenital heart disease as underlying cause Management Congestive heart failure and congenital heart disease Oxygen caution with ductal dependent systemic flow due to pulmonary steal Use of prostaglandin for ductal dependent cardiac lesions Use of furosemide diuretic for fluid overload Cautious use of IV fluids if cardiogenic shock is suspected Specific conditions that occur more frequently in the elderly Myocardial infarction Patient will usually have atypical chest pain or no pain May present with only dyspnea acute confusion delirium syncope weakness or nausea and vomiting Congestive heart failure A frequent condition in the elderly May present with dyspnea orthopnea or mental status alteration Peripheral edema is frequently present in elderly patients with or without failure and may signify a variety of conditions Fluid balance is sometimes difficult to achieve Biliary disease disorders of the liver and gallbladder Evaluation of pathophysiology through history possible risk factors and current medications Liver disease Congestive heart failure Gallstones Cholecystitis Medications that cause adverse effects on the liver