Heart attack :A congestive heart failure.

Congestive heart failure is a chronic progressive condition that affects the pumping power of the heart muscles.

As a pharmacist, I want to share with you information about a disease Congestive heart failure, which is a fatal one and common in human beings. I want to enlighten you about the seriousness of this disease.

Congestive Heart Failure

“Congestive heart failure is a chronic progressive condition that affects the pumping power of the heart muscles”

Heart has four chambers. The upper part of our heart has two atria and lower half of our heart has two ventricles. The ventricles pump blood to the body’s organs and tissues and the atria receive blood from the body as it circulates back from the rest of the body. Congestive heart failure develops when ventricles cannot pump enough blood volume to the body.

Cause: Congestive heart failure is caused by many conditions that damage the muscles.

• Heart attack: It occurs when a coronary artery suddenly blocked or stopping the flow of blood to the heart muscle. Heart attack damages the heart muscle, resulting in a scarred area that does not function properly.

• Coronary heart disease (CHD): It is a disease of the arteries that supply blood and oxygen to the heart. It decreases the blood flow to the heart muscle .If the arteries become blocked then the heart becomes starved for oxygen and nutrients.

• Cardiomyopathy : It damage to the heart muscle from other than the artery or blood flow problems, such as infections,alcohol,drug abuse.

Symptoms :

• Fatigue.

• Irregular heart beat.

• Chest pain.

• Swelling in the ankle, feet, legs.

• Weight gain.

• Shortness of breath.

Types of Congestive Heart Failure (CHF).

(A) 1.Acute heart failure:

"Symptoms of the acute heart failure appear suddenly and rapid development occurs in the following conditions"

• Larger myocardial infarction.

• Valve rupture.

• Cardiac temponade.

• Massive pulmonary embolism.

• Acute viral myocarditis.

• Acute bacterial toxemia.

2. Chronic heart failure:

"Symptoms are continuous and develops slowly. It conditions are-"

• Myocardial ischemia from atherosclerotic coronary artery disease.

• Multivalvular heart disease.

• Systemic arterial hypertension.

• Chronic lung disease resulting in hypoxia and pulmonary arterial hypertension.

(B) 1.Left sided heart failure:

"It occurs when the ventricle does not pump efficiently. This prevents the body from getting enough blood or oxygen. Its conditions are-"

• Systemic hypertension.

• Stenosis.

• Ischaemic heart disease.

• Myocardial disease.

• Restrictive pericarditis.

2.Right sided heart failure :

"It occurs due to left sided heart failure, when the left ventricle loses power to efficiently pump blood to the rest of the body and the fluid is forced back through the lungs Its conditions are-"

• As a consequence of left ventricular failure.

• Pulmonary or tricuspid valvular disease.

• Pulmonary hypertension secondary to pulmonary thromboembolism.

• Myocardial disease affecting right heart.

(C) 1.Systolic heart failure:

"It occurs when the heart muscle losses its ability. The contractions of the heart are necessary to pump oxygen and blood out to the body."

2. Diastolic heart failure:

"When the heart muscle becomes stiffer than normal. Stiffness due to heart disease means heart does not fill with blood easily."

Pathophysiology of Congestive heart failure :

• Over activity of sympathetic nervous system.

• Over activation of renin angiotensin aldosterone system.

• Down regulation of the nuturetic peptide.

• Over activation of the arganin, vasopressin and antidiuretic.

• Endothelin secreted by the endothelial cells which have a local vasoconstriction effect.

• Over activity of inflammatory cytokines.

• Swelling of odema of the heart, swelling of leg, lack of appetite, etc.

How CHF is diagnosed:

• Electrocardiogram ( EKG or ECG ).

• MRI.

• Echocardiogram.

• Blood test.

• Stress test.

Medication:

"ACE inhibitors"

• Benazepril(Lotensin).

• Captopril(Capoten).

• Enalapril(Vasotec).

• Quinapril(Accupril).

• Trandolapril(Mavik).

"Beta-Blockers"

• Atenolol(Tenormin).

• Acebutolol(Sectral).

• Metaprolol(Lopressor).

• Esmolol(Brevibloc).

• Propanolol(Inderal LA).

"Diuretics"

• Thiazide diuretics – Metolazone(Zaroxolyn),Hydrochlorothiazide(Microzide), Indapamide(Lozol).

• Loop diuretics – Furosemide(Lasix),Ethacrynic acid(Edecrin).

• Potassium-sparing diuretics – Eplerenone(Inspra), Spironolactone(Aldactone).

"This is some of the information about Congestive heart failure (CHF), I want to enlighten you. If you like my above blog, keeping following it with utmost interest and don’t forget to comment if you have some suggestions regarding my future blogs and also hit on some queries if you have any. I will try my level best to clarify them."