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Heart failure Causes Symptoms and Signs

Heart failure Causes Symptoms and Signs

August 9, 2016 @ 12:04 pm
by Heart News 247

Now what makes the heart fail then, well the heart is a pump and if
the pump wears out then that would be the cause of congestive cardiac failure and the common cause is the disease of the heart muscle, the engine goes and the most important cause of muscle disease is the disease of the coronary arteries, the coronary arteries become occluded the muscle becomes fibrotic and with time it fails, Second cause not nearly as common as it use to be 20/30years ago is that patient has something wrong with the valve of the heart, either thevalves become narrow stenotic or they become incompetent, so valvular disease of any cause puts an added strain on the heart muscle which has to work much harder and that also is a cause of heart failure, and third important cause perhaps should have said I am talking about the left heart her is that the Blood pressure is unduly raised patient has hypertension and off course the left ventricle has to work against a greater resistance and therefore not surprisingly hypertension is a cause of heart failure,

Heart Failure Causes Symptoms And Signs

Right herat failure occur on its own comparatively rare compared to the left and we have chronic lung disease, sometimes disease of chest wall and an important thing which we will come back and talk about is pulmonary emboli an infart.

Heart Failure Causes Symptoms And Signs

Before I leave the causes I ought to explain this one there is a condition called cardiomyopathy, is another name for muscle disease….

Heart Failure Causes Symptoms And Signs

Let's ttalk about symptoms, a posh word for shortness of breath is
dyspnoea difficulty with breathing so we talk about dyspnoea as being the principal symptom of heart failure and from what I have said you realise probably most common when the left heart fails
Edema is another feature that is tissue fluid, fluid around the cells
in various tissues and this usually occurs in the dependant parts and
body cavities when you are walking about that means around your ankles when you are lying in bed that means in your lumbar sacral region so you must not expect patients lying in bed to show much ankle edema because they are likely to have this in their dependant parts and the most dependant part in bed is the lumbar sacral region.Fluid can also occur in the body cavities so that the chest can fill up a pleural effusion fluid in the pleural cavities outside the lungs
but next to the chest wall that can occur in heart failure, the abdomen can swell because of the retained fluid ascites and sometimes very rarely fluid retained in the pericardial cavities

Heart Failure Causes Symptoms And Signs

So the major symptoms we see with patient with congestive HF they
complain of shortness of breath swelling of the ankles and perhaps
there may be fluid in the body cavities

Heart Failure Causes Symptoms And Signs

Say word or two about symptoms this shortness of breath it comes on when patients do something, obviously so we call that effort dyspnoea so heart failure would be an important cause of effort dyspnoea patients may be only able to walk 5 to 10 yards not to be able to manage the stairs not be able to go out etc and we grade it and give them various tasks can you do sos and so and so and so and we grade it grade 1 to 4 so when next see the patient whether they have made progress or. whether they are more dyspnoeic.

Heart Failure Causes Symptoms And Signs

Other thing that happens when patients have Left heart failure is PND means attacks of shortness of breath not when walking or running up the stairs but at rest in bed so that it wakes them of their slumber they wake up gasping for breath and we call it PND paroxysmal because is an attack nocturnal because is at night time and dyspnoea because that is what it is , is sometimes called CARDIAC ASTHMA sometimes so you expect patients with HF to have shortness of breath on exertion but more than that patients may tell you that they walk up at night having gone to bed quite ordinarily perhaps little bit short breath taking their clothes off but wake up at night desperately short of breath and there are various reasons for that I need not bother you about …….

One other important thing patients may complain off if they have heart failure simply because the liver is congested swollen tense stretched its capsule and patients may complain of right sided abdominal pain.

NOW what would we see with patients with heart failure, almost
certainly you see patient who is short of breath for the reasons we
have just said,, you might see that the mucus membrane is blue that
there is central cyanosis,,..

What else would you notice well if you look in the neck the most
important physical sign of Congestive HF is that there's Jugular
venous congestion and you can often see J Veins congested in the neck and if you can not see it you can certainly see its upper limit
because is pulsating so we look for JVenous congestion and raised J
Venous pressure and that is most important….,,

Heart failure Causes Symptoms and Signs

Now what makes the heart fail then, well the heart is a pump and if
the pump wears out then that would be the cause of congestive cardiac failure and the common cause is the disease of the heart muscle, the engine goes and the most important cause of muscle disease is the disease of the coronary arteries, the coronary arteries become occluded the muscle becomes fibrotic and with time it fails, Second cause not nearly as common as it use to be 20/30years ago is that patient has something wrong with the valve of the heart, either thevalves become narrow stenotic or they become incompetent, so valvular disease of any cause puts an added strain on the heart muscle which has to work much harder and that also is a cause of heart failure, and third important cause perhaps should have said I am talking about the left heart her is that the Blood pressure is unduly raised patient has hypertension and off course the left ventricle has to work against a greater resistance and therefore not surprisingly hypertension is a cause of heart failure,

Right herat failure occur on its own comparatively rare compared to the left and we have chronic lung disease, sometimes disease of chest wall and an important thing which we will come back and talk about is pulmonary emboli an infart.

Before I leave the causes I ought to explain this one there is a condition called cardiomyopathy, is another name for muscle disease....

Let's ttalk about symptoms, a posh word for shortness of breath is
dyspnoea difficulty with breathing so we talk about dyspnoea as being the principal symptom of heart failure and from what I have said you realise probably most common when the left heart fails
Edema is another feature that is tissue fluid, fluid around the cells
in various tissues and this usually occurs in the dependant parts and
body cavities when you are walking about that means around your ankles when you are lying in bed that means in your lumbar sacral region so you must not expect patients lying in bed to show much ankle edema because they are likely to have this in their dependant parts and the most dependant part in bed is the lumbar sacral region.Fluid can also occur in the body cavities so that the chest can fill up a pleural effusion fluid in the pleural cavities outside the lungs
but next to the chest wall that can occur in heart failure, the abdomen can swell because of the retained fluid ascites and sometimes very rarely fluid retained in the pericardial cavities

So the major symptoms we see with patient with congestive HF they
complain of shortness of breath swelling of the ankles and perhaps
there may be fluid in the body cavities

Say word or two about symptoms this shortness of breath it comes on when patients do something, obviously so we call that effort dyspnoea so heart failure would be an important cause of effort dyspnoea patients may be only able to walk 5 to 10 yards not to be able to manage the stairs not be able to go out etc and we grade it and give them various tasks can you do sos and so and so and so and we grade it grade 1 to 4 so when next see the patient whether they have made progress or. whether they are more dyspnoeic.

Other thing that happens when patients have Left heart failure is PND means attacks of shortness of breath not when walking or running up the stairs but at rest in bed so that it wakes them of their slumber they wake up gasping for breath and we call it PND paroxysmal because is an attack nocturnal because is at night time and dyspnoea because that is what it is , is sometimes called CARDIAC ASTHMA sometimes so you expect patients with HF to have shortness of breath on exertion but more than that patients may tell you that they walk up at night having gone to bed quite ordinarily perhaps little bit short breath taking their clothes off but wake up at night desperately short of breath and there are various reasons for that I need not bother you about .......

One other important thing patients may complain off if they have heart failure simply because the liver is congested swollen tense stretched its capsule and patients may complain of right sided abdominal pain.


NOW what would we see with patients with heart failure, almost
certainly you see patient who is short of breath for the reasons we
have just said,, you might see that the mucus membrane is blue that
there is central cyanosis,,..

What else would you notice well if you look in the neck the most
important physical sign of Congestive HF is that there's Jugular
venous congestion and you can often see J Veins congested in the neck and if you can not see it you can certainly see its upper limit
because is pulsating so we look for JVenous congestion and raised J
Venous pressure and that is most important....,,

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Comments

  • James Kamonga
    October 17, 2015

    you are really good at explain things… your sense of humour really makes
    things easy for us to remember . if you where my internal medicine lecturer
    in med school of sure I will get distinctions all the time. keep up the
    good work Mr. Amir, and please make more videos on different systems
    for the world’s medical students easy understanding.:-)

    • Amir Moughadam
      November 24, 2015

      +James Kamonga dear james sorry for the late reply BUT thank you

  • Shafaaq Ahmed
    November 23, 2015

    can someone die suddenly of left ventricular heart disease with no build
    up?

    • Shafaaq Ahmed
      November 24, 2015

      +Amir Moughadam …thanks for your response. .. my brother died suddenly in
      a restaurant and they have said it was related to heart disease. A blood
      sample was never taken either during a post modem. .my family are in bits
      as there was no indication he was ill. He had mental issues and a diebitic
      and over weight. No one is helping us to understand why this happened as he
      was in regular contact with the gp.

    • Amir Moughadam
      November 24, 2015

      +Shafaaq Ahmed
      I am sorry for loss of your good brother
      My name is amir I am not a doctor or a cardiologist but a little dentist I
      have passion for education and heart failure hence the various videos I
      have made.

      If you are overweight and have diabetes you are definitely prone to heart
      disease, that is your brother GP would have taken regular blood pressure
      and felt the pulse but they would not have indicated that the was a heart
      attack waiting to occur. The blood vessels around the heart were under a
      strain and eventually give way and burst.

      I am on your side not your brother GP but your brother could have gone to
      his GP that same morning and got clean bill health.

      Sometimes my lord calls his favourite loved ones early and that’s what
      happened to your brother.

      Once again sorry for your loss he was obviously lovely son and a brother

    • Shafaaq Ahmed
      November 24, 2015

      +Amir Moughadam Thank you for your response. Things don’t add up. Why was
      he never taken to hospital only straight to the mortuary. A blood sample
      was never taken during postmodern. Police never invetgatwd his whereabouts.
      Restaurant failed to supply us with cctv footage. Monney was missing from
      him. No marks on him though. He’s cigarettes was missing he smoked 50 a
      day. No receipts on him for a whole days activity and he had tale out £500
      pound from the bank and cash machine. Now he is buried I feel we should
      have done a inquest. But the mortuary said we have no doubt it was a
      natural death.

    • Amir Moughadam
      November 24, 2015

      +Shafaaq Ahmed
      If you feel you are being short changed then firstly ask your brother next
      of kin to write to his GP asking for copy of all his medical records then
      write to the hospital for the same then write to the restaurant asking them
      to please keep the tape in a safe place as it may be subject to legal
      enquiries then write to the police and ask for a report of the events upon
      them attending your brother at the restaurant.
      Medical notes are protected by an ACT of parliament everything recorded is
      now your property to obtain copy providing you pay for the copies

      Hope is useful

    • Shafaaq Ahmed
      November 24, 2015

      +Amir Moughadam – police have said because the motuary said it’s natural we
      will not investigate. A have put in a compliant and awaiting a reponse.
      .restaurant delayed it so long that they have said they did not know the
      code on the cctv and when they do find it the information has now gone. ..I
      have the medical records and they have said there was nothing we could have
      done if the patient never complained about any pains etc it’s down to the
      patient to advise on how they feel because he never we never acted. I lm
      forced to accept all this nonsense. I appreciate your time.I hope in find
      out what happened as I feel 5 here is blame in the circunstances.Thank you

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