Congestive cardiac failure or CCF- Left and Right heart failure

Congestive cardiac failure is also known as heart failure. it is a very well known disease in the United States in which about 5 million are the sufferer. And approximately 1 million people are hospitalized. 

 

Here the congestive cardiac failure really means that the heart isn’t able to pump the blood to supply all over the body. Specifically, the cardiac muscles are not able to do their work. But, somehow the scenario is quite interesting as it is related to different origins.

 The causes may be due to left and right heart failure. And it is also related to the systolic and diastolic failure. Whatever they may be. At last, all are interrelated.

 

What are the common failures related to congestive cardiac failure?

The common failures that give rise to heart failure are

  1. Forward failure
  2. Backward failure
  3. Systolic heart failure
  4. Diastolic dysfunction
  5. Left heart failure
  6. Right heart failure

 

What is the role of forwarding failure in Congestive cardiac failure?

 

In forward failure, the heart doesn’t pump enough blood for the body. And also the blood doesn’t reach different parts. That’s why the insufficient blood failed to meet the demand of the organ system and viscera.

 

What do you mean by backward failure?

 

The backward failure causes the backward pooling of the blood. In this the heart doesn’t pump enough blood and pooling occurs in veins. It can cause congestion in the heart.

 

How does systolic dysfunction cause heart failure?

 

It is also called left ventricular heart failure. The systolic dysfunction takes place when the ventricle contracts, but doesn’t eject the right amount of blood volume, it should eject out.

 

Here the disturbance is mostly seen due to ischemic heart disease or in the dilated heart. Here the EDV(End diastolic volume) and ESV(End systolic volume) become altered. Both EDV and ESV are increasing. So, more and more blood is present inside the left ventricle after the systole. The cardiac output also gets less along with the stroke volume.

 

How is diastolic dysfunction related to CCF?

 

The diastolic dysfunction causes many more complications in congestive cardiac failure. In this, the heart becomes thick( hypertrophy).so, the EDV(End diastolic volume) and ESV( End systolic volume) become decreased. Also, the cardiac output and stroke volume get less.

 

The physiology of left heart failure

Systolic heart failure, diastolic dysfunction, myocardial infarction, dysfunction of the papillary muscles, fibrous of the heart, and dilated cardiomyopathy are responsible for left heart failure. In this problem, blood pooling occurs in the lungs. This is due to the backflow of the blood through the pulmonary vein to the lungs.

 

What is the pathophysiology behind left heart failure?

 

  1. Due to systolic dysfunction, blood pooling occurs. so that the blood reserves in the left ventricle of the heart. 
  2. Gradually, the pooling form in the left atrium. That blood then moves back into the pulmonary vein. In that the capillaries are present.
  3. Accumulation of fluid in the veins and capillaries leads to an increase in blood pressure and hydrostatic pressure.
  4. After that, the fluid leaks in the capillaries and goes to the alveoli where interstitial cells are present.
  5. From the interstitial cells, the fluid goes to the respiratory membranes and causes shortness of breath in the patient having congestive cardiac failure.

 

Is that the rusty sputum a sign of left heart failure?

 

In left heart failure, there is the formation of alveolar edema. So, when the patient coughs, the erythrocytes come out from the capillaries. It occurs due to the extra pressure on the pulmonary artery. Then the macrophages(WBC) and RBC  form hemocyanin. And cause rust-colored sputum in congestive cardiac failure.

 

How does left heart failure cause right heart failure?

 

  • The right heart failure takes place due to the left heart failure.
  • In left heart failure, the lungs become edematous. It can give pressure to the pulmonary artery. 
  • Then blood on the pulmonary artery keeps pressuring the right ventricle.
  • This is how the right heart failure takes place due to the left heart failure.

 

What are the clinical manifestations of congestive cardiac failure?

The clinical features are like

  • Cyanosis
  • Decreased cardiac output
  • Clubbing fingers
  •  Orthopnea
  • Perihyler congestion
  • dyspnea

In congestive cardiac failure, when the patient sleeps feels like dyspnea, why?

In congestive cardiac failure, when the patient lies down, the venous return increases. It can cause more pumping of the heart. But, due to the left heart failure, pulmonary embolism takes place. So, this is the reason behind orthopnea in heart failure.

 

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