Identify common symptoms of heart failure. Describe physical findings suggestive of heart failure. Discuss basic drug classes used in treating heart failure. Introduction Heart failure results when, provided adequate venous return, the heart is unable to pump enough blood to meet the oxygen demands of the body. The underlying causes are many and often complex.
Treatment generally is focused on symptomatic relief and management of contributing medical factors.
Evaluation Of the many causative factors for heart failure, chronic hypertension, ischemic heart disease and myocardial infarction are the most common. Other causes or contributing factors include toxic, infectious or inflammatory myocardial diseases, diabetes, thyroid disease, anemia and valvular heart disease. The diagnosis of heart failure should be considered when there is a history of any of these conditions accompanied by fatigue, fluid retention, decreased exercise endurance, orthopnea, paroxysmal nocturnal or exertional dyspnea, nocturia or confusion. Evidence of cardiac enlargement may manifest as lateral displacement or enlargement of the apical point of maximal impulse. If the patient is over the age of 65 or there a cardiac arrhythmia is noted, a TSH should also be obtained.