Congestive heart failure (CHF) is a clinical syndrome in which the pumping action of the heart becomes less powerful and fluid builds up forcing it into the lungs causing pulmonary edema or causing edema in the peripheral vascular system. CHF is used interchangeably with Heart failure (HF). HF is characterized by myocardial dysfunction, which is an alteration in ventricular contraction. Myocardial dysfunction can be caused by a result of many different conditions such as coronary artery disease, hypertension, cardiomyopathy, valvular disorders, renal dysfunction, ischemia and myocardial infarction. It can be systolic heart failure in which the heart muscles are weakened and results in decreased blood ejected from the ventricle, …show more content…
The sympathetic nervous system tries to compensate for the decreased blood flow by increasing heart rate and contractility by releasing epinephrine and norepinephrine; also causing vasoconstriction. The kidneys are highly sensitive to a drop in blood flow and are stimulated by vasoconstriction and a decreased level of carbon dioxide which activates the renin-angiotensin system to increases blood pressure and afterload. Angiotensin II stimulates the adrenal cortex to start secreting aldosterone to retain sodium and water to increase blood volume (Hinkle and Cheever, 2015). All of these mechanisms puts the body in to fluid overload causing stress on ventricular …show more content…
Assessment of ventricular function by an echocardiogram is essential in diagnosing CHF. It is used to identify any structural abnormalities and assessment of the ejection factor to determine what type of HF: a normal ejection factor is in-between 55% to 65% of ventricular volume. A chest x-ray and a 12-lead electrocardiogram will be needed to assess any fluid in the lungs and the condition and rhythm of the heart (Hinkle and Cheever, 2015).
Important lab work includes; BUN, creatinine, liver function tests, thyroid stimulating hormone, complete blood count, urinalysis, and BNP. High levels of BNP indicate high cardiac filling pressure which if the key factor in diagnosing HF. Physicians may also want patients to cardiac stress testing or cardiac catheterization to determine if the cause is related to coronary artery disease or cardiac ischemia (Hinkle and Cheever,