Congestive Heart Failure, Lab Work up

Congestive Heart Failure
Definition of the congestive heart failure
- Heart failure is also called congestive heart failure.
- Congestive heart failure is due to damage to the cardiac muscles.
- In this condition, the heart cannot pump the blood at a rate needed by the body for the metabolism of the tissues.
Pathophysiology of Congestive Heart Failure
- The heart failure may be due to:
- Coronary artery disease (CAD). If the coronary arteries become blocked or severely narrowed, the heart becomes starved of oxygen and nutrients.
- The heart attack damages the heart muscle, resulting in a scarred area that does not function properly.
- Cardiomyopathy. Damage to the heart muscle causes other than artery or blood flow problems, such as infections or alcohol or drug abuse.
- High blood pressure leads to overwork of the heart.
- Other diseases like valvular diseases, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure.
- Heart failure can occur when several diseases or conditions are present at once.
- Coronary artery disease (CAD). If the coronary arteries become blocked or severely narrowed, the heart becomes starved of oxygen and nutrients.
- In many pathologic conditions, the onset of heart failure is preceded by cardiac hypertrophy, which is the compensatory response of the heart.
Clinical presentation of heart failure
- Congestive heart failure is the most common cause of transudative pleural effusion.
- In treated cases, transudate may change into exudate.
- Effusion due to congestive heart failure is more on the right side.
Classification of congestive heart failure:
Heart failure, according to the American College of Cardiology and American heart association, has divided into four stages:
Stage A:
- These patients in stage A are those groups of patients who have the following illness and risk developing heart failure but have no sign or symptom of failure.
- Patients with diabetes.
- With H/O blood pressure.
- Patient with H/O coronary disease.
- Patient with metabolic syndrome.
- Excessive use of alcohol.
- With H/o cardiac toxic drug therapy.
- H/O rheumatic fever.
- Patients with family H/O of cardiomyopathy.
Stage B:
- These patients have heart disease but no symptoms.
- Patients with H/O heart attack.
- Patient with low ejection fraction.
- Valvular diseases without symptoms.
Stage C:
- This group has heart disease and symptoms.
- These patients have shortness of breath.
- Decreased stamina or decreased ability for exercise.
- Easy fatigability.
Stage D:
- This group has advanced heart disease and needs aggressive medical treatment.
- These patients have systolic heart failure and all signs and symptoms of heart failure.
Workup of the patient with heart failure:
- Electrocardiogram (ECG).
- X-Ray chest.
- Blood test for electrolytes, Na. K, Mg.
- Kidney function test.
- Stress test.
- MRI
- Cardiac catheterization or angiography.
Lab findings in heart failure:
Serum | |
Sodium | Normal or decreased |
Potassium | Normal |
Bicarbonate | Normal |
Chloride | Decreased |
Volume | Increased |
Urine | |
Sodium | Decreased |
Potassium | Normal |
pH | Normal |
Volume | Decreased |