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Adrianne Bazo
Congestive heart failure occurs when there is a malfunction in the pumping action of
either the left ventricle, right ventricle, or both which causes blood to pool in the
pulmonary arteries and/or veins. This pooling causes pulmonary congestion (fluid build
up in the lungs), reduced cardiac output, increased strain on the heart, decreased
efficiency of the heart muscle contraction, reduced stroke volume, increased heart rate,
and hypertrophy; leading to increased risk of cardiac arrest and a decreased blood supply
to the rest of the body. Since blood is the oxygen/nutrient supply to the cells, the effects
Risk factors for developing CHF are disorders that increase cardiac workload and
disorders that disrupt the pumping ability of the heart. Examples of such diseases are,
CAD, cardiomyopathy, acute myocardial infarction, disease of the heart valves, fluid
My patient had triple bypass surgery six years ago, so the cause of her CHF is most likely
The diagnosis of CHF is primarily made from a composite of patient history, physical
exam, laboratory studies, and radiographs. Lab studies that indicate CHF are, low serum
sodium and Hct from hemodilution and inadequate oxygen levels in the arteries from
poor pulmonary perfusion. The effects of CHF cause reduced renal funciton producing
The treatment of CHF is directed on decreasing the effects of the underlying causes.
Pharmaceuticals are used to decrease excess fluid (diuretics), and improve cardiac output
intra-aortic balloon pump, ventricular assist devices, and biventricular pacing. Also a diet
My patient presents with peripheral edema, low SaO2 oxygenation, rales heard in the
lower 2/3 of the posterior lungs, shortness of breath, low Hct (30.5), high total carbon
dioxide, high Lactate dehydrogenase (778), and high natriuretic peptide (823). Lactate
dehydrogenase and natriuretic peptide are indicators of tissue damage and degree of heart
failure. My patient’s clinical presentation of heart failure, both pulmonary and systemic
effects, indicates that her CHF is from both right and left ventricle malfunction. She is