Clinical features: It is a state in which an abnormality of cardiac function is responsible for the failure of the heart to pump sufficient blood to meet tissue requirement.
Dyspnoea, orthopnea, paroxysmal nocturnal dyspnea, basal crepitation, congestive hepatomegaly and peripheral oedema. The principles of therapy are removal of the precipitating cause, e.g. pneumonia, correction of the underlying cause e.g. hypertension and control of the congestive heart failure state.
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NOTE
• constrictive pericarditis, liver and renal failure should be excluded before the diagnosis of cardiac failure is made.
• precipitating factors should be sought and treated e.g.:
• hypertension
• infections (especially Subacute bacterial endocarditis) arrhythmias
• electrolyte imbalance
• anaemia
• drug overdose especially digoxin
• pulmonary embolism
• thyrotoxicosis
• Daily weights and fluid balance (intake/output) should be recorded as a simple mea sure of response to treatment. Weight loss should not exceed 1 kg per day.
• Restrict salt in diet
• Encourage bed rest
• Check BP daily
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