Chronic Heart Failure Overview:
Chronic heart failure is a progressive disease affecting the hearts ability to pump blood to the rest of the body. The issue can arise from either systolic or diastolic dysfunctions, and may even occur together. With either case, the stroke volume of the heart is reduced, as well as cardiac reserve.
Although the end result is virtually the same, there are some differences depending on which part of the heart is affected.
+ Systolic Dysfunction
Involves inadequate ventricular contraction. This results in reduced ejection fraction. This condition can affect either the left ventricle or the right ventricle. Left ventricular failure almost always leads to right ventricular failure eventually.
- Myocardial infarction
- Dilated Cardiomyopathy
Signs & Symptoms:
Left Ventricular Failure
- Pulmonary oedema
Right Ventricular Failure:
- Peripheral oedema
- Liver dysfunction
+ Diastolic Dysfunction
Involves impaired ventricular filling. The ejection fraction will remain close to normal with this condition.
- Valvular Disease
- Prolonged Hypertension
- Hypertrophic Cardiomyopathy
Shortness of Breath
Oedema Around The Abdomen
Loss of Appetite
Functional Classification System
From The New York Heart Association
|Class 1||Patients have cardiac disease but without the resulting limitations of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnoea or anginal pain.|
|Class 2||Patients have cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnoea or anginal pain.|
|Class 3||Patients have cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation, dyspnoea or anginal pain.|
|Class 4||Patients have cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.|
- Serum creatinine - high levels may indicate kidney dysfunction is the cause for high blood pressure and fluid buildup rather than heart.
- Blood Urea Nitrogen (BUN) - indicates kidney damage, which may be due to severe heart failure, or a biproduct of ACE inhibitors.
- Brain Natriuretic Peptide (BNP) - BNP is made in the heart and should only be present in small amounts. HIgh concentrations are a good indication of heart failure.
- Serum albumin - if decreased, it could indicate that an intestinal disorder (hypoalbuminemia), a liver problem, or kidney disease is the cause of fluid buildup rather than heart function.
- Thyroid tests - if hypo or hyper thyroid and cardiac arrhytmia, this may be the cause.
- Reverse T3
- Urine analysis - protein or blood in urine may indicate kidney disorder
- Blood Glucose - High levels of glucose in the blood may indicate diabetes.
- Liver funciton testing - heart failure may lead to fluid buildup in the liver.
- Total cholesterol
- Electrolytes - esp if taking diuretics which can deplete Na, K, or Mg levels. ACE inhibitors may cause high K.
- Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) - tests how long it takes the blood to clot. This is used esp to see how well blood thinners are working.
1. Improve Ventricular Competence
- Positive Inotropic Substances (Crataegus oxycanthus, Astragalus membranaceus)
2. Improve Myocardial Energy Metabolism
- Nutritional (CoQ10, Magnesium, Taurine, B Vitamins)
3. Reduce Pulmonary Oedema or Peripheral Oedema
- Diuretics (Taraxicum officinale, Olea europa)
4. Manage Risk Factors (Hypertension)
- Hypotensives (Crataegus oxycanthus, Allium sativum)
5. Manage Risk Factors (Ischaemic Heart Disease)
6. Manage Risk Factors (Cardiomyopathy)
7. Decrease Stress
- Adaptogens (Panax ginseng, Eleutherococcus senticosus)
- Thymoleptics (Melissa officinalis, Rosa centrifolia)
- Antidepressants (Hypericum perforatum)
- Sudden cardiac death
- Fatty liver disease
Avoid using Inula racemosa or Valeriana officinalis in larger doses as they may reduce stroke volume further.
The Sunlight Experiment
Updated: March 2018
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