Definition, assessment and management of left ventricular failure. lifestyle modifications in heart failure.

1. MANAGEMENT OF ACUTE LVF,
LIFESTYLE MODIFICATIONS
THAJUDHEEN
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2. WHAT IS ACUTE LVF?
Sudden onset of dyspnoea at rest or worsening of dyspnoea of pre-existing chronic CCF
Occur in patients with a cardiac condition
Not a disease but a syndrome and complication of heart disease
ETIOLOGY
MI
Cardiac tamponade
Pulmonary edema
Mitral stenosis

3. SYMPTOMS
1. Patient present with sudden onset of dyspnea (shortness of breath) at rest
2. Orthopnea and severe respiratory distress also seen
3. Cough, wheezing, pink frothy sputum also seen.

4. INITIAL ASSESSMENT AND
MANAGEMENT
AIRWAY
 Is the airway clear?
sputum production makes breathing difficult-suction can be provided
BREATHING
 If patient able to sit ,do so
 Check resp rate, o2 saturations, and do respiratory examination
- jvp increased, rr inc,o2 sat decreased
 O2 inhalation-start immediately, using facemask or nasal probes

5. INITIAL ASSESSMENT AND
MANAGEMENT
CIRCULATION
pulse, bp, urine output should be noted
- tachycardic, bp elevated, 3rd heat sound

6. MANAGEMENT-SEDATIVES
Give mild sedative like Alprazolam if needed
Morphine:  Given as slow IV injection.
 Repeated at 15 min interval till patient sedated or relieved from
dyspnea.

7. MANAGEMENT-LOOP DIURETICS
FUROSEMIDE IV 40mg is given
First line of treatment
It will act by vasodilation and diuresis
It will reduce preload and ventricular filling pressure
Bumetanide and torsemide can also be used

8. Management-nitrates
 Indications; in acute lvf other than due to aortic stenosis
◦ Eg ; 1. isosorbide dinitrate,orally,10mg,thrice daily
2. Nitroglycerin, iv
 Monitoring of bp required to avoid hypotension
 Headache also limit usage

9. Management-digoxin
Indications-all cases of heart failure except heart failure formed by acute MI
DOC when heart failure associated with atrial fibrillation

10. LIFE STYLE MODIFICATION
IN HEART FAILURE

11. LIFE STYLE MODIFICATIONS
1. Do proper exercise regularly: Brisk walking, cycling, jogging, playing tennis, jumping rope,
etc. Start with mild exercise and elaborate over days.
2. Quit smoking.
3. Lose weight: plan diet accordingly and do proper exercise.
4. Eat heart healthy food:  Fresh fruit and vegetables
 Low fat diaries
 Food rich in omega 3 fatty acids like salmon
and mackeral
 Plant based oils like olive oils.
 Berries, grains, walnuts.

12. LIFE STYLE MODIFICATIONS
5. Avoid : Red meat, fried food, butter, junk foods, gravy, etc.
6. Include chocolate in diet.
7. Don’t exert stress: Do yoga, meditation, massages, etc to relieve
stress.
8. Limit alcohols and fluids.