CONGESTIVE HEART FAILURE

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CONGESTIVE HEART FAILURE

• Definition
• Heart failure occurs when the output from the
  heart is no longer able to meet the body's
  metabolic demands for oxygen. Heart failure is an
  important cause of illness and death in dogs and
  cats.

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Etiology

1. Mitral valve regurgitation. The mitral valve is
   the valve that separates the left atrium from the
   left ventricle.
2. Regurgitation means that blood moves backwards
   from the ventricle to the atrium when the
   ventricle is contracting, instead of flowing out
   into the aorta and then the body.
3. Mitral valve disease usually occurs from chronic
   scarring of the valve (often due to bacterial
   infection),

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• 2. Dilated cardiomyopathy, where the heart muscle
  becomes distended and incapable of properly
  transmitting the electrical current of the heart
  beat (more often seen in older, small breed
  dogs).
• 3. Cats, it usually associated with hypertrophic
  cardiomyopathy, where the heart muscle becomes
  too thick to work properly, and the chambers are
  too small to move an adequate amount of blood
  with each beat

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Pathophysiology
When the ventricle's performance and output
decline
the body activates several types of compensatory
mechanisms in order to try to preserve blood
pressure and cardiac output
Many of the smaller blood vessels will
constrict, or narrow, to help raise the blood
pressure
The heart rate begins to increase to get out as
much blood to the body as possible
The body starts to retain sodium and water, also
to increase the blood pressure.
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• When excessive pressure is found in the ventricle
  during filling, edema begins to occur as fluid
  begins to seep (ooze) out of the blood vessels,
  into certain areas of the body, such as
• the lung tissue,
• around the outside of the lungs,
• and into the liver and abdomen leading to the so
  called congestive heart failure.

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Clinical signs

• - Congestive heart failure is divided into left
  and right sided diseases.
• - The clinical symptoms of each one are
  different.
• A) Left sided congestive heart failure (CHF)
  (lung edema)
• 1- Respiratory distress- shortness of breath, and
  coughing
• 2- At first these symptoms may just be seen with
  exertion, but eventually they are seen even at
  rest.
• B) Right sided CHF is seen as
• 1- Ascites, or fluid accumulation in the abdomen,
  causing a pot-bellied appearance.
• 2- Sometimes, fluid accumulates in the chest,
  around the lung tissue, causing compression of
  the lung tissue and heavy breathing.
• In both cases, weight loss can be seen, as well
  as decreased appetite,

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Diagnosis

1. History and clinical signs.
2. X ray and ultrasonography for the mitral
   insufficiency and the hypertrophic cardiomyopathy.

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Treatment

• 1. Diuretic medication to reduce fluid in the
  lungs and to make the heart work.
• 2. Vasodilators are also often helpful to reduce
  the workload on the heart.
• 3. Diet changes may be necessary to reduce salt
  (sodium) intake, which in turn reduce retained
  fluids - especially in the lungs. This decreases
  the workload for the heart.
• 4. Reduce exercise regimen to help control signs
  of CHF.
• 5. Continued monitoring to maintain a stable
  condition of CHF.

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Prognosis

• The prognosis for heart failure is generally poor
  unless the underlying heart disease is amenable
  to medical or surgical therapy.
• Most of the causes are slowly progressive, and
  patients seldom survive more than 6-12 months
  with therapy.

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• Heat sound in pet animals (dog and cat)

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• Questions