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Clinical Manifestations | Drugs For Treatment of Cardiac Heart failure

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Treatment of Cardiac Heart failure | Clinical Manifestations | Drugs Used For Heart Attack

Treatment of Cardiac Heart failure | Clinical Manifestations | Drugs Used For Heart Attack

The most common manifestation of left ventricular failure is dyspnoea, or a sense of breathlessness. This is caused predominantly by decreased lung compliance resulting from pulmonary edema and congestion, and by increased activity of autonomic stretch receptors
within the lung. Dyspnoea is most noticeable during periods of physical activity. It is also prominent when the person is lying down (Orthopnoea), because of the increased amount of venous blood returned to the thorax from the lower extremities and because the
diaphragm is elevated in this position. Paroxysmal nocturnal dyspnea is an especially dramatic form of dyspnea that awakens the patients with sudden severe shortness of breath, accompanied by coughing, a chocking sensation, and wheezing. Other manifestations of left ventricular failure include muscle fatigue, an enlarged heart, tachycardia, a third heat sound and fine edematous pulmonary alveoli. With progressive ventricular dilation, the papillary muscles are displaced laterally, causing mitral regurgitation and a high pitched systolic murmur. Chronic dilation of the left atrium may also occur and it is often associated with the development of atrial fibrillation manifested by an irregular heartbeat.

As CHF progresses, patients may become frankly cyanotic and acidotic owing to decreased tissue perfusion. Ventricular arrhythmias caused by myocardial irritability and over activity of the sympathetic nervous system are common and are an important cause of sudden death in this setting.

Fluid Retention and Swelling:

Nonpitting edema is generally not caused by heart failure.


Treatment of Congestive Cardiac Failure | Medication for Congestive Cardiac Heart Failure (CCHF)


Treatment of Congestive Cardiac Failure is focused on improving the symptoms and preventing the progression of the disease. The major and often neglected form of treatment is lifestyle improvement, which includes:

  1. Regulation of the salt and fluid intake: As the entire body suffers from congestion due to fluid accumulation and also that sodium leads to increased fluid accumulation in the body tissues, it is often recommended to restrict the sodium and fluid intake during the cardiac failure.

  2. Exercise: It is recommended to do any activity which one can sustain for more than just a few minutes while your heart, lungs and muscles work overtime. Such an exercise is known as aerobic exercise. Regular exercise, according to the patient’s tolerance level, appears to provide significant benefits and should be used only when the patient is compensated and stable


Pharmacological treatment of CHF involves the use of following category of medications:

(a) Inotropic Drugs:

b) ACE inhibitors: These agents act by inhibiting the Angiotensin converting
enzyme which is responsible for conversion of Angiotensin I (inactive) to Angiotensin II (active). ACE Inhibitors improve symptoms, decrease mortality and reduce ventricular hypertrophy. E.g: Candesartan.

c) Diuretics: These removes excess extracellular fluid in patients with systolic or diastolic heart failure.

d) Surgical treatment: Heart transplantation may be recommended for a person who does not respond to medication.
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