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What is heart failure? Less blood is pumped out of the heart to organs and tissues in the body. Heart failure does not mean that your heart has stopped working. Heart failure can be ongoing (chronic), or it may start suddenly (acute). Basically, the heart can’t keep up with its workload. Congestive heart failure (also called heart failure) is a serious condition in which the heart doesn’t pump blood as efficiently as it should. What will happen if heart failure is left untreated? Premature death What is another word or term for heart failure? Congestive heart failure What can cause congestive heart failure? 1. Coronary artery disease (disease of the arteries that supply blood to the heart) 2. High blood pressure 3. Cardiomyopathy (disease of the heart muscle) 4. Valvular heart diseases (diseases of the valves present in the heart) 5. Past heart attack (myocardial infarction) 6. Birth defects of the heart 7. Diabetes 8. Diseases of the covering of the heart 9. Arrhythmia (irregular heartbeat) 10. Severe infections 11. Anemia 12. Thyroid disease 13. Vitamin deficiencies 14. Drugs, such as hydroxychloroquine 15. Chronic diseases of the lungs (e.g., COPD) 16. Obesity 17. Smoking 18. Kidney diseases 19. Alcohol use Heart failure: What are the most common causes? 1. Coronary artery disease/ischemic heart disease 2. Hypertension 3. Cardiomyopathy (disease of the heart muscle)/dilated cardiomyopathy 4. Valvular heart disease 5. Past heart attack (myocardial infarction) What are the types of heart failure? Heart failure can be ongoing (chronic), or it may start suddenly (acute). The most common type of heart failure is left-sided heart failure. 1. Left-sided heart failure: This is most common type of heart failure. 2. Diastolic heart failure: Your left ventricle has become stiffer than normal. See further details of EF. 3. Systolic heart failure: The ventricle cannot contract the way it should. See further details of EF. 4. Right-sided heart failure: Right-sided heart failure is less common than left-sided heart failure. 5. Biventricular heart failure: Biventricular heart failure affects both sides of the heart. 6. Congestive heart failure: Congestive heart failure is a condition that results from heart failure on the right side, left side, or both sides of the heart. 7. Chronic heart failure: When heart failure develops over the course of multiple months or years, it is called chronic heart failure. Most cases of heart failure are chronic. 8. Acute heart failure: When heart failure develops suddenly, it is called acute heart failure. This type of heart failure is less common than chronic heart failure. 9. Decompensated heart failure: If a person has heart failure that suddenly worsens, it is known as decompensated heart failure. What are various case scenarios? Case 1 1991 Srinagar. Here are the summarized case details. A 70-year-old male complains of severe chest pain. On examination, the patient is breathless, restless, sweating, and unable to stand. His systolic blood pressure is less than 90 mm Hg. The patient is transferred to the hospital emergency room. His ECG shows ST elevation and blood biochemistry indicates high cardiac enzymes, which proves myocardial infarction. What was the diagnosis? Acute myocardial infarction Left-sided heart failure Systolic heart failure Acute heart failure After treatment, the person recovered completely and lived for another 15 years, as circulated by Dr. Asif Qureshi. Case 2 September 23, 2021 Valvular heart disease case. Chronic heart failure Ejection fraction What is a normal ejection fraction? A normal ejection fraction ranges from 50% to 70%. The ventricle is filled with 100ml of blood 60 ml is ejected. This means the ejection fraction is 60%. What is ejection fraction? How is EF measured? EF can be measured in your doctor’s office during tests such as:
* Cardiac catheterization * Magnetic resonance imaging (MRI) scan of the heart * Nuclear medicine scan (multiple gated acquisition or MUGA) of the heart; also called a nuclear stress test * Computerized tomography (CT) scan of the heart What happens to the ejection fraction in diastolic and systolic heart failure? Ejection fraction is utilized to differentiate between systolic and diastolic dysfunction. What are the causes of diastolic dysfunction? Hypertrophic cardiomyopathy Restrictive cardiomyopathy Hypertension Is heart failure reversible? Fix the underlying cause. Make sure there is an appropriate treatment plan. Stage D heart failure is not reversible. Right-sided heart failure can be caused by left-sided heart failure. Systolic heart failure. Failure of contraction. Diastolic heart failure. Failure of relaxation. Treatment can include the treatment of acute heart failure and treatment of chronic heart failure. See also heart failure due to acute myocardial infarction. Acute hospitalization will be required. IV medications Oxygenation Sometimes ventilatory support may be required. In case of further complications, further treatment is required. Chronic heart failure will require oral medication. CHF usually requires a treatment program of * rest * proper diet * modified daily activities * drugs such as o diuretics o ACE (angiotensin-converting enzyme) inhibitors o beta blockers o digitalis o vasodilators How do you do on a quiz relevant to this issue? What must a specific physician do if this medical condition does not respond to the treatment? Go ahead with stages of congestive heart failure. What is the stage of this heart failure? In Stage D heart failure, treatment does not help. Stages of Congestive Heart Failure American Heart Association endorses these stages of congestive heart failure. What are the stages of congestive heart failure? Stages of congestive heart failure - Stage A Stages of congestive heart failure - Stage B Stages of congestive heart failure - Stage C Stages of congestive heart failure - Stage D (End-Stage) Stages of Congestive Heart Failure - Stage A Stage A can be a reversible diagnosis. Here is the treatment for this situation. 1. Lifestyle changes to slow or stop disease progression. The usual treatment plan for Stage A can include: Engaging in regular, daily exercise Quitting smoking Treating high blood pressure with medications, a low-sodium diet, and an active lifestyle Lowering cholesterol levels Not drinking alcohol or using recreational drugs If reducing salt intake and making lifestyle changes do not control high blood pressure, start with Hydrochlorothiazide (oral route) 12.5 mg. Take one tablet by mouth one time daily. Stages of Congestive Heart Failure - Stage B Usually accompanied by a reduced ejection fraction (EF). Here is the treatment for this situation. 1. Lifestyle changes to slow or stop disease progression. See stage A guidelines. 2. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, if you aren’t taking any as part of your Stage A treatment plan. 3. Beta blockers if you’ve had a heart attack and your EF is 40% or lower, if you aren’t taking any as part of your Stage A treatment plan. 4. Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease, or congenital heart disease. Stages of Congestive Heart Failure - Stage C Congestive Heart Failure - Stage C: What are the symptoms and signs? 1. Fluid retention resulting in edema (swelling) in the legs, ankles, feet, and/or abdomen. 2. Shortness of breath 3. The above are symptoms that a doctor should look for. There may be some general symptoms as well, like fatigue, decreased exercise tolerance, and increased nighttime urination. What are the Stage C treatments of congestive heart failure? 1. Same as the Stage A or Stage B treatments. 2. Additional medications, as needed (blood pressure, heart efficiency, heart rate control, etc.). 3. If there is fluid retention, a diuretic (water pill). 4. Sodium and fluid restrictions. 5. Daily weights. Stages of Congestive Heart Failure - Stage D (End-Stage) The patient has symptoms even at rest and is unable to carry out any physical activity without discomfort. With Stage D heart failure, treatment does not help. Treatment will not make this mildly better or even a little bit better. Symptoms do not go away. Shortness of breath and edema do not go away. This is also known as end-stage heart failure. Stage D treatment options 1. Continuous intravenous medication that helps the heart pump stronger (inotropic therapy). This is an option, but impossible in the real world every day. Have a public discussion on this issue. 2. Left ventricular assistive device (LVAD). This is an option, but impossible in the real world. 3. Evaluation for a heart transplant. This is an option but impossible in the real world. 4. Palliative or hospice care. Also known as end-of-life care. Possible. How many Americans and people worldwide had heart failure? On or before July 22, 2021, at least 6 million Americans had heart failure. Worldwide statistics are pending. Heart failure: How can this be prevented? How could this be prevented? One way to prevent heart failure is to prevent and control conditions that can cause it, such as coronary artery disease, high blood pressure, and obesity. Not smoking Controlling certain conditions, such as high blood pressure and diabetes Fix underlying causes of heart failure before it progresses to Stage D Staying physically active Eating healthy foods Maintaining a healthy weight Staying away from harms What other resources have some guidelines that are less useful, although I felt like displaying these entities? Mayo Clinic American Heart Association Government health department websites On or before July 1, 2022, your entities had not displayed the resources required in a question-and-answer format via the internet. You can display the resources required in a question-and-answer format authored by Dr. Asif Qureshi through your website. Reimbursement for Dr. Asif Qureshi for these resources is required. |
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What needs to be accomplished in this case on or after 1 PM local time on September 23, 2021? Monitor the pulse oximeter 24 hours a day, 7 days a week. There should be 95% or above oxygen saturation by pulse oximeter. The local specific physicians in Karachi, Sindh, need to be reminded about their responsibilities. There is a specific case presentation a physician must make that has not be presented in this case. This shows a lack of training. The facts displayed here are from Umer Sharif’s family members and video coverage. Thanks to those who provided video coverage in the interest of his recovery. Continue further video coverage until he fully recovers. How should local specific physicians have presented? The 66-year-old Umer Sharif is conscious and oriented to time, space, and person. On September 22, 2021, Umer Sharif was not in a coma. Umer Sharif was able to spontaneously open his eyes, talk, and move his limbs while sitting, as evidenced in the video. Umer Sharif started having symptoms of breathlessness that were of a cardiac origin. When did these symptoms start? Where did they start? How did they start? These questions need further answers. Latest pulse oximetry readings: Not available Blood biochemistry: Not available Echocardiography ejection fraction: Not available What is ejection fraction relevant to the human heart? Ejection fraction is a measurement of the percentage of blood pumped out of a filled ventricle each time it contracts. Ejection fraction is usually measured only in the left ventricle. What equipment is used to measure the ejection fraction of human heart? 1. Echocardiogram 2. Cardiac catheterization 3. Magnetic resonance imaging (MRI) 4. Computerized tomography (CT) 5. Nuclear medicine scan What is the normal ejection fraction of a human heart? A normal ejection fraction is about 50% to 75% according to the American Heart Association. A borderline ejection fraction can range between 41% and 50%. What are the causes of a reduced ejection fraction of the human heart? 1. Weakness of the heart muscle, such as cardiomyopathy. 2. Heart attack (myocardial infarction) that damaged the heart muscle. 3. Heart valve problems. 4. Long-term, uncontrolled high blood pressure. What was the ejection fraction of Umer Sharif at 1 PM on September 23, 2021? Where is the lesion? How did you verify the location of lesion with reasons, for example an echocardiography presentation? Who did or will do further echocardiography? What is the diagnosis? What are the workable treatment options? Who has the answer? Who is willing to answer? Who has the responsibility to answer? |
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Antihypertensive medications: What are various examples? Diuretics (water pills) hydrochlorothiazide ACE inhibitors Beta blockers Potassium binders What is the maximum oral dose of hydrochlorothiazide per day? The dose is usually not more than 50 mg per day. What are examples of diuretics? Aldactone (spironolactone) Bumex (bumetanide) Demadex (torsemide) Esidrix (hydrochlorothiazide) Lasix (furosemide) Zaroxolyn (metolazone) What is the first choice of medicine for hypertension in adults in this situation? Hydrochlorothiazide (oral route) 12.5 mg. Take one tablet by mouth one time daily. |