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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Congestive Heart Failure

Congestive Heart Failure

Congestive heart failure is a condition in which the heart's function as a pump to deliver oxygen rich blood to the body is inadequate to meet the body's demand. Congestive heart failure can be caused by weakness or stiffening of heart muscles



  • Right sided or left sided heart failure
  • Systolic or diastolic dysfunction
  • Low out failure or high output failure

Functional classification- New York Heart Association Functional Classification

  • Class I- No limitation is experienced in any activities; there are no symptoms from ordinary activities.
  • Class II- Slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.
  • Class III- Marked limitation of any activity; the patient is comfortable only at rest.
  • Class IV- Any physical activity brings on discomfort and symptoms occur at rest.

Clinical signs and symptoms

Left sided heart failure

Right sided heart failure

  • Pedal edema or anasarca
  • Frequent nighttime urination
  • Fluid accumulation in the abdominal cavity causing swelling
  • Enlargement of liver


Rare causes of heart failure

Tests and diagnosis

  • Echocardiography
  • Chest X-ray
  • Serum electrolytes
  • Renal function test
  • Liver function test
  • BNP
  • Angiogram


Acute decompensated heart failure

  • Ensure airway, breathing and circulation is adequate.
  • Vasodilators- Nitroglycerine, Diuretics
  • Ionotrophic agents- Dopamine and Dobutamine
  • Non invasive positive pressure ventilation- NIPPV

Chronic management

  • Loop diuretics

  • Beta blockers

  • ACE inhibitors and angiotensin converting enzyme

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