Unit #8 (Group C). Congestive Heart Failure (Causes SOB and edema)
Congestive heart failure has the following 3 major symptoms: shortness of breath, edema, exercise
intolerance
The chain of pathological change in myocardium such as decreased contractility, increased preload,
and increased afterload are main causes left heart failure( McCance, K., & Huether, E., 2006).
CHF can be asymptomatic, but more often the early manifestation of CHF are shortness of breath,
inability to take a deep breath and cough. (Congestive Heart Failure, 2008).
When the left ventricle cannot adequately pump blood out of the left atrium, shortness of
breath results from pulmonary vascular congestion and impaired low perfusion in blood
circulation. It results in dyspnea. Orthopnea appears when CHF worsens and fluid retention in
the lungs (pulmonary edema) starts to interfere with oxygen exchange. Person with CHF” may
awaken at night short of breath and have to sit or stand up to get relief. This is called paroxysmal
nocturnal dyspnea. Several pillows may help with a more comfortable sleep. A person may also
prefer sleeping in a recliner rather than in a bed”. (Congestive Heart Failure, 2008, p.1).
“When an abnormality or condition affects the flow of blood through the right ventricle,
pressure in the blood vessels increases and fluid is forced from the blood vessels into body
tissues. This "right-sided" heart failure causes swelling (edema), usually in the feet and legs, and
sometimes, in the abdomen.” (Congestive heart failure. Overview, 2008, p.1.)
Exercise intolerance. Even simple exercise, as well as the ability to walk at a normal pace, may be
reduced by tiredness, fatigue and SOB. “A person may be unable to tolerate exercise or even mild
physical exertion that he or she may have been able to do in the past. The body needs oxygen and other
nutrients during physical activity. A failing heart cannot pump enough blood to provide these nutrients
to the body. Ordinary activities, such as sweeping, vacuuming, pushing a lawnmower, or even walking
about the house, may be difficult or impossible. The shortness of breath that accompanies these
activities usually gets better with rest.” (Congestive Heart Failure, 2008, p.1).
References
Congestive heart failure. Overview (n.d.) Retrieved 2 July, 2008 from
http://www.cardiologychannel.com/chf/index.shtml
Congestive heart failure (n.d.) Retrieved 2 July, 2008 from
http://www.emedicinehealth.com/congestive_heart_failure/page3_em.htm
McCance, K.L., Huether, E.H., (2006). Pathophysiology. The biologic basis for disease in adults and
children. St. Louise, Missouri: Mosby
I found some interesting material about risk factors for PE on this website
http://www.mayoclinic.com/health/pulmonary-embolism/DS00429/DSECTION=risk-factors