Symptom >> Internal Medicine >> Cardiology

Congestive heart failure

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction When the left heart fails, the blood pumping function of the heart decreases, and the blood volume of the left atrium is higher than normal. The blood of the pulmonary vein cannot reach the left atrium effectively and stagnates in the lungs. The blood stasis occurs over time. Right heart failure means that the right heart cannot Excessive discharge of venous return blood causes congestion in the body venous system and insufficient blood supply to the arterial system, secondary to pulmonary hypertension in the left heart failure.

Cause

Cause

The cause of congestive heart failure:

Organic heart disease, often caused by infection, fatigue, pulmonary circulatory blood stasis, left heart enlargement, rapid heartbeat and other congestive heart failure, decreased cardiac output, pulmonary congestion or associated systemic venous congestion, increased venous pressure Finally, the internal organs are bruised.

Examine

an examination

Related inspection

Electrocardiogram Doppler echocardiography M-mode echocardiography (ME)

Examination and diagnosis of congestive heart failure:

The main clinical manifestations are edema, proteinuria, hematuria and renal dysfunction.

Diagnosis

Differential diagnosis

Congestive symptoms of congestive heart failure:

Congestive kidney is effective renal blood flow decline, renal blood flow stagnation, renal tissue congestion, hypoxia, thickening of the glomerular basement membrane, tubular epithelial cells turbidity, degeneration and even necrosis. The main clinical manifestations are edema, proteinuria, hematuria and renal dysfunction.

In chronic congestive heart failure, renal blood flow is redistributed, renal cortical blood flow is reduced and medullary blood flow is relatively increased, effective renal plasma flow is often significantly decreased, and filtration fraction is increased. At this time, the hydrostatic pressure in the capillary lumen of the renal tubular tube decreased, and the colloid osmotic pressure increased. These hemodynamic changes can increase the reabsorption of water and sodium by the renal tubules, produce water, sodium retention, edema and oliguria.

The azotemia in congestive heart failure is mainly pre-renal, and the glomerular filtration rate is significantly reduced due to the decrease in effective renal blood flow. At this time, the amount of urine can be reduced. However, the urine specific gravity is higher at around 1.025. Nitrogenemia can often be relieved after heart failure control. In severe refractory congestive heart failure, renal tubular epithelial cells can be deformed, necrotic, and eventually lead to kidney sclerosis. At this time, the urine specific gravity is lowered, and the renal function is not easily improved after the heart failure control, and eventually the uremia can be caused.