Cardiology, Course Material

Anaesthetic implications in a patient with history of heart failure.

10 Jun

HEART FAILURE OR CARDIAC FAILURE is a complex pathological disorder resulting in the failure of the cardiac pump to deliver oxygen and meet the metabolic demands of the tissues.

The failure may result from pathologies affecting the myocardium, endocardium, epicardium, valvular system of the heart, or alteration in vascular dynamics. The resulting myocyte death, myocyte dysfunction, or the long-lasting volume/ pressure overload (often act in tandem, confounding each other) result in a debilitating ventricular dysfunction.

Ventricular dysfunction in heart failure.

AETIOLOGY:

  1. Hypertension
  2. IHD
  3. Valvular heart disease
    1. Congenital
    1. Senile
    1. Rheumatic
    1. Infective endocarditis
  4. Cardiomyopathy
    1. Infective
    1. Dilatated
    1. Pregnancy-induced CMP
    1. Nutritional deficiencies
    1. Senile
    1. Infiltrative (amyloidosis, sarcoidosis, hemochromatosis)
  5. Diabetes mellitus, thyroid disorders, acromegaly
  6. Infections
  7. Nutritional deficiencies
    • Beri-Beri (B12 deficiency)

RISK OF DEVELOPING HF:

  • Age: The lifetime risk of developing heart failure rises with advancing age. As per AHA (2013), the risk is 20% for adults > 40 years of age in the developed world. Over 65 years of age, HF is the commonest cause of hospital admission.
  • Gender: male gender
  • Smoking
  • CAD
  • Metabolic syndrome
  • Obesity
  • Hypertension

TO CONTINUE READING THE REST OF THE CHAPTER, DOWNLOAD THE HEART FAILURE MODULE BY TARGETEDAIC. THE CHAPTER COVERS THE DEFINITION, CLASSIFICATION, PATHOPHYSIOLOGY, AETIOLOGY, CLINICAL PRESENTATION, MANAGEMENT, AND ANAESTHETIC IMPLICATIONS OF A PATIENT WITH A HISTORY OF CARDIAC FAILURE POSTED FOR NON-CARDIAC SURGERY.

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