Cardiovascular Medicine Book

http://www.fpnotebook.com/

Congestive Heart FailureAka: CHF, Heart Failure, Dropsy

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  1. Epidemiology
    1. Prevalence: 4.6 Million Americans with CHF
    2. Incidence: 400,000 cases CHF diagnosed per year
    3. Morbidity: 870,000 hospitalizations
    4. Mortality: 200,000 patients die from CHF per year
    5. CHF costs
      1. Accounts for 5-10% of all hospital admissions
      2. Annual U.S. Cost: $38.1 billion
  2. Pathophysiology
    1. Heart failure is a syndrome, not a disease
      1. Heart failure is a final common pathway
      2. Maximize treatment of the underlying causes
      3. Control the causes and prevent end organ damage
  3. Causes
    1. See Heart Failure Causes
  4. Types
    1. Systolic Dysfunction (60-70% of heart failure cases)
      1. Decreased contractility
      2. Decreased Left Ventricular Ejection Fraction
    2. Diastolic Dysfunction (30-40% of heart failure cases)
      1. Decreased compliance
      2. Decreased filling
      3. Variable Left Ventricular Ejection Fraction
  5. Diagnostics: Echocardiogram in Congestive Heart Failure
    1. All CHF patients should undergo echocardiogram
  6. Classification of Congestive Heart Failure
    1. See NYHA Heart Failure Classification
  7. Resources
    1. American Heart Association CHF Website
      1. http://www.americanheart.org/chf
  8. References
    1. Hoyt (2001) Am Fam Physician 63(8):1593
    2. Senni (1997) Mayo Clin Proc 72:453
    3. (1995) Circulation 92:2764
    4. (1999) J Card Fail 5:357

Edema (C0013604)

Definition (MSH)Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE.
Definition (CSP)swelling from excessive accumulation of serous fluid in tissue.
Definition (NCI)(eh-DEE-ma) Swelling caused by excess fluid in body tissues.
Definition (UWDA)Pathological transudate within one or more tissues.
Definition (NCI)Accumulation of an excessive amount of watery fluid in cells or intercellular tissues.
ConceptsPathologic Function (T046)
ICD9782.3, 782.3
MSHD004487
Englishdropsy, Edema, Edema - lesion, Edema - symptom, Edematous, Hydrops, Interstitial edema, Interstitial oedema, OEDEMA, Oedema - lesion, Oedema - symptom, Oedematous, SWELLING
Spanishedema, edema - lesion, edematoso, hidropesia
Parent Concepts[D]Anasarca (C0151603), Fluid overload (C0546817), Signs and Symptoms (C0037088), Physical findings (C0311392), Water Balance Disorders (C0549566), HEART: MUSCLE/VALVE (C0549605), Other symptoms involving skin and integumentary tissues (C0159037), Swelling (C0038999), Edema (C0013604), Fluid disturbance (C0333228), Accumulation of fluid (C0333229), Skin symptom (C0586407), Clinical history/examination observable (C1274016), Duplicate concept (C1274013), Pathological transudate (C1179868)
SourcesAOD, COSTAR, CSP, CST, ICD9CM, LCH, LNC, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT, UWDA
Derived from the NIH UMLS (Unified Medical Language System)


Heart failure (C0018801)

Definition (CSP)inability of the heart to pump blood at an adequate rate to fill tissue metabolic requirements or the ability to do so only at an elevated filling pressure.
Definition (NCI)Inability of the heart to pump blood at an adequate rate to fill tissue metabolic requirements or the ability to do so only at an elevated filling pressure.
Definition (NCI)Inability of the heart to pump blood at an adequate rate to meet tissue metabolic requirements or the ability to do so only at an elevated filling pressure.
Definition (MSH)A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
ConceptsDisease or Syndrome (T047)
ICD9428, 428.9, 428.9
MSHD006333
BasqueDESKONPENTSAZIO KARDIAKOA
DanishHjerteinsufficiens
DutchDecompensatio cordis
EnglishCardiac failure, Cardiac Insufficiency, FAILURE HEART, HEART FAILURE, HF - Heart failure, Insufficiency - cardiac, INSUFFICIENCY CARDIAC, Weak heart
FinnishSYDAMEN VAJAATOIMINTA
FrenchDecompensation cardiaque
GermanHerzinsuffizienz
Hebrewi sfikat lev
Hungarianszivelegtelenseg
ItalianInsufficienza cardiaca
NorwegianHJERTESVIKT
PortugueseInsuficiencia cardiaca
Spanishcorazon debil, fallo cardiaco, insuficiencia cardiaca
SwedishHJARTSVIKT
Parent ConceptsHeart failure (C0018801), Shock, Cardiogenic (C0036980), Congestive heart failure; nonhypertensive (C0810005), Heart Diseases (C0018799), Cardiac Disorders, General, Functional and NEC (C0549515), HEART: MUSCLE/VALVE (C0549605), Other heart disease (C0178273), circulatory system (C0497231), Diagnosis/Diseases Component (C0497531), Non-Neoplastic Heart Disorder (C1335015), Disorder of cardiac function (C1290383), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesAOD, CCS, COSTAR, CSP, CST, DXP, ICD9CM, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHEB, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, LCH, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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