Congestive Heart Failure and Pulmonary Edema

Excerpt

Heart failure is a growing public health problem and is now the most common cause of hospitalizations in the U.S. among patients 65 years and older. The increasing prevalence of heart failure in the population is most likely secondary to the aging of the population, increased risk factors, better outcomes for acute coronary syndrome survivors, and a reduction in mortality from other chronic conditions. Healthcare providers should be familiar with the pathophysiology, presentation, and treatment of heart failure because of the morbidity, mortality, and projected increased prevalence of the condition.

Heart failure (HF) is a clinical syndrome and constellation of symptoms secondary to impaired cardiac function. There are numerous etiologies for impaired heart function. The causative factors for heart failure are generally divided into either structural or functional categories. Patients who suffer from heart failure can also be classified based on the stage or degree of heart failure and symptoms, including episodes of acute exacerbation and pulmonary edema heart failure can be divided into two broad categories. HFpEF (heart failure with preserved ejection fraction) and HFrEF (heart failure with reduced ejection fraction). The incidence of HFpEF increases with age. The majority of cases of heart failure in the elderly is due to HFpEF.

Acute decompensated heart failure (ADHF) is a common and potentially fatal cause of cardiac dysfunction that can present with acute respiratory distress. In ADHF, pulmonary edema and the rapid accumulation of fluid within the interstitial and alveolar spaces leads to significant dyspnea and respiratory decompensation. There are many different causes of pulmonary edema, though cardiogenic pulmonary edema is usually a result of acutely elevated cardiac filling pressures.