Nurse Teaching on Complications of Congestive Heart Failure (CHF)

Effectively contracting and optimally functioning heart muscle is needed to pump blood from one chamber in the heart to the next in orderly fashion, pump blood into the lungs for oxygen pick-up, and pump oxygen rich blood to the vital organs and tissues in the body. Congestive heart failure (CHF) is an abnormal condition of the heart, in which the heart muscle is damaged. The signs and symptoms could slightly vary depending on the severity of damage and the chambers affected. Overall, damaged heart muscle cannot contract effectively, contributing to poor contractions and inadequate pumping activity of the involved heart chambers.  This post discussed complications of congestive heart failure if this situation is not controlled and the damage continues further.

In summary, complications of congestive heart failure can be listed as below

Hypotension:

Reduced output of blood from the heart due to congestive heart failure, can result in low blood volume in circulation, low blood pressure, and hypotensive symptoms of dizziness and lightheadedness. Also, reduced blood supply to brain, secondary to hypotension and reduced output from heart, can contribute to altered level of consciousness. Eventually, this increase risk for falls and accidents.

Compromised end organ function:

Progressively reduced blood supply to the end organs due to congestive heart failure, such as, brain, heart, lung, stomach, and kidneys, can result in deterioration of overall function of these organs. Individuals with history of stroke, renal failure, and heart attack, can be at increased risk for symptoms of compromised organ function.

Exacerbation of SOB:

Reduced supply of oxygenated blood to the lungs due to congestive heart failure, can result in poor oxygen pick-up and increased dyspnea. Also, fluid back-up into the lungs can lead to fluid retention in the chest, difficulty in gas exchange in the lungs, and exacerbation of shortness of breath.

Chest pain and discomfort:

Back-up of blood in the heart chambers can result in increased pressure and discomfort in the chest and increased workload on the heart. This increased workload on the heart can result in demand for extra blood and oxygen supply. As, blood and oxygen supply to heart muscle is already compromised in individuals with heart failure, any extra demand can result in increased risk for chest pain and discomfort. In severe cases, individuals can even present with an episode of myocardial infarction or heart attack, damaging the heart muscle further.

Worsening of heart failure:

Persistent back-up of fluid in the heart chambers can lead to increased workload on the heart, progressive deterioration of heart function, further weakening of heart muscle, and worsening of heart failure. Patients can present with worsening symptoms of heart failure, such as, fluid retention in the chest leading to difficulty in gas exchange in the lungs, swelling of the extremities with pitting edema, and grossly limited exercise tolerance with exacerbation of episodes of shortness of breath.

Increased weakness and fatigue:

Reduced blood supply to the muscles due to congestive heart failure, can result in reduced oxygen supply to the muscle, thus leading to muscle pain, fatigue, and reduced endurance to activity.

Arrhythmia:

Damaged heart muscle, secondary to poor blood and oxygen supply, can lead to palpitations and arrhythmias. Individuals with history of arrhythmia can be at increased risk for presentation with fluttering in the chest, abnormal heartbeat, poorly felt pulse, dizziness, chest pain, altered levels of consciousness, and fainting.

Blood clot formation:

Compromised heart function with fluid back-up, in individuals with congestive heart failure, can increase the risk for blood clot formation. A case of coexisting arrhythmia can increase the risk for clot significantly. These blood clots floating in circulation can be deposited in any vital organ as emboli, obstruct the blood flow, and can result in serious complications such as myocardial infarction and stroke.

Acute weight gain:

Fluid back-up and edema due to congestive heart failure can contribute to acute weight gain.

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