Congestive Heart Failure

I want to know how jugular vein distention plays a role in chf and how

important it is when you see it to have it treated? also what heart

evaluation tests must be done for someone with suspected chf?



One thought on “Congestive Heart Failure

  1. Hi – quick disclaimer, the information provided herein is meant solely

    for informational purposes and does not substitute for the opinion of

    a licenced healthcare professional.

    Congestive heart failure is a condition in which the heart can no

    longer pump blood efficiently throughout the body. Due to the

    inability of the heart to adequately pump blood, blood backs-up into

    the venous system (the veins of the body where blood is returning from

    the body to the heart). The blood which backs-up causes "congestion"

    in these organs. This congestion is manifest by peripheral edema

    (limb swelling, usually in the legs), pulmonary edema (fluid in the

    lungs, causes coughing, difficulty breathing, shortness of breath),

    congestive hepatomegaly (liver damage due to backed-up blood in the

    liver), and jugular venous distention (swelling of the neck veins due

    to excess blood).

    In a recent study last year published in the New England Journal of

    Medecine (a well respected medical journal), it was reported that

    jugular venous distention is an independent risk factor for poor

    outcomes in patients with CHF – basically this means that having JVD

    indicates a poor state of the patient's heart regardless of which

    other symptoms are found. An explanation of this article can be

    found:

    http://www.newswise.com/articles/2001/8/EXAM.SWM.html

    http://dallas.bizjournals.com/dallas/stories/2001/08/20/daily29.html

    the abstract of the article:

    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11529211&dopt=Abstract

    and the article itself (although it is not free):

    http://content.nejm.org/cgi/content/full/345/8/574

    Tests which should be done for a patient with CHF:

    Blood tests – tests can be done on cardiac enzymes (can help

    demonstrate if a recent heart attack is causing or worsening the

    symptoms of CHF) and liver enzymes (to examine for liver damage due to

    congestive failure). An arterial blood gas (ABG) can be drawn to

    examine how well the lungs are putting oxygen into the blood (as heart

    failure worsens, the lungs become full of fluid and cannot put oxygen

    into the blood very well).

    Chest X-ray – as the heart fails it gets bigger (or distends) – these

    changes can be seen by looking at the heart on an x-ray. An x-ray can

    also examine for pulmonary edema (fluid in the lungs).

    Echocardiography (an "echo" or "cardiac echo") – this is an ultrasound

    examination of the heart which can measure its size and ability to

    pump blood (the size goes up and the ability to pump decreases with

    heart failure).

    Electrocardiogram (EKG or ECG) – this is a test of the electrical

    system of the heart which allows it to beat – as the heart fails and

    enlarges, the electrical system is altered which can be detected by

    changes in the measurement of the heart's electrical activity (the

    EKG).

    A good, approachable page on heart failure from CHFpatients.com,

    titled "The Manual" – this site also contains many other useful links

    to information on CHF

    http://www.chfpatients.com/CHFinfo.htm

    A good page from WebMD.com on the physical exam which a doctor will

    perform and what it can indicate (mentions JVD as "swelling of the

    neck veins"):

    http://my.webmd.com/encyclopedia/article/1675.62013

    Another nice page from WebMD.com on heart failure (does not

    specifically mention JVD):

    http://my.webmd.com/encyclopedia/article/1675.60669

    Two good pages on heart failure, mainly intended for doctors from

    eMedicine.com:

    http://www.emedicine.com/EMERG/topic108.htm

    http://www.emedicine.com/wild/topic17.htm

    Another nice page meant for doctors:

    http://www.vh.org/Providers/ClinRef/FPHandbook/Chapter03/04-3.html

    synarchy

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