هي حالة مرضية تحدث نتيجة أي خلل وظيفي أو عضوي يؤثر على وظيفة القلب كمستقبل للدم ومضخة كافية لانتشار الدم خلال أنحاء الجسم لإمداده بالمواد الغذائية والأكسجين.يجب تمميز قصور القلب عن حالة مثل السكتة القلبية التي تصيب قلب كان يقوم بوظيفته بصورة طبيعية ثم توقف مما يؤدي إلى هبوط في الدورة الدموية والموت. ولكن في مرض قصور القلب يستمر القلب في العمل ولكن بكفاءة أقل ،وتعتمد درجة المرض على درجة القصور في عمل القلب كمستقبل وكمضخة للدم. . و سنتطرق اليوم فى نقاش بسيط وسريع يعرض ذاك المرض العصىّ العصيب ويتناوله من عدة جوانب كما يلى :
Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from
narrowed arteries that supply blood to the heart muscle — coronary artery disease
past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work
high blood pressure
heart valve disease due to past rheumatic fever or other causes
primary disease of the heart muscle itself, called cardiomyopathy.
heart defects present at birth — congenital heart defects.
infection of the heart valves and/or heart muscle itself — endocarditis and/or myocarditis
The "failing" heart keeps working but not as efficiently as it should. People with heart failure can't exert themselves because they become short of breath and tired.
As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Often swelling (edema) results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.
And this an animated video showing the condition simply :
Heart failure also affects the kidneys' ability to dispose of sodium and water. The retained water increases the edema.
And This is a more advanced animated video explaining the condition in some detail:
Studies in this field:
A 19 year study of 13000 healthy adults in the United States (the National Health and Nutrition Examination Survey (NHANES I) found the following causes ranked by Population Attributable Risk score:
Ischaemic heart disease 62%: هو مرض يتميز بنقص الأوكسجين (إنخفاض إمدادات الدم) في عضلة القلب، عادة ما يرجع إلى داء شريان القلب التاجي (تصلب عصيدي للشرايين التاجية).
Cigarette smoking 16%
Hypertension (high blood pressure)10%
Obesity 8%
Diabetes 3%
Valvular heart disease 2% (much higher in older populations)
An Italian registry of over 6200 patients with heart failure showed the following underlying causes:
Ischaemic heart disease 40%
Dilated cardiomyopathy 32%: هو أحد اعتلالات العضلة القلبية والذي قد ينشأ ذاتياً - مجهول السبب
Valvular heart disease 12%
Hypertension 11%
Other 5%
How do you diagnose and treat congestive heart failure?
The doctor is the best person to make the diagnosis. The most common signs of congestive heart failure are swollen legs or ankles or difficulty breathing. Another symptom is weight gain when fluid builds up.
CHF usually requires a treatment program of:
rest
proper diet
modified daily activities
drugs such as
ACE (angiotensin-converting enzyme) inhibitors
beta blockers مثبطات مستقبلات البيتا studies in the late 1990s showed their efficacy at reducing morbidity and mortality in congestive heart failure.
Digitalis ( ايوة هى دى) :)) It is used to increase cardiac contractility (it is a positive inotrope) and as an antiarrhythmic agent to control the heart rate, particularly in the irregular (and often fast) atrial fibrillation. Digitalis is hence often prescribed for patients in atrial fibrillation, especially if they have been diagnosed with congestive heart failure.
diuretics كمدر للبول للتخلص من السوائل الزائدة
vasodilators (موسعات للشرايين )
Various drugs are used to treat congestive heart failure. They perform different functions. ACE inhibitors and vasodilators expand blood vessels and decrease resistance. This allows blood to flow more easily and makes the heart's work easier or more efficient. Beta blockers can improve how well the heart's left lower chamber (left ventricle) pumps.
Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water.
When a specific cause of congestive heart failure is discovered, it should be treated or, if possible, corrected. For example, some cases of congestive heart failure can be treated by treating high blood pressure. If the heart failure is caused by an abnormal heart valve, the valve can be surgically replaced.
If the heart becomes so damaged that it can't be repaired, a more drastic approach should be considered. A heart transplant could be an option.
Most people with mild and moderate congestive heart failure can be treated.
