Defination
It is a condition characterized by inability of the right ventricle 1 blood forwards resulting in engorgement of right atrium, systemic veins with enlargement of liver and dependent oedema The term ‘Congestive failure is applicable to conditions
ated with venous congestion, whether systemic or nary. Thus it denotes left or right sided heart failure associate Causes
1. Mitral stenosis commonest cause
2. Secondary to left ventricular failure
3. Chronic lung diseases, e.g. emphysema and fibrosis of lungs
4. Pulmonary embolism
5. Congenital heart diseases, e.g.. pulmonary stenosis and others
6. Cardiomyopathy
7. Ventricular tachyarrhythmia
Symptoms
Cardiac symptoms
1. Palpitation due to tachycardia or cardiac arrhythmia.
2. Heaviness of the precordium.
Pulmonary symptoms
i. Breathlessness or Dyspnoea-Theoretically speaking this
should not be a feature of right heart failure, but as majority
of the cases are secondary to left heart failure or from
pulmonary diseases, dyspnoea becomes an invariable
accompaniment of this condition. Associated hydrothorax
ascites, hydropericardium, etc. are also added factors.
2. Cough and sputum may also be present Cerebral symptom (due to cerebral congestion) Insomnia, blurring of vision, lack of concentration forgetfulness, lack of personality, restlessness, drowsiness, eto may be present. Gastrointestinal symptoms
1. Due to hepatic congestion-Pain in the right hypochondriac region, particularly after meals, tightness of the upper
abdomen due to stretching of the hepatic capsule.
2. Due to gastrointestinal congestion as a result of portal congestion-Anorexia, nausea, vomiting, flatulence
constipation, swelling of the abdomen (ascites), tightness of the abdomen (due to enlarged liver and ascites)
1.SS. Right ventriclar failure (Neck veins, heart, liver & legs Swelling of the body This at first appears around the ankle (dependent oedema) andis particularly noticed by the patient at the end of day’s work Tightness of the socks or shoes may he complained of Gradually not only the lower limbs but also the ahdomen and S remaining part of the body become distinctly oedematous This oedema is chiefly due to the following factors

1. Less renal blood flow and more tubular reabsorption of sodium and chloride from the proximal tubule 2 Increased venous pressure
3. Anoxaemic damage to the capillary wall leading toincreased permeability.
4. Increased aldosterone and antidiuretic hormone as theseare not detoxicated by the congested liver
5. Low colloidal osmotic pressure of blood from anorexia,congested liver, albuminuria, malabsorption from congested
intestine, protein loss in transudates in serous sacs.Signs
General Survey
1. Decubitus-propped up.
2. Respiration rate-hurried
3. Pulse shows tachycardia, this is due to Bainbridge auricular reflex

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