Although CAD and advancing age are the primary risk factors for (CHF), or chronic heart failure. other risk factors, include hypertension , diabetes ,cigarette smoke , obesity ,and high serum cholesterol.Hypertension is a major contributing factor increasing the risk of (CHF) approximately threefold . The risk of (CHF) increases progressively with the severity of hypertension and systolic and diastolic hypertension equally predicting risks. Diabetes mellitus predisposes and individual to CHF regardless of the presence of concomitant CAD or hypertension , diabetes is more likely to predispose women than man to (CHF).
Coronary artery disease ,anemia ,bacterial endocarditis, Cor pulmonale ,arrhythmia , and ventricular septal defect are direct causes for the development and the pathological progression of chronic heart failure.
Ace inhibitors ,rest,diuretics,digitalis, B- Adrenergic agonist ;Vasodilators, carredilol, Human B type natruretic peptid and metoprolol.
The New York Association Functional Classification of Persons with Cardiac Disease
1-Class 1, no limitations of physical activity, ordinary physical activity does not cause fatigue, dyspnea, palpitations or anginal pain
2-Class 2,slight limitation of physical activity .No symptoms at rest ,ordinary physical activity results in fatigue,dyspnea,palpitations or anginal pain
3_Class 3,marked limitations of physical activity.Usually comfortable at rest.Ordinary physical activity causes fatigue ,dyspnea ,palpitations,or anginal pain.
4-Class 4,Inhability to carry on any physical activity without discomfort symptoms of cardiac insufficiency .
Lewis, H.D (2009) Medical Surgical Nursing,Assessment and Management of Clinical Problems .Mosby/Evolve