Lecture Notes: Pulmonary Edema and Congestive Heart Failure (CHF)

Overview

• Pulmonary Edema: Fluid in the lung bases, filling up alveoli and hindering gas exchange, causing hypoxia, low SpO2, chest pain, and difficulty breathing.
• Congestive Heart Failure (CHF): Heart's inability to pump effectively, leading to fluid buildup.

Causes of Heart Failure

• Myocardial Infarction: Heart muscle damage due to heart attack.
• Valve Failure: Malfunctioning valves lead to blood backup.
• Weak Ventricles: Chronic conditions or CHF flare-ups weaken the left ventricle.

Left-Sided Heart Failure

• Function: Left ventricle pumps blood to the body.
• Anatomy:
  • Mitral valve above left ventricle.
  • Left atrium above mitral valve.
  • Pulmonary vein feeds the left atrium.
• Pathophysiology:
  • Left ventricle fails to pump effectively.
  • Pressure builds in pulmonary veins.
  • Blood backs up into lungs, causing poor gas exchange.
  • Audible signs: Rails bilaterally on chest auscultation.

Right-Sided Heart Failure

• Function: Right ventricle pumps blood to the lungs.
• Anatomy:
  • Tricuspid valve connects to the right atria.
  • Right atrium receives blood from venous system (SVC & IVC).
• Pathophysiology:
  • Right ventricle failure leads to blood backup in SVC & IVC.
  • Causes venous congestion, jugular vein distension (JVD), and pedal edema.

Signs and Symptoms of CHF

• Chest Pain: Related to heart and lung issues.
• Shortness of Breath: Increased respiratory rate, decreased SpO2.
• Rails or Crackles: Indicative of fluid in lungs.
• Exertional Symptoms: Pain or shortness of breath during activities.
• Fatigue or Weakness: General tiredness, inability to perform daily tasks.
• Edema: Increasing leg edema and JVD.
• Tripod Position: Classic posture for patients with respiratory distress.

Management and Diagnosis

• EKG: Essential for investigating potential heart attacks.
• Assessment: Evaluate history of CHF and symptom onset.

Additional Resources

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• Target Audience: EMR, EMT, Advanced EMT, or paramedic students preparing for exams.