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Cardiac Failure. Adie Andrea & Emma. What is Cardiac Failure?. Definition “ A chronic or acute state that results when the heart is not capable of supplying the oxygen demands of the body” (Tortora & Anagnostakos 1990). Classification of Cardiac Failure (Nicolas 2004).

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cardiac failure

Cardiac Failure

Adie Andrea & Emma

what is cardiac failure
What is Cardiac Failure?
  • Definition

“ A chronic or acute state that results when the heart is not capable of supplying the oxygen demands of the body”

(Tortora & Anagnostakos 1990)

classification of cardiac failure nicolas 2004
Classification of Cardiac Failure (Nicolas 2004)
  • Class 1: Patient asymptomatic, ordinary physical activity does not cause SOB or palpitation
  • Class 2: Patient comfortable at rest ordinary physical activity causes fatigue, palpitations or SOB
  • Class 3: Patient has marked limitation of physical activity though comfortable at rest
  • Class 4: Patient unable to carry out any physical activity without causing discomfort
types of cardiac failure waugh grant 2002
Types of Cardiac Failure (Waugh & Grant 2002)
  • Acute Cardiac Failure

Sudden Decrease in output of blood from both ventricles resulting in acute reduction in blood supply

  • Chronic Cardiac Failure

Develops gradually and there may be no symptoms because of compensatory changes – if compensation no longer possible there is a decline in myocardial efficiency

manifestations of cardiac failure waugh grant 2002
Right Sided (Congestive) Cardiac Failure

Pressure developed within right ventricle is less than the force to push it through the lungs

Right atrium and venae cavae become congested with blood

congestion through venous system

Left Sided Ventricular failure

Pressure in Left ventricle is less than the pressure in the aorta

Incomplete emptying of the ventricle

Results in dilation of the atrium and an increase in the pulmonary blood system eventually resulting in systemic venous congestion

Manifestations of cardiac failure (Waugh & Grant 2002)
manifestations of cardiac failure swearing keen 2001
Manifestations of Cardiac Failure (Swearing & Keen 2001)
  • Bi-Ventricular Failure

Left Ventricular MI combined with a right Ventricular MI

causes of cardiac failure puttaroo 2004
Primary causes


Myocardial infarction

Cardiac tamponade/pericardial effusion

Hypertensive heart disease

Valve disease

Drugs e.g. Tricylic antidepressants






Rheumatic Heart Disease

Septal defect

Secondary Causes


Airway obstruction


Tension pneumothorax

Severe blood loss


Septic Shock


Severe Anaemia

Systemic Lupus



Causes of Cardiac Failure (Puttaroo 2004)
management of cardiac failure ayers 2005
Management of Cardiac Failure(Ayers 2005)

Nurse led MDT intervention has resulted in substantial benefits (Alexander et al 2000)

  • Clinical management – Angiotensin-converting enzyme (ACE) Inibitors; Beta-blockers, digoxin and diuretics
  • Education – explanation of diagnosis home monitoring pharmacokinetics & early symtom recognition
  • Palliative care – access to palliation services for patients with end stage cardiac failure
  • Supplementary Support Services – new conditions may present such as diabetes, renal failure & anaemia – appropriate referral service
  • ALEXANDER, M.F., FAWCETT, M.F. & RUNCIMAN, P.J (2000) Nursing Practice: Hospital and Home; The Adult. 2nd Edition Edinburgh: Churchill Livingstone
  • AYERS, N. (2005) Evaluating the effect of setting up a nurse-led heart failure service Nursing Times Vol 101(2) 34-36
  • NICHOLAS, M. (2004) Heart failure: pathophysiology, treatment and nursing care. Nursing Standard Vol 19(11) 46-51
  • PUTTAROO, M. (2004) Cardio-Respiratory Failure Lecture Notes Thames Valley University
  • SWEARINGEN, P.L. & KEEN, J.H. (2001) Manual Care Nursing: Nursing Interventions & Collaborative Management. 4th Edition St Louis: Mosby
  • TORTORA, G.J. & ANAGNOSTAKOS, N.P.(1990) Principles of Anatomy and Physiology. 6th Edition. New York: Harper Collins
  • WAUGH, A. & GRANT, A. (2002) Ross and Wilson: Anatomy and Physiology in Health and Illness. 9th Edition. Edinburgh: Churchill Livingstone