CHAPTER 1 Cardiovascular System^33
While most hearts can tolerate some changes in the above items, some diseased,
older hearts may not be able to do so; heart failure results.
Treatment results of early disease are usually good. Long-term prognosis can
be variable, depending on the severity of the disease and associated conditions.
HALLMARK SIGNS AND SYMPTOMS
- Early:
- Basilar rales from fluid overload
- Nocturia
- Exertional dyspnea
- Fatigue
- Positive hepatojuglar reflux from liver congestion
- S3 heart sound
- Mid:
- Cough
- Orthopnea
- Discomfort in right upper abdomen due to hepatomegaly
- Cardiac rales
- Edema
- Cardiomegaly
- Late:
- Anasarca—generalized edema from ineffective pump function
- Frothy or pink sputum from capillary permeability
INTERPRETING TEST RESULTS
- B-type natriuretic peptide—elevated levels in CHF; produced when the ven-
tricles are stretched. - EKG may show signs of ischemia (T-wave inversion), tachycardia, or extra-
systole (extra beats). - CBC may show anemia—Hgb less than 12 in female, less than 14 in male;
HCT; less than 3 times the Hgb. - Chemistry may show renal problems, electrolyte disturbance.