| Disease |
MI HEART ATTACK |
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| Quotation |
“Foxglove made up with some sugar and honey, is available to claeanse the body, both upwards and downwards”. |
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| Definition |
Defined as a stable in which the heart is unable to transport adequate blood to perfuse the peripheral tissues.
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| Prognosis |
Generally good in the initial phase whatever the cause of the failure, but long-term mortality ranges from 10% annual mortality in those with mild symptoms to 50% in those with advanced and progressive symptoms. Ejection faction <20% indicates very poor prognosis. About 40-50% of cardiac failures dies suddenly due presumably to ventricular dysrhythmias.
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| General Measures |
Treatment of underlying cause like arrhythmia, anemia, thyroid disorder, cardiomyopathy.
Initially restrictionof physical activity especially in acute HF, but later carefully guided cardiac rehabilitation programme and aerobic exercises.
Salt restricted diet (2-3 Gms/Done) would help reduce diuretic requirements
Small frequent feeds. Reduce calories in over weight patients.
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| Advice to Patient |
Strict control of dietary measures, especially salt restriction (3 gms/day), low fat, low cholesterol as indicated.
Proper use of medications and their possible side effects.
On permissible physical exercise.
Adequate rest. (Prolonged bed rest causes physical and mental deterioration).
A knowledge of signs and symptoms that would warrant hospitalization.
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| Follow Up |
Depending on the clinical state of the patient but initially 2 weeks after the patient is stabilized.
Monitoring of digoxin blood levels BUN, electrolytes, ECG, chest x rays as indicated.
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| Inadequate Response |
Non-compliance on part of patient especially with regards to salt restriction, rest, drug taking or fluid restriction as advised in advanced failure states.
Inadequate management of underlying problems like anaemia, infection, etc.
Uncorrected arrhythmias like supraventricular tachycardia, atrial fibrillation.
Digitalis toxicity, or electrolyte disturbances after diuretic therapy.
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| Prevention |
Treatment of the underlying disorder early, where possible.
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| Reference From |
Packer M. Cohen J (ed) consensus recommendation for the management of chronic heart failure.
AM.J. of Cardiology 83 (2a): 1A, 38A, 1999.
www.ovc.uoguelph.ca/BioMed/Courses/Public/Pharmacology/pharmsite/98-309/Cardio/CHF/CHF.html |
