• Title/Summary/Keyword: heart failure

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A case of Pleural effusion (심부전(心不全)에의한 흉막삼출증(胸膜渗出症)으로 의심되는 환자(患者) 1례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Kim, Hee-Chul;Lee, Kang-Nyung;Lee, Dong-Joon;Lee, Young-Soo;Lim, Jin-Hoon;Lee, Young-Yoon;Kim, Il-Ryul;Choi, Chang-Won
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.671-676
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    • 2000
  • Pleural effusion is a state, retention of a mount of liquid in pleural cavity. Main causes of pleural effusion is Congestive Heart Failure that is caused by left ventricular heart failure. And that of Congestive heart failure is caused by increase of pleural capillary pressure or remain of effusion in pleural cavity. Bilateral venous pressure of pleura make worse pleural effusion and one way of venous pressure of that bring out pleural effusion. The purpose of this study is to examine the efficacy of oriental treatment for pleural effusion is caused by heart failure. One woman of 86 years old complained the symptom of general weakness, dyspnea, flank pain, anorexia, insomnia, coughing, secretion mixed blood. The symptom is caused by effusion that is brought out acute pneumonia, heart failure. At the time of Admission, in the diagnosis of Admission, in the diagnosis of Hyuneum(懸飮) she had taken Kungha-tang hap pleurisy-bang,(芎夏湯合助膜炎方), so improved dyspnea, flank pain, insomnia, coughing. In views of examination, decrease of heart failure' s symptom and pleural effusion. After 13days of admission, she had taken palmul-tang.(八物湯). As a conseguence of that, the symptom of general weakness. anorexia is improved and she was discharged.

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Dyadic Interventions for Heart Failure Patients and Their Family Caregivers: A Systematic Review (심부전 환자와 가족 돌봄제공자를 위한 다이애딕 중재에 관한 체계적 고찰)

  • Kim, Da-Young;Kim, Sun-Hee;Park, Eun Ju;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.113-127
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    • 2021
  • Purpose : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient-family caregiver dyads to improve patient and/or their family caregivers outcomes. Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration's tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients' outcomes compared to family caregivers' outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure

  • Sang Min Park;Soo Youn Lee;Mi-Hyang Jung;Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Seok-Min Kang;Byung-Su Yoo;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • v.53 no.7
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    • pp.425-451
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    • 2023
  • Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

The Application of B-Type Natriuretic Peptide Level of the Dyspneic Patients : Differentiation Between Cor Pulmonale and Left Ventricular Dysfunction (호흡곤란을 주소로 내원한 환자에서 혈청 B-type Natriuretic Peptide 검사의 유용성 : 폐성심과 좌심부전의 감별에 대하여)

  • Park, Hong-Hoon;Kim, Sehyun;Choi, Jeongeun;Kim, Kang-Ho;Cheon, Seok-Cheol;Lee, Jihyun;Lee, Yong-Gu;Kim, In-Jae;Cha, Dong-Hoon;Hong, Sang-Bum;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.320-329
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    • 2003
  • Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.

Right ventricular failure in congenital heart disease

  • Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.56 no.3
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    • pp.101-106
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    • 2013
  • Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.

Design of Acute Heart Failure Prevention System based on QRS Pattern of ECG in Wearable Healthcare Environment (웨어러블 헬스케어 환경에서 ECG 전기패턴 QRS을 이용한 급성 심장마비 예방 시스템)

  • Lee, Joo-Kwan;Kim, Man-Sik;Jun, Moon-Seong
    • The Journal of the Korea institute of electronic communication sciences
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    • v.11 no.11
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    • pp.1141-1148
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    • 2016
  • This paper proposed a heart attack predictive monitoring system using QRS pattern of ECG for wearable healthcare. It detects abnormal heart pattern with a ECG (X, Y) coordinate pattern DB on wearable monitoring smart watch. We showed the acute heart failure prevention system and method with a proposed scheme. Especially, It proved the method which can do first aid in gold time through abnormal heart analysis with a digital ECG(X, Y) pattern information when acute heart failure occurs.

Recovery Trajectory in Tachycardia Induced Heart Failure Model (빈맥을 이용한 심부전 모델에서 회복궤도)

  • 오중환;박승일;원준호;김은기;이종국
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.422-427
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    • 1999
  • Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

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The Oriental Medical Study To The Causes And Symptoms Of Heartfailure (심부전(心不全)의 원인(原因) 및 증후(症候)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Kim, Hyong-Kyue;Jo, Ki-Ho;Lee, Won-Chol;Kim, Yong-Seok;Bhae, Hyung-Sup;Lee, Kyung-Sup;Goo, Bon-Hong
    • The Journal of Internal Korean Medicine
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    • v.11 no.1
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    • pp.61-75
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    • 1990
  • According to the research, the Estern and Western medical literatural records about the causes and symptoms of the heart failure, the results as follows are concluded. 1. The asthma, suceptibility to fright and severe palpitation are generally revealed from the left heart failure. The causes of it are belong to the Yang and Yeum deficiency which are mainly caused by primordial energy deficiency. 2. The symtoms of asthma which are derived from left heart failure are related to the gasping that contain dyspnea, asthma due to the accumulation of phlegm and severe palpitation and related to shortness of breath due to fluid retention (水喘) that make asthma. 3. In the right heart failure, the edema which is derived from the congestion of vein, is revealed as stoppage of main channel that is mainly caused by the Yang or the Yeum deficiency. 4. The edema which is caused by the right heart failure, is mainly related to the symptoms of Yeum type edema, also it is related to the five viscera-fluid, moreover to the heart-fluid (心水), lung-fluid (肺水) and liver-fluid (肝水). 5. In heart failure, the pathologic symptoms which are derived from the stoppage of blood circulation, are phlegm-retention disease (痰飮), diffuse fluid-retention syndrom (溢飮), fluid-retention syndrome characterized by dyspnea and edema (支飮).

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