Course Library

Congestive Heart Failure

Information Covered:

1. Past medical history
   1. Coronary artery disease
   2. Atherosclerotic heart disease
      1. Abnormal lipid metabolism or excessive intake or saturated fats and cholesterol
      2. Subendothelial accumulation of fatty streaks
      3. Altered endothelial function
      4. Disruption of endothelium
      5. Formation of mature fibrous plaque
      6. Resultant diseases:
         1. angina
         2. previous MI
         3. hypertension
         4. congestive heart failure
2. Related terminology
   1. Preload
   2. Afterload
   3. Congestive heart failure
   4. Left to right shunt
      1. Coarctation of the aorta (CoA)
      2. Atrial septal defect (ASD)
      3. Ventricular septal defect (VSD)
      4. Patent ductus arteriosus (PDA)
      5. Truncus arteriosus
      6. Congestive heart failure
3. Congestive heart failure
   1. Myocarditis
   2. Cardiomyopathy
   3. Congenital heart disease as underlying cause
4. Management
   1. Congestive Heart Failure and Congenital Heart Disease
      1. Oxygen (caution with ductal dependent systemic flow due to pulmonary steal)
      2. Use of prostaglandin for ductal dependent cardiac lesions
      3. Use of furosemide diuretic for fluid overload
      4. Cautious use of IV fluids if cardiogenic shock suspected

1. Specific conditions that occur more frequently in the elderly
   1. Myocardial infarction
      1. Patient will usually have atypical chest pain or NO pain
      2. May present with only dyspnea, acute confusion (delirium), syncope, weakness or nausea and vomiting
   2. Congestive Heart Failure
      1. A frequent condition of elderly
      2. May present with dyspnea, orthopnea, or mental status alteration
      3. Peripheral edema is frequently present in elderly patients with or without failure and may signify a variety of conditions
      4. Fluid balances are sometimes difficulty to achieve
   3. Biliary disease is disorders of the liver and gallbladder.
      1. Evaluation of pathophysiology through history, possible risk factors, and current medications.
         1. Liver disease
         2. Congestive heart failure
         3. Gallstones
         4. Cholecystitis
         5. Medications that cause adverse affects on the liver

Content Creator: Joyce Lockwood
CAPCE Course Number:  21-EMTP-F3-7207
Total CE Hours: 1
Level: Advanced
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.