HEALTH TIPS - CONGESTIVE CARDIAC FAILURE

Cardiac failure may be said to exist when the output of the heart is insufficient for the needs of the tissues. It may be acute or chronic. The clinical picture of acute failure is very similar to that which occurs in peripheral circulatory failure or shock (p.143). The term ‘congestive cardiac failure’ is used to describe the clinical syndrome which usually results from chronic failure. The term ‘congestive cardiac failure’ has sometimes been confined to patients in whom evidence of congestion has appeared in the peripheral circulation, i.e. distended neck veins, engorgement of the liver, and oedema. However, in patients with primary left-sided failure (as defined blow), congestion may sometimes be confined to the lungs, at least for a considerable time. Ultimately it is often followed by evidence of congestion in the peripheral circulation. In other instances, congestion in the lungs and in the peripheral circulation appears simultaneously.

In the discussion that follows, an attempt is made o present a unified conception of congestive failure and to explain the underlying mechanisms of failure and its clinical manifestations. The term ‘congestive failure’ is in fact applicable whenever and wherever congestion appears as the result of heart failure. In most cases there is a general cause for congestion, namely an increased blood volume, which results from the retention of sodium and water by the kidneys, and a localizing factor which determines whether congestion is solely or principally confined to the lesser or greater circulations.