Re: cardiac failure
mohhaider - 10-02-08 12:31

sackatdoc ,I read that few weeks ago ,but can't arrange the proper answer .It seems that no one will reply, please tell us yourself .

Re: cardiac failure
sackatdoc - 10-03-08 09:07

i'll love to my friend
systolic-
on history-any age,usually male,previous myocardial infarction,symptoms-shortness of breath, signs-AFib-tends to be persistent, 3rd heart sound heard(S3 gallop)
distolic-
on history-usually female, elderly,H/o hypertention, diabetes and obesity, symptoms-shortness of breath,signs-paroxysmal atrial fib, 4th heart sound(S4 gallop)

Re: cardiac failure
nina42 - 10-05-08 19:09

There is something that you have forgotten, accumulation of fluid in ankl es , legs,... in right sided heart failure or diastolic failu.

Re: cardiac failure
mohhaider - 10-06-08 04:35

Ankle edema is associated with right ventricular failre ,no matter the machanism of failure as hydrostatic pressure is incrased in he venous side and favors more filtration and transudation of fluid .

Re: cardiac failure
sackatdoc - 10-06-08 05:36



nina "42",hi, i didnt forget that but i will certainly remember when i'm talking of which side failure is it, right or left, here we are talking of mechanism-(not side)as pointed out already by my friend,diastolic or systolic, and that ankle edema you have remembered may be in both diastolic or systolic(i hope now the concept is clear)

Re: cardiac failure
anasarca0101 - 11-08-08 12:10

can i ask.. how does it change ur management by differentiating the two? because the principle of treating heart failure is decrease afterload,increase contratility and remove the stressor.. ppl can have isolated systolic failure but can't have isolated diastolic failure.. please correct me if my concept is wrong.Thanks

Re: cardiac failure
sackatdoc - 11-08-08 16:03

Anasarca,are you also confusing it with which side of heart is failing, coz people do get that jumbled up,here it is mechanism,Diastolic and systolic but when we talk of side of the heart, the left side which can be isolated failure and right sided failure cannot be isolated , has to be both side to get right sided.do try and clear this up.

Re: cardiac failure
anasarca0101 - 11-09-08 04:29

i know we are talking about diastolic and systolic failure and not which side of the heart is in failure.To correct my previous statement,From "diagnosis and management of diastolic dysfunction and heart failure" by Chhabi Satpathy from india, it stated that ppl can have isolated diastolic function e.g hypertension ,but all patient with systolic dysfunction have comitant diastolic dysfunction.Kind of disagree that right heart failure cannot be isolated.. because what about sepsis, hyperthyrodism, pregnancy( with complications), fever, you will find patient shows signs of right heart failure( high output failure ) and no features of left heart failure.

Re: cardiac failure
sackatdoc - 11-09-08 09:51

GOOD for pointing that thing out,and that too with a reference and it is logical as well.dont know i'll have to check in order to say anything for sure.

Re: cardiac failure
anasarca0101 - 11-11-08 09:30

To sackatdoc

i'm also struggling to differentiate diastolic failure and systolic failure clinically, apparently it's very difficult according to the study.Anyways, hope you can solve the puzzle.Please post more similar thread because i do enjoy reading them :) when is ur usmle 3?when are u writing?i'm thinking of writing next yr march.

Re: cardiac failure
sackatdoc - 11-11-08 10:00

mine is hopefully in january if all goes well, coz i'm still waiting my CS results.

Re: cardiac failure
doctor1 - 11-12-08 14:24

history - systolic with decrease in the functional capacity due tot he decrease in the cardiac output, i.e getting short of breath , and most imp is syncope and chest pain,

physcial examination-low pulse volume ,

most significant of al the investigation is echo which shows a decrease in the ejection fracrtion of the left ventricle which indicates the left ventricular systolic function