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Pathophysiology:
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Caused by left ventricular dysfunction, which can be systolic or diastolic.
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Systolic failure: the left ventricle can’t contract effectively, reducing ejection fraction (<40%) and cardiac output. Increased preload and afterload (often due to hypertension).
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Diastolic failure: the left ventricle becomes stiff and cannot relax properly, leading to poor filling and reduced volume output.
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Key Features:
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Pulmonary congestion and decreased cardiac output due to backward blood flow into the lungs.
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Affects both the pulmonary system and cardiac function.
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Major Complications:
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Pulmonary edema: fluid accumulation in alveoli, leading to hypoxia.
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May present as acute or chronic.
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Key symptoms: crackles, shortness of breath (SOB), pink frothy sputum, poor urine output, hypo/hypertension.
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Flash pulmonary edema is a medical emergency — gas exchange is impaired.
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Priority Interventions:
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Administer oxygen.
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Position the patient upright with legs dangling to reduce venous return.
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Medications:
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IV diuretics: remove excess fluid.
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Nitroglycerin (IV or subQ): causes vasodilation.
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Morphine IV: reduces anxiety and vasodilates.
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Inotropes: improve heart contractility in heart failure.
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Ultrafiltration: for fluid removal when diuretics are ineffective.
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