Friday, January 17, 2014

HIDDEN SIGNS OF HEART FAILURE

In daily medical practice, it is not uncommon to hear some words or sentences trying to explain feelings and symptoms described by our patients. Whatever their approach, they help us  figure out  what goes underneath with respects to the basic ailments.


Besides the classical SOB shortness of breath, chest pain or squeezing, we very often  watch our patients mentioning some  rapid weight gain, due most of the time to fluid retention related to some impaired renal function. Mental confusion, impaired thinking, disorientation ensue as   blood flow is reducing  at the brain level.  There also exists some incapacity for the  feet  to fit the  shoes because of ankle and feet swelling.  French authors note the  current spoon shaped  nails  of people with heart failure condition while noticing “crackles sounds” at the base of the lungs heard at the stethoscope. Coughing is common as well as blood tainted sputum. Some  people wake up at night all of a sudden gasping for air. This is the classical PND. They happen to  need more pillows to rest upon and breathe better. Sometimes, they have to sit down to  at the edge of their beds. This position is called orthopnea. Many doctors used to diagnose at distance this heart condition nothing but by watching the way these patients try to cope with their air hunger.
More, we learn from these patients how cold they feel. Even though at rest, they keep sweating, are unable to exercise even by holding a piece of paper between their fingers. They  feel  exhausted  even on walking  by their bed.

Put shortly, hidden signs of heart failure imply gastro intestinal symptoms such as abdominal discomfort, loss of appetite and nausea, simulate urinary disorders because people with this condition urinate a lot at night, have also pulmonary symptoms caused by the blood backing up into the lungs, hence the pinkish sputum. Some patients may have heart attacks without any symptom. This is the silent myocardial infarction,  the silent killer associated sometimes with diabetes, let alone chest pain  spreading at the shoulder, jaws, neck, elbows and the back

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