Heart Failure and Acute Pulmonary Edema Overview

Heart Failure Overview

• Heart failure is the heart's inability to supply adequate oxygenated blood, leading to fluid buildup in the pulmonary or systemic circulation.
• It's a complication of many heart conditions, resulting from structural or functional problems in the ventricles.
• Key symptoms include dyspnea (shortness of breath), fatigue, and fluid retention.
• The older term "congestive heart failure" is less accurate.
• Left-sided failure causes pulmonary congestion, while right-sided failure shows systemic congestion. Both may occur independently or together.
• Acute pulmonary edema, fluid in the lungs, is a severe symptom of left-sided heart failure and a life-threatening condition.

Acute Pulmonary Edema

• Acute pulmonary edema is characterized by fluid buildup in the lungs.
• It causes marked difficulty breathing, leading to a sensation of suffocation and chest oppression.
• Symptoms include heightened heart rate and blood pressure, further stressing the heart.
• Hypoxemia (low oxygen in the blood) can worsen the problem, creating a harmful cycle leading to rapid death if not addressed promptly.

Heart Function and Dysfunction

• The heart acts as a pump, maintaining blood flow to supply the body's tissues and organs with necessary oxygen and nutrients.
• Heart disorders, genetic, metabolic and environmental, can affect its function.
• Cardiac dysfunction presents in two primary ways: directly at the heart (chest pain, palpitations, etc.) or extracardiac symptoms (caused by blood flow issues to organs).
• Left ventricle is more susceptible to damage than the right, and therefore left-sided heart failure is more common.

Heart Failure Statistics and Prognosis

• 5.7 million Americans (2.3% of the U.S population) had heart failure in 2009.
• Heart failure prevalence increases with age, impacting a greater percentage of individuals aged 75 and older.
• Heart failure was directly, or indirectly, noted in more than 280,000 deaths (1 in 9) in 2008.
• Heart failure prognosis is poor. 80% of men, 70% of women under 65 with heart failure die within 8 years of diagnosis, with 50% dying within 5.
• 1-year mortality rate is high, at 1 in 5.
• Sudden cardiac death is 6 to 9 times more likely in patients with heart failure.
• Deaths from heart failure increased 35.3% from 1992-2002..

Heart Failure and Dental Treatment

• Patients with heart failure are at higher risk during dental procedures.
• Dental treatment plans should consider the extent of heart dysfunction.
• Acute pulmonary edema (a symptom of worsening heart failure) due to physiological or emotional stress during dental treatment is a significant concern.
• Patients should be adequately assessed prior to procedures to avoid triggering acute situations.