What are the symptoms / clinical features of the heart failure
early HF, dyspnea is observed only during exertion, when it may simply represent
an aggravation of the breathlessness that occurs normally. As HF advances, dyspnea
occurs with progressively less strenuous activity and ultimately it is present
even at rest.
This symptom, i.e. dyspnea in the recumbent position, is usually a later manifestation of HF than exertional dyspnea. Orthopnea results form the redistribution of fluid from the abdomen and lower extremities into the chest during recumbency,
increase the pulmonary capillary pressure, combined with elevation of the diaphragm.
Patients with orthopnea must elevate their head on several pillows at night and
frequently awaken short of breath and coughing if their head slips off the pillows.
Paroxysmal (nocturnal) dyspnea
term refers to attacks of severe shortness of breath and coughing that generally
occurs at night, usually awaken the patient from sleep, and may be quite frightening.
Patients with severe HF, particularly elderly patients with cerebral arteriosclerosis,
reduced cerebral perfusion, and arterial hypoxemia, may develop alterations in
the mental state characterized by confusion, difficulty in concentration, impairment
of memory, headache, and anxiety. Nocturia is common in HF and may contribute
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