Upon conducting a heart examination, it is noted that there is tachycardia, the heart sounds have become muted, there are galloping sounds and systolic rumours in the vicinity of the xiphoid process, which all indicate a functional insufficiency of the tricuspid valve. In the epigastric region one can observe the pulsations of the enlarged right ventricle. As a consequence of venous stasis, the jugulars are swollen, the venous pressure is high, and the speed of blood circulation is slow.
Following a radiological examination: The right ventricle, and at times the right atrium are enlarged. The infundibulum (a conical pouch formed from the upper and left angle of the right ventricle in the chordate heart) appears more swollen. There are other examinations that can be performed in order to visualize the enlarged heart, but the radiological examination is the most effectively clear method that can be used to set a diagnosis.
The electrocardiogram exhibits hypertrophy of the right ventricle, which oftentimes can be accompanied by a blockage of the right branch.
Global cardiac insufficiency occurs as a consequence of the combination of the insufficiency of the left and right ventricles. There are no particular symptoms, but more often than not the symptoms of the insufficiency of the right ventricle (with peripheral venous stasis) are more predominantly visible. Usually when the insufficiency of the right ventricle emerges, the patient feels better, because symptoms such as cardiac asthma and acute pulmonary edema disappear.
Hypo diastolic cardiac insufficiency is mostly due to the fact that the heart cannot become sufficiently filled with blood, as often occurs in exudative pericarditis and especially for constrictive pericarditis. Patients appear to have cyanosis, swelling of the jugular veins, hepatomegaly, ascites (which usually appears before the edemas in the lower extremities), rise in venous pressure, etc. These are signs of the stasis in the systemic circulation, whereas there are no changes for the pulmonary circulation.
Cardiac insufficiency is a clinical syndrome which is characterized by the inability of the heart to pump well enough to supply all the tissues of the body with blood. Since the heart and peripheral vessels are functionally a joint system, one can also use the term cardiovascular insufficiency as well as cardiac insufficiency.
The reduction in contractile power of the myocardium causes the cavities of the heart to not be fully emptied, hence the residual systolic blood and the ventricular diastolic pressure rise. Alongside the aforementioned, the atrial pressure rises, and the flow of venous blood is obstructed.
The causes of cardiac insufficiency are multiple and include: determining factors, factors which lead to the emergence of the disease like extreme physical exertions, various infections such as acute pneumopathies, influenza, etc.
There are many cardiac insufficiency classifications being used. These classifications are used in order to help with a better understanding of the different stages and the treatment of the various stages.
Patients suffering from cardiac insufficiency are more predisposed to developing acute pneumopathy, which is favored for development due to pulmonary stasis; embolisms and pulmonary infarctions; bacterial endocarditis, etc.
The diagnosis is based on the information collected from the patient history; organic cardiopathic signs such as dyspnea, pulmonary stasis, tachycardia, galloping rhythm, coughing with hemoptoic sputum etc, are all symptoms related to the left ventricle.
Preventive non-drug based treatments include bed rest and diet. Drug based treatments vary across different stages, symptoms and various patients belonging to various age groups and specifications. Treatment is usually complex and involves utilizing drug combinations.
Acute insufficiency of the left ventricle is characterized by dyspnea which occurs mostly at night, resembling cardiac asthma or acute pulmonary edema. The earliest symptom to emerge in chronic insufficiency of the left ventricle is dyspnea.
Upon conducting an examination of the heart, one can observe the left ventricle has been displaced to the bottom left, the heart sounds are muted, fast and a galloping rhythm and systolic noise can be heard at the apex of the heart as a consequence of the functional mitral insufficiency.
Acute insufficiency of the right ventricle usually emerges as a consequence of a pulmonary embolisms. Chronic insufficiency of the right ventricle patients complain of a feeling of heaviness or pain in the right hypochondrium.
Upon conducting a heart examination, it is noted that there is tachycardia, the heart sounds have become muted, there are galloping sounds and systolic rumours in the vicinity of the xiphoid process, which all indicate a functional insufficiency of the tricuspid valve.