Def: acute,severe LV failure with pulmonary venous hypertension and alveolar flooding; usually as a secondary to other dss.
*suspected in pt had history of CVD.
- Extreme dyspnea
- Cough producing blood tinged sputum (pink color)
- Diaphoresis(profuse sweating)
- Paroxysmal nocturnal dyspnea (PND): pt need to use pillow to sleep.
- Crackles heard all the time.
*In pneumonia,crackles heard at the peak of inspiration.
LV failure—heart fail to pump—blood pooling in pulmonary circ—plasma moves frm pulmonary capillaries into interstitial spaces n alveoli—APO
- Kidney failure
- Valvular disorder.
- CXR – increase fluid in lung
- ECG – to find the etiology
- Serum BNP(brain natriuteric peptide)
– BNP is secreted by heart ventricle in response to excessive stretching of cardiomyocytes.
– >100picogram per ml indicates CHF.
- O2 100% – nonrebreather mask,upright position.
- Furosemide 1mg/kg IV
- Nitroglycerin 0.4mg SL(5min) followed by IV drop 10-20µg/min
- Morphine 1-5mg IV
- A – airway
– Max 3L/hr nasal prong(s/e: septal damage)
– Max 5L/hr mask
– Max HFM 8L/hr
– In peads,max 2L /hr
- B – breathing in upright position
- C- circulation (BP checking TRO shock)