Acid-Base Balance: Congestive Heart Failure

Writing III – Acid-Base Balance

Congestive heart failure (CHF) is caused by the inability of the heart to fill correctly, eject blood completely, or a combination of the two, which results in a decrease in cardiac output. Chronic hypertension (CH) is a constantly elevated blood pressure. Peripheral vascular disease (PVD) causes a restriction in blood circulation due to atherosclerosis, fatty deposits on the inner linings of the arteries that cause a blockage of blood flow; arteriosclerosis, loss of elasticity in the arteries themselves; or both. Restricted peripheral blood flow causes an increase in blood pressure because the heart would have to pump with more force to maintain proper cardiac output. Hypertension strains the filtration
The resulting decreased blood flow to the lungs also decreases gas exchange in the alveoli. Decreased gas exchange can result in inadequately oxygenated blood. Incomplete ejection of blood during ventricular contraction can cause mitral valve prolapsed, allowing blood to backflow into the left atrium, which increases pressure in pulmonary veins, causing pulmonary edema. Excess fluid in the alveoli due to edema disrupts normal gas exchange in the lungs, causing shortness of breath. Peripheral vascular disease causes narrowing of peripheral blood vessels and a decrease in blood flow to the lungs. The restriction of peripheral blood flow causes an increase in blood pressure because the heart has to pump with more force to maintain the amount of blood circulating to the tissues and organs with every heartbeat. A decrease in cardiac output and in blood flow can cause the blood returning to the heart to back up in the tissues causing peripheral
Hyperventilation, or increased respiratory rate, is attempting to correct his metabolic acidosis by expelling more carbon dioxide to allow the bicarbonate ion buffer system to kick in to raise blood pH. Also, the presence of large molecules in Robert’s urine indicate renal damage, at the very least, and even though many of his test levels returned to the normal range, upon 2nd admission to the hospital, his blood hemoglobin count continued to fall, creatinine level was still elevated, albumin level was above normal, urine ketone level was still above normal, and hemoglobin and bilirubin in his urine show RBC breakdown. Severe, prolonged acidosis ultimately led to complete pulmonary