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Abdominal and Pelvic Trauma
Acute Angle-Closure Glaucoma
Bowel Obstruction
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Fifth Metatarsal Fracture
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Infant Botulism
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Optic Neuritis
Panic Disorder
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Congestive Heart Failure

Acute exacerbation of CHF is typically caused by cardiac ischemia, although a hypertensive emergency and, less commonly, cardiomyopathy can also cause acute CHF.


  • Main cause of heart failure is coronary artery disease, which is secondary to loss of left ventricular muscle, ongoing ischemia, or decreased diastolic ventricular compliance.
  • Most common causes of heart failure are hypertension or high blood pressure.
  • Other functional causes of heart failure such as including valvular heart disease, congenital heart disease, dilated cardiomyopathy, lung disease, heart tumo.
  • Heart failure may be occur during the last 3 months of pregnancy or several months after pregnancy. It may be occur due to an abnormal immune system response.


  • Shortness of breath at rest is the major presenting symptom ++++.
  • Paroxysmal nocturnal dyspnea +++
  • Orthopnea ++
  • Cough
  • Fatigue
  • Symptoms of myocardial ischemia are common: angina, diaphoresis, and decreased exercise tolerance.


The presence of physical findings in CHF tends to be more specific than sensitive.

  • Vital signs (abnormal): tachycardia, normal or elevated blood pressure, hypotension indicative of cardiac decompensation (shock)
  • Wet crackles
  • S3 gallop (common in systolic dysfunction), representing rapid ventricular filling associated with impaired ventricular function ++ (>90% specific)
  • S4 gallop (common in diastolic dysfunction), representing diminished ventricular compliance
  • Peripheral edema ++ (80% specific)
  • Jugular venous distention ++ (>90% specific)
  • Hepatojugular reflux ++ (>90% specific)


  • For the treatment of CHF, it requires treatment program of rest, proper diet, modified daily activities, drugs such as including ACE(angiotensin-converting enzyme) inhibitors, digitalis, diuretics, vasodilators.
  • Heart failure means, it causes the heart to pump harder to compensate for its weakened pumping ability. To treat the heart failure used beta-blockers, because it help to relax the heart, reduce the vigor of its contractions, and reduce additional strain on the heart.
  • Other treatments that are depend on the cause of heart failure, such as including Coronary angioplasty, Coronary artery bypass surgery, Implantable cardiac defibrillator (ICD), Intra-aortic balloon pump (IABP), Left ventricular assist device (LVAD), Valve repair or valve replacement surgery.

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