When a physician examines someone with CHF, he or she may find the following:
Enlargement of the heart (cardiomegaly)
A third heart sound (S3) -- Normally, the heart makes two sounds (S1 and S2) often described as "lub dub, lub dub." In CHF there is a third sound, which is also called an S3 gallop because the three sounds are reminiscent of a horse galloping.
Sound of fluid in the lungs during inspiration (Rales)
Enlargement of the jugular vein in the neck (jugular venous distention) -- This occurs because CHF causes an increase in the amount of blood and pressure in veins.
Enlargement of the liver (hepatomegaly) -- This is caused by a back-up of blood from the heart.
Hepatojugular reflex -- When the liver is depressed, more blood travels into the jugular veins, causing them to become even more enlarged.
Edema -- This is usually located in the legs, ankles, feet. The term "pitting edema" is often used because applying slight fingertip pressure produces a temporary pit which resolves quickly.
Fast heart rate (tachycardia)
Increased rate of breathing (tachypnea)
High blood pressure (hypertension)
Low blood pressure (hypotension) -- When the cardiac output is severely decreased, then low blood pressure occurs. This is obviously an ominous sign and may mean death is imminent. This is also called cardiogenic shock.
Fluid in the abdominal cavity (ascites)
Fluid in the space between the lungs and the ribs (pleural effusion)
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