It can be acute or chronic.
Adrenal failure may be caused by a disorder of the adrenal glands, in which case it is called Addison’s disease, or by reduced stimulation of the adrenal cortex by ACTH, a hormone produced by the pituitary gland.
Structure Each suprarenal gland has an enveloping layer of ?brous tissue. Within this, the gland shows two distinct parts: an outer, ?rm, deep-yellow cortical (see CORTEX) layer, and a central, soft, dark-brown medullary (see MEDULLA) portion. The cortical part consists of columns of cells running from the surface inwards, whilst in the medullary portion the cells are arranged irregularly and separated from one another by large capillary blood vessels.
Functions Removal of the suprarenal glands in animals is speedily followed by great muscular prostration and death within a few days. In human beings, disease of the suprarenal glands usually causes ADDISON’S DISEASE, in which the chief symptoms are increasing weakness and bronzing of the skin. The medulla of the glands produces a substance – ADRENALINE – the effects of which closely resemble those brought about by activity of the SYMPATHETIC NERVOUS SYSTEM: dilated pupils, hair standing on end, quickening and strengthening of the heartbeat, immobilisation of the gut, increased output of sugar from the liver into the bloodstream. Several hormones (called CORTICOSTEROIDS) are produced in the cortex of the gland and play a vital role in the metabolism of the body. Some (such as aldosterone) control the electrolyte balance of the body and help to maintain the blood pressure and blood volume. Others are concerned in carbohydrate metabolism, whilst others again are concerned with sex physiology. HYDROCORTISONE is the most important hormone of the adrenal cortex, controlling as it does the body’s use of carbohydrates, fats and proteins. It also helps to suppress in?ammatory reactions and has an in?uence on the immune system.... adrenal glands
Left-sided heart failure may be caused by hypertension, anaemia, hyperthyroidism, a heart valve defect (such as aortic stenosis, aortic incompetence, or mitral incompetence), or a congenital heart defect (see heart disease, congenital). Other causes of left-sided heart failure include coronary artery disease, myocardial infarction, cardiac arrhythmias, and cardiomyopathy.
The left side of the heart fails to empty completely with each contraction, or has difficulty in accepting blood that has been returned from the lungs. The retained blood creates a back pressure that causes the lungs to become congested with blood. This condition leads to pulmonary oedema.
Right-sided heart failure most often results from pulmonary hypertension, which is itself caused by left-sided failure or by lung disease (such as chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive). Right-sided failure can also be due to a valve defect, such as tricuspid incompetence, or a congenital heart defect.
There is back pressure in the circulation from the heart into the venous system, causing swollen neck veins, enlargement of the liver, and oedema, especially of the legs and ankles. The intestines may become congested, causing discomfort.
Immediate treatment consists of bed rest, with the patient sitting up. Diuretic drugs are given, and digitalis drugs and vasodilators, especially ACE inhibitors, may also be administered. Morphine and oxygen may be given as emergency treatment in acute left-sided failure.... heart failure
Failure of the left ventricle may occur in cases of pericarditis, disease of the aortic valve, nephritis or high blood pressure.
Left ventricular failure is often of sudden onset, urgent, and may manifest as “cardiac asthma”.
Causes: blood clot, anaemia, thyroid disorder, coronary disease, congenital effects, drug therapy (beta blockers, etc), and to fevers that make heavy demands on the left ventricle.
Symptoms: breathlessness, wheezing, sweating, unproductive cough, faintness, bleeding from the lungs, palpitation. Cardiac asthma at night: feels he needs air; better upright than lying flat. Exertion soon tires. Sensation as if heart would stop. Blueness of lips and ears from hold-up in circulation of the blood through the lungs. Frequent chest colds. Awakes gasping for breath. Always tired. Cold hands and feet. Symptoms abate as compensation takes place. ‘Cream and roses’ complexion. The failure of left ventricle soon drags into failure of the right ventricle.
Right ventricular failure leads to congestive heart failure, with raised venous pressure in neck veins and body generally, causing oedema, ascites and liver engorgement.
Treatment. Agents to strengthen, support, and eliminate excess fluids from the body. BHP (1983) advises four main remedies: Hawthorn, Motherwort, Broom and Lily of the Valley. The latter works in a digitaloid manner, strengthening the heart, contracting the vessels, and lessening congestion in the lungs. Tinctures. Hawthorn 2; Stone root 1. Lily of the Valley 1. Dose: 15-45 drops thrice daily.
Broom tea. 2 teaspoons flowers, or 2-3 teaspoons tops and flowers, in cup water brought to boil and simmered one minute. 1 cup freely.
To remove fluid retention in the lungs, diuretics are indicated; chief among which is Dandelion root because of its high potassium content to prevent hypokalaemia. Dandelion coffee. As urinary excretion increases, patient improves.
Vitamin E. Not to be taken in left ventricular disorders.
Diet. See entry: DIET – HEART AND CIRCULATION.
UK Research. Researchers found that left ventricular failure was reduced by a quarter when patients were given magnesium intravenously for the first 24 hours after admission to the coronary care unit. They conclude that it should be given before any other heart therapy is commenced, and that patients should receive regular infusions if no other drug treatment is used. (The Lancet, 2.4.1994). This supports the use of magnesium sulphate (Epsom’s salts) by a past generation of herbal practitioners for the condition. ... heart – left ventricular failure (lvf)
Mitral disease leads to heart failure either by a narrowing of the orifice (stenosis) or a regurgitation blocks the passage of blood from the left atrium (auricle) to the left ventricle. The left atrium enlarges (hypertrophies) in an effort to counter the impediment. Real compensation – increased thrust of the blood – is provided by the right ventricle. In order to overcome a mitral impediment the right ventricle has to enlarge.
Sooner or later the right ventricle cannot enlarge any further and general heart failure sets in. Though caused primarily by a lesion of the mitral valve, it may be secondary to left ventricular failure (LVF), thyroid disorder (thyrotoxicosis), pericarditis, congenital heart disease, or any disease which weakens ventricular muscle.
Venous congestion and back pressure of RVF leads to congestion and accumulation of fluid in the lungs, cough and spitting of blood, painful swelling of the liver, nausea, loss of appetite and severe wasting.
Where the right ventricle fails to move the blood forward as it arrives from the systemic circulation, generalised dropsy sets in. Congestion of the kidneys leads to reduced urinary excretion and presence of albumin in the urine.
The picture is well known to the cardiac practitioner: blueness of the skin, congestion of the brain circulation with sleeplessness and delirium. Soon the tension of water-logged tissues results in pain and extreme anxiety. Feet are swollen and ankles pit on pressure; chest cavities fill with fluid and the abdomen swells (ascites).
Alternatives. Cardio-tonics would be given to strengthen the ventricle and diuretics to correct fluid retention: Lily of the Valley, Hawthorn, Motherwort, Broom. BHP (1983).
Due to rheumatic fever: Hawthorn.
High Blood Pressure: Mistletoe.
Effort Syndrome: Motherwort.
Tinctures. Combine, Lily of the Valley 2; Hawthorn 2; Motherwort 3. Dose: 1 teaspoon thrice daily after meals.
Diet. Low salt, low fat, high fibre. Restricted fluids, vegetarian protein foods, yoghurt. See also: DIET – HEART AND CIRCULATION.
Supplements. Potassium (bananas), Vitamin B6.
General. Stop smoking. Correction of overweight. Complete bed-rest with legs raised above level of the abdomen and patient propped-up to relieve difficult breathing. ... heart – right ventricular failure (rvf)
A genetic defect causes congenital adrenal hyperplasia, in which the adrenal cortex is unable to make sufficient hydrocortisone and aldosterone, and androgens are produced in excess. In adrenal failure, there is also deficient production of hormones by the adrenal cortex; if due to disease of the adrenal glands, it is called Addison’s disease. Adrenal tumours are rare and generally lead to excess hormone production.
In many cases, disturbed activity of the adrenal glands is caused, not by disease of the glands themselves, but by an increase or decrease in the blood level of hormones that influence the action of the adrenal glands. For example, hydrocortisone production by the adrenal cortex is controlled by ACTH, which is secreted by the pituitary gland. Pituitary disorders can disrupt production of hydrocortisone.... adrenal gland disorders
In severe cases, the disorder is apparent soon after birth. In milder cases, symptoms appear later, sometimes producing premature puberty in boys and delayed menstruation, hirsutism, and potential infertility in girls.
Congenital adrenal hyperplasia is confirmed by measuring corticosteroid hormones in blood and urine. Treatment is by hormone replacement. If this is started early, normal sexual development and fertility usually follow.... adrenal hyperplasia, congenital
Treatment is with ventilation and oxygen for the underlying cause.... respiratory failure
Acute liver failure requires urgent hospital care.
Although no treatment can repair damage that has already occurred in acute and chronic liver failure, certain measures, such as prescribing diuretic drugs to reduce abdominal swelling, may be taken to reduce the severity of symptoms.
Consumption of alcohol should cease in all cases.
The prognoses for sufferers of chronic liver failure vary depending on the cause, but some people survive for many years.
For acute liver failure, a liver transplant is necessary to increase the chances of survival.... liver failure
Health Encyclopedia