69-445: The Queen Dowager The Tengku Temenggong The Tengku Puan Temenggong The Tengku Sri Kelana D’Raja The Tengku Kaya Perkasa Sultan Ismail Petra ibni Almarhum Sultan Yahya Petra ( Jawi : سلطان إسماعيل ڤيترا ابن المرحوم سلطان يحيى ڤيترا ; 11 November 1949 – 28 September 2019) was the 28th Sultan of Kelantan and the 11th Sultan of Modern Kelantan who reigned from 30 March 1979 to 13 September 2010. He succeeded on
138-585: A cause (e.g., aortic stenosis ) or as a consequence (e.g., mitral regurgitation ) of heart failure. Reverse insufficiency of the left ventricle causes congestion in the blood vessels of the lungs so that symptoms are predominantly respiratory. Reverse insufficiency can be divided into the failure of the left atrium, the left ventricle, or both within the left circuit. Patients will experience shortness of breath (dyspnea) on exertion and, in severe cases, dyspnea at rest. Increasing breathlessness while lying down, called orthopnea , also occurs. It can be measured by
207-465: A decrease in intracardiac pressures or in ejection during systole , reducing cardiac output to the rest of the body. The filling failure and high intracardiac pressure can lead to fluid accumulation in ventricles of the heart. This manifests as water retention and swelling due to fluid accumulation ( edema ) called congestion . Impaired ejection can lead to inadequate blood flow to the body tissues, resulting in ischemia . Congestive heart failure
276-499: A massive stroke on 14 May 2009. He received follow-up treatments at the Universiti Sains Malaysia Hospital, Kubang Kerian. The Kelantan government then appointed medical specialists to form a medical panel to check his health. When Sultan Ismail Petra remained ill, the panel decided that he was not capable of ruling the state and it was decided that his eldest son, Crown Prince Tengku Muhammad Faris Petra be crowned
345-678: A myocardial infarction is suspected, various cardiac markers may be used. Blood tests routinely performed include electrolytes ( sodium , potassium ), measures of kidney function , liver function tests , thyroid function tests , a complete blood count , and often C-reactive protein if infection is suspected. Hyponatremia (low serum sodium concentration) is common in heart failure. Vasopressin levels are usually increased, along with renin, angiotensin II, and catecholamines to compensate for reduced circulating volume due to inadequate cardiac output. This leads to increased fluid and sodium retention in
414-587: A normal ECG virtually excludes left ventricular systolic dysfunction. N-terminal pro-BNP (NT-proBNP) is the favored biomarker for the diagnosis of heart failure, according to guidelines published 2018 by NICE in the UK . Brain natriuretic peptide 32 (BNP) is another biomarker commonly tested for heart failure. An elevated NT-proBNP or BNP is a specific test indicative of heart failure. Additionally, NT-proBNP or BNP can be used to differentiate between causes of dyspnea due to heart failure from other causes of dyspnea. If
483-627: A period of a year. He then worked at the Land and District Office in Kota Bharu. During this time, he gained vast experience and extensive knowledge on all fields of administration. Ismail Petra succeeded his father as the Sultan of Kelantan on 30 March 1979. A year later, on 30 March 1980, he was crowned as the Sultan of Kelantan in the throne room of the Istana Balai Besar in Kota Bharu. Sultan Ismail Petra
552-419: A person with a failure of one ventricle lives long enough, it will tend to progress to failure of both ventricles. For example, left ventricular failure allows pulmonary edema and pulmonary hypertension to occur, which increases stress on the right ventricle. Though still harmful, right ventricular failure is not as deleterious to the left side. Since heart failure is a syndrome and not a disease, establishing
621-485: A person with heart failure may have a reduced force of contraction due to overloading of the ventricle . In a normal heart, increased filling of the ventricle results in increased contraction force by the Frank–Starling law of the heart , and thus a rise in cardiac output . In heart failure, this mechanism fails, as the ventricle is loaded with blood to the point where heart muscle contraction becomes less efficient. This
690-423: A result of a blocked coronary artery . Cardiomyopathy refers specifically to problems within the heart muscle, and these problems can result in heart failure. Ischemic cardiomyopathy implies that the cause of muscle damage is coronary artery disease. Dilated cardiomyopathy implies that the muscle damage has resulted in enlargement of the heart. Hypertrophic cardiomyopathy involves enlargement and thickening of
759-501: A result, coronary catheterization may be used to identify possibilities for revascularisation through percutaneous coronary intervention or bypass surgery . Heart failure is commonly stratified by the degree of functional impairment conferred by the severity of the heart failure, as reflected in the New York Heart Association (NYHA) functional classification . The NYHA functional classes (I–IV) begin with class I, which
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#1732870145283828-572: A second wife, Cik Puan Elia Suhana Ahmad, whom he married on 23 December 2007. It was reported that Sultan Ismail Petra, filed an application for verification of his divorce from his second wife, at the Syariah High Court on 9 March 2010. However, the Syariah Court of Appeal rejected an application to validate the divorce pronouncement allegedly uttered by Sultan Ismail Petra against his second wife on 30 March 2011. Sultan Ismail Petra suffered
897-429: Is a pathophysiological condition in which the heart's output is insufficient to meet the needs of the body and lungs. The term "congestive heart failure" is often used because one of the most common symptoms is congestion or fluid accumulation in the tissues and veins of the lungs or other parts of a person's body. Congestion manifests itself particularly in the form of fluid accumulation and swelling (edema) , in
966-420: Is a common, costly, and potentially fatal condition, and is the leading cause of hospitalization and readmission in older adults. Heart failure often leads to more drastic health impairments than the failure of other, similarly complex organs such as the kidneys or liver. In 2015, it affected about 40 million people worldwide. Overall, heart failure affects about 2% of adults, and more than 10% of those over
1035-702: Is a worsening of chronic heart failure symptoms, which can result in acute respiratory distress . High-output heart failure can occur when there is increased cardiac demand that results in increased left ventricular diastolic pressure which can develop into pulmonary congestion (pulmonary edema). Several terms are closely related to heart failure and may be the cause of heart failure, but should not be confused with it. Cardiac arrest and asystole refer to situations in which no cardiac output occurs at all. Without urgent treatment, these events result in sudden death. Myocardial infarction ("Heart attack") refers to heart muscle damage due to insufficient blood supply, usually as
1104-471: Is by the side of the heart involved (left heart failure versus right heart failure). Right heart failure was thought to compromise blood flow to the lungs compared to left heart failure compromising blood flow to the aorta and consequently to the brain and the remainder of the body's systemic circulation. However, mixed presentations are common, and left heart failure is a common cause of right heart failure. A more accurate classification of heart failure type
1173-421: Is caused by any condition that reduces the efficiency of the heart muscle, through damage or overloading . Over time, these increases in workload, which are mediated by long-term activation of neurohormonal systems such as the renin–angiotensin system and the sympathoadrenal system, lead to fibrosis , dilation, and structural changes in the shape of the left ventricle from elliptical to spherical. The heart of
1242-410: Is consistent with an international 2021 report termed "Universal Definition of Heart Failure". Score-based algorithms have been developed to help in the diagnosis of HFpEF , which can be challenging for physicians to diagnose. The AHA / ACC / HFSA defines heart failure as symptoms and signs consistent with heart failure in combination with shown "structural and functional alterations of the heart as
1311-432: Is defined as a person who experiences no limitation in any activities and has no symptoms from ordinary activities. People with NYHA class II heart failure have slight, mild limitations with everyday activities; the person is comfortable at rest or with mild exertion. With NYHA class III heart failure, a marked limitation occurs with any activity; the person is comfortable only at rest. A person with NYHA class IV heart failure
1380-483: Is due to the reduced ability to cross-link actin and myosin myofilaments in over-stretched heart muscle. No diagnostic criteria have been agreed on as the gold standard for heart failure, especially heart failure with preserved ejection fraction (HFpEF). In the UK , the National Institute for Health and Care Excellence recommends measuring N-terminal pro-BNP (NT-proBNP) followed by an ultrasound of
1449-605: Is exposure to certain toxins such as lead and cobalt . Additionally, infiltrative disorders such as amyloidosis and connective tissue diseases such as systemic lupus erythematosus have similar consequences. Obstructive sleep apnea (a condition of sleep wherein disordered breathing overlaps with obesity, hypertension, and/or diabetes) is regarded as an independent cause of heart failure. Recent reports from clinical trials have also linked variation in blood pressure to heart failure and cardiac changes that may give rise to heart failure. High-output heart failure happens when
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#17328701452831518-422: Is made by measuring ejection fraction , or the proportion of blood pumped out of the heart during a single contraction. Ejection fraction is given as a percentage with the normal range being between 50 and 75%. The types are: Heart failure may also be classified as acute or chronic. Chronic heart failure is a long-term condition, usually kept stable by the treatment of symptoms. Acute decompensated heart failure
1587-499: Is mentioned in the Ebers Papyrus around 1550 BCE. When the heart functions poorly as a pump and does not circulate blood adequately via the circulatory system to meet the demands of the body the term cardiovascular insufficiency is sometimes used. This generally leads to the syndrome of heart failure, a combination of signs and symptoms It develops when the heart fails to properly fill with blood during diastole , resulting in
1656-883: Is not the same as cardiac arrest , in which blood flow stops completely due to the failure of the heart to pump. Diagnosis is based on symptoms, physical findings, and echocardiography . Blood tests , and a chest x-ray may be useful to determine the underlying cause. Treatment depends on severity and case. For people with chronic, stable, or mild heart failure, treatment usually consists of lifestyle changes, such as not smoking , physical exercise , and dietary changes, as well as medications. In heart failure due to left ventricular dysfunction, angiotensin-converting-enzyme inhibitors , angiotensin II receptor blockers (ARBs), or angiotensin receptor-neprilysin inhibitors , along with beta blockers , mineralocorticoid receptor antagonists and SGLT2 inhibitors are recommended. Diuretics may also be prescribed to prevent fluid retention and
1725-613: Is symptomatic at rest and becomes quite uncomfortable with any physical activity. This score documents the severity of symptoms and can be used to assess response to treatment. While its use is widespread, the NYHA score is not very reproducible and does not reliably predict walking distance or exercise tolerance on formal testing. In its 2001 guidelines, the American College of Cardiology / American Heart Association working group introduced four stages of heart failure: The ACC staging system
1794-471: Is the X-ray imaging of blood vessels , which is done by injecting contrast agents into the bloodstream through a thin plastic tube ( catheter ), which is placed directly in the blood vessel. X-ray images are called angiograms. Heart failure may be the result of coronary artery disease, and its prognosis depends in part on the ability of the coronary arteries to supply blood to the myocardium (heart muscle). As
1863-626: Is the former Raja Perempuan ( Queen consort ) of Kelantan . She is the widow of the late Sultan Ismail Petra , the 28th Sultan of Kelantan and the mother of Sultan Muhammad V , the current and 29th Sultan of Kelantan . Tengku Anis was born on 6 January 1949 at Palm Manor, Kota Bharu as a daughter of Tengku Abdul Hamid bin Tengku Muda Sulong Abdul Putra ( Thai : มานพ พิพิธภักดี ; RTGS : Manop Phiphitphakdi ) and his wife, Tengku Azizah binti Tengku Sri Maharaja Muhammad Hamzah. Her paternal grandfather, Tengku Abdul Putra,
1932-494: Is the precipitating cause, and may manifest as regional wall motion abnormalities on echo. Chest X-rays are frequently used to aid in the diagnosis of CHF. In a person who is compensated, this may show cardiomegaly (visible enlargement of the heart), quantified as the cardiothoracic ratio (proportion of the heart size to the chest). In left ventricular failure, evidence may exist of vascular redistribution (upper lobe blood diversion or cephalization), Kerley lines , cuffing of
2001-491: Is useful since stage A encompasses "pre-heart failure" – a stage where intervention with treatment can presumably prevent progression to overt symptoms. ACC stage A does not have a corresponding NYHA class. ACC stage B would correspond to NYHA class I. ACC stage C corresponds to NYHA class II and III, while ACC stage D overlaps with NYHA class IV. Histopathology can diagnose heart failure in autopsies . The presence of siderophages indicates chronic left-sided heart failure, but
2070-613: The shortening fraction is the preferred measure of systolic function. Normally, the EF should be between 50 and 70%; in systolic heart failure, it drops below 40%. Echocardiography can also identify valvular heart disease and assess the state of the pericardium (the connective tissue sac surrounding the heart). Echocardiography may also aid in deciding specific treatments, such as medication, insertion of an implantable cardioverter-defibrillator , or cardiac resynchronization therapy . Echocardiography can also help determine if acute myocardial ischemia
2139-508: The Mentri Besar of Kelantan Dato' Ahmad Yakob officially announced his death. Prime Minister Mahathir Mohamad said of Sultan Ismail Petra: But when Sultan Ismail Petra was the ruler, I had good relations with His Highness. I found him an orderly person and easy to work with On the same day, a state funeral was held. At the funeral were the Yang di-Pertuan Agong , Sultan Abdullah of Pahang and
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2208-1156: The Raja Permaisuri Agong Tunku Azizah Aminah Maimunah Iskandariah , the Sultan of Brunei Hassanal Bolkiah , Raja Sirajuddin of Perlis and the Raja Perempuan of Perlis Tuanku Fauziah . Also in attendance were the Deputy Prime Minister Wan Azizah Wan Ismail and her husband Anwar Ibrahim . He was buried near the grave of his father, Sultan Yahya Petra at the Langgar Royal Mausoleum in Kota Bharu , Kelantan . Several places were named after him, including: Raja Perempuan Tengku Anis The Queen Dowager The Tengku Temenggong The Tengku Puan Temenggong The Tengku Sri Kelana D’Raja The Tengku Kaya Perkasa Raja Perempuan Tengku Anis binti Almarhum Tengku Abdul Hamid ( Jawi : راج ڤرمڤوان تڠکو أنيس بنت المرحوم تڠكو عبدالحميد; born 6 January 1949)
2277-519: The age of 70. Rates are predicted to increase. The risk of death in the first year after diagnosis is about 35%, while the risk of death in the second year is less than 10% in those still alive. The risk of death is comparable to that of some cancers. In the United Kingdom, the disease is the reason for 5% of emergency hospital admissions. Heart failure has been known since ancient times in Egypt ; it
2346-453: The amount of blood pumped out is more than typical and the heart cannot keep up. This can occur in overload situations such as blood or serum infusions, kidney diseases, chronic severe anemia , beriberi (vitamin B 1 / thiamine deficiency), hyperthyroidism , cirrhosis , Paget's disease , multiple myeloma , arteriovenous fistulae , or arteriovenous malformations . Chronic stable heart failure may easily decompensate (fail to meet
2415-418: The areas around the bronchi , and interstitial edema. Ultrasound of the lung may also detect Kerley lines. An electrocardiogram (ECG or EKG) may be used to identify arrhythmias , ischemic heart disease , right and left ventricular hypertrophy , and presence of conduction delay or abnormalities (e.g. left bundle branch block ). Although these findings are not specific to the diagnosis of heart failure,
2484-407: The blood , is a late sign of extremely severe pulmonary edema. Other signs of left ventricular failure include a laterally displaced apex beat (which occurs when the heart is enlarged) and a gallop rhythm (additional heart sounds), which may be heard as a sign of increased blood flow or increased intracardiac pressure. Heart murmurs may indicate the presence of valvular heart disease, either as
2553-604: The body first, causing foot and ankle swelling in people who are standing up and sacral edema in people who are predominantly lying down. Nocturia (frequent night-time urination) may occur when fluid from the legs is returned to the bloodstream while lying down at night. In progressively severe cases, ascites (fluid accumulation in the abdominal cavity causing swelling) and liver enlargement may develop. Significant liver congestion may result in impaired liver function ( congestive hepatopathy ), jaundice, and coagulopathy (problems of decreased or increased blood clotting). Dullness of
2622-457: The body's metabolic needs). This most commonly results from a concurrent illness (such as myocardial infarction (a heart attack) or pneumonia ), abnormal heart rhythms , uncontrolled hypertension , or a person's failure to maintain a fluid restriction, diet, or medication. Other factors that may worsen CHF include: anemia, hyperthyroidism, excessive fluid or salt intake, and medication such as NSAIDs and thiazolidinediones . NSAIDs increase
2691-412: The body; the rate of fluid retention is higher than the rate of sodium retention in the body, this phenomenon causes hypervolemic hyponatremia (low sodium concentration due to high body fluid retention). This phenomenon is more common in older women with low body mass. Severe hyponatremia can result in accumulation of fluid in the brain, causing cerebral edema and intracranial hemorrhage . Angiography
2760-478: The brain. Right-sided heart failure is often caused by pulmonary heart disease (cor pulmonale), which is typically caused by issues with pulmonary circulation such as pulmonary hypertension or pulmonic stenosis . Physical examination may reveal pitting peripheral edema, ascites, liver enlargement , and spleen enlargement . Jugular venous pressure is frequently assessed as a marker of fluid status, which can be accentuated by testing hepatojugular reflux . If
2829-561: The death of his father, Sultan Yahya Petra . He was succeeded by his eldest son, Sultan Muhammad V who ascended to the throne on 13 September 2010 after Sultan Ismail Petra was incapacitated. Sultan Ismail Petra died at the Raja Perempuan Zainab II Hospital in Kota Bharu on 28 September 2019, aged 69, after 10 years of suffering from a massive stroke and was buried at the Kelantan Royal Mausoleum . Ismail Petra
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2898-602: The effects of diuretic medications. Gossypol can increase the effects of diuretics, leading to toxicity. Gynura can cause low blood pressure. Licorice can worsen heart failure by increasing blood pressure and promoting fluid retention. Lily of the Valley can cause abnormally slow heart rates with mechanisms similar to those of digoxin. Tetrandrine can lower blood pressure by inhibiting L-type calcium channels . Yohimbine can exacerbate heart failure by increasing blood pressure through alpha-2 adrenergic receptor antagonism. Heart failure
2967-523: The force with which the heart ejects blood , thus are not recommended in people with heart failure with a reduced ejection fraction. Breast cancer patients are at high risk of heart failure due to several factors. After analyzing data from 26 studies (836,301 patients), the recent meta-analysis found that breast cancer survivors demonstrated a higher risk heart failure within first ten years after diagnosis (hazard ratio = 1.21; 95% CI: 1.1, 1.33). The pooled incidence of heart failure in breast cancer survivors
3036-509: The form of peripheral edema (causing swollen limbs and feet) and pulmonary edema (causing difficulty breathing) and ascites (swollen abdomen). Pulse pressure , which is the difference between the systolic ("top number") and diastolic ("bottom number") blood pressures, is often low/narrow (i.e. 25% or less of the level of the systolic) in people with heart failure, and this can be an early warning sign. Symptoms of heart failure are traditionally divided into left-sided and right-sided because
3105-673: The formation of prostaglandins , NSAIDs may exacerbate heart failure through several mechanisms, including promotion of fluid retention, increasing blood pressure , and decreasing a person's response to diuretic medications. Similarly, the ACC/AHA recommends against using COX-2 inhibitor medications in people with heart failure. Thiazolidinediones have been strongly linked to new cases of heart failure and worsening of pre-existing congestive heart failure due to their association with weight gain and fluid retention. Certain calcium channel blockers, such as diltiazem and verapamil , are known to decrease
3174-619: The functions of the King of Malaysia (Yang di-Pertuan Agong). The second time was from 12 July 1975 to 28 August 1975 when his father was visiting Europe. The third time was when his father was elected King of Malaysia from 21 September 1975 until his death on 29 March 1979. In 1968, Ismail Petra joined the Government Administrative Services as an officer and was attached to the Kelantan State Secretary Office for
3243-721: The heart if positive. In Europe , the European Society of Cardiology , and in the United States, the AHA / ACC / HFSA , recommend measuring NT-proBNP or BNP followed by an ultrasound of the heart if positive. This is recommended in those with symptoms consistent with heart failure such as shortness of breath . The European Society of Cardiology defines the diagnosis of heart failure as symptoms and signs consistent with heart failure in combination with "objective evidence of cardiac structural or functional abnormalities". This definition
3312-666: The heart is affected, HF typically presents with shortness of breath , excessive fatigue , and bilateral leg swelling . The severity of the heart failure is mainly decided based on ejection fraction and also measured by the severity of symptoms. Other conditions that have symptoms similar to heart failure include obesity , kidney failure , liver disease , anemia , and thyroid disease . Common causes of heart failure include coronary artery disease , heart attack , high blood pressure , atrial fibrillation , valvular heart disease , excessive alcohol consumption , infection , and cardiomyopathy . These cause heart failure by altering
3381-529: The heart muscle. An echocardiogram ( ultrasound of the heart) is commonly used to support a clinical diagnosis of heart failure. This can determine the stroke volume (SV, the amount of blood in the heart that exits the ventricles with each beat), the end-diastolic volume (EDV, the total amount of blood at the end of diastole), and the SV in proportion to the EDV, a value known as the ejection fraction (EF). In pediatrics,
3450-599: The heart's myocardial tissue (termed myocarditis ) can similarly contribute to the development of heart failure. Genetic predisposition plays an important role. If more than one cause is present, progression is more likely and prognosis is worse. Heart damage can predispose a person to develop heart failure later in life and has many causes including systemic viral infections (e.g., HIV ), chemotherapeutic agents such as daunorubicin , cyclophosphamide , trastuzumab and substance use disorders of substances such as alcohol , cocaine , and methamphetamine . An uncommon cause
3519-430: The left and right ventricles supply different parts of the circulation. In biventricular heart failure, both sides of the heart are affected. Left-sided heart failure is the more common. The left side of the heart takes oxygen-rich blood from the lungs and pumps it to the rest of the circulatory system in the body (except for the pulmonary circulation ). Failure of the left side of the heart causes blood to back up into
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#17328701452833588-441: The lung fields when percussed and reduced breath sounds at the base of the lungs may suggest the development of a pleural effusion (fluid collection between the lung and the chest wall ). Though it can occur in isolated left- or right-sided heart failure, it is more common in biventricular failure because pleural veins drain into both the systemic and pulmonary venous systems. When unilateral, effusions are often right-sided. If
3657-446: The lungs, causing breathing difficulties and fatigue due to an insufficient supply of oxygenated blood. Common respiratory signs include increased respiratory rate and labored breathing (nonspecific signs of shortness of breath). Rales or crackles are heard initially in the lung bases and when severe in all lung fields indicate the development of pulmonary edema (fluid in the alveoli ). Cyanosis , indicates deficiency of oxygen in
3726-711: The new sultan on 13 September 2010 by order of the Kelantan Succession Council. However, lawyers acting on behalf of Sultan Ismail Petra filed a petition to the Federal Court to have the appointment of the Crown Prince as the Sultan of Kelantan nullified, claiming that the appointment was unconstitutional. Sultan Ismail Petra died of heart failure on 28 September 2019 at 8:11 am at the Royal Ward of Raja Perempuan Zainab II Hospital, Kota Bharu, aged 69. On that day,
3795-575: The number of pillows required to lie comfortably, with extreme cases of orthopnea forcing the patient to sleep sitting up. Another symptom of heart failure is paroxysmal nocturnal dyspnea : a sudden nocturnal attack of severe shortness of breath, usually occurring several hours after falling asleep. There may be " cardiac asthma " or wheezing . Impaired left ventricular forward function can lead to symptoms of poor systemic perfusion such as dizziness , confusion , and cool extremities at rest. Loss of consciousness may also occur due to loss of blood supply to
3864-503: The resulting shortness of breath. Depending on the case, an implanted device such as a pacemaker or implantable cardiac defibrillator may sometimes be recommended. In some moderate or more severe cases, cardiac resynchronization therapy (CRT) or cardiac contractility modulation may be beneficial. In severe disease that persists despite all other measures, a cardiac assist device ventricular assist device , or, occasionally, heart transplantation may be recommended. Heart failure
3933-403: The right ventricular pressure is increased, a parasternal heave which causes the compensatory increase in contraction strength may be present. Backward failure of the right ventricle leads to congestion of systemic capillaries. This generates excess fluid accumulation in the body. This causes swelling under the skin ( peripheral edema or anasarca ) and usually affects the dependent parts of
4002-626: The risk twofold. A number of medications may cause or worsen the disease. This includes NSAIDs , COX-2 inhibitors , a number of anesthetic agents such as ketamine , thiazolidinediones, some cancer medications , several antiarrhythmic medications , pregabalin , alpha-2 adrenergic receptor agonists , minoxidil , itraconazole , cilostazol , anagrelide , stimulants (e.g., methylphenidate ), tricyclic antidepressants , lithium , antipsychotics , dopamine agonists , TNF inhibitors , calcium channel blockers (especially verapamil and diltiazem ), salbutamol , and tamsulosin . By inhibiting
4071-436: The structure or the function of the heart or in some cases both. There are different types of heart failure: right-sided heart failure , which affects the right heart , left-sided heart failure , which affects the left heart , and biventricular heart failure, which affects both sides of the heart. Left-sided heart failure may be present with a reduced ejection fraction or with a preserved ejection fraction . Heart failure
4140-602: The time King of Malaysia) passed away and Tengku Ismail Petra was installed as the Sultan of Kelantan ; subsequently, she was installed as the Raja Perempuan (Queen consort) of Kelantan on 30 March 1979. Her husband, Sultan Ismail Petra, reigned until 13 September 2010, and was succeeded by their eldest son, Tengku Muhammad Faris Petra . As a queen dowager , she is now styled as "Yang Maha Mulia Raja Perempuan Tengku Anis binti Almarhum Tengku Abdul Hamid". The royal couple have four children: Tengku Anis always pays serious attention to
4209-541: The underlying cause for the clinical presentation", for HFmrEF and HFpEF specifically requiring "evidence of spontaneous or provokable increased left ventricle filling pressures". The European Society of Cardiology has developed a diagnostic algorithm for HFpEF , named HFA-PEFF. HFA-PEFF considers symptoms and signs, typical clinical demographics (obesity, hypertension, diabetes, elderly, atrial fibrillation), and diagnostic laboratory tests, ECG, and echocardiography. One historical method of categorizing heart failure
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#17328701452834278-565: The underlying cause is vital to diagnosis and treatment. In heart failure, the structure or the function of the heart or in some cases both are altered. Heart failure is the potential end stage of all heart diseases. Common causes of heart failure include coronary artery disease , including a previous myocardial infarction (heart attack), high blood pressure , atrial fibrillation , valvular heart disease , excess alcohol use , infection , and cardiomyopathy of an unknown cause. In addition, viral infection and subsequent inflammation of
4347-479: The welfare of the people and always shows a deep interest in the movement of charities in the state of Kelantan. She is the patron of various organisations such as: She was awarded: Several places were named after her, including: Heart failure Heart failure ( HF ), also known as congestive heart failure ( CHF ), is a syndrome caused by an impairment in the heart 's ability to fill with and pump blood . Although symptoms vary based on which side of
4416-488: Was 4.44 (95% CI 3.33-5.92) per 1000 person-years of follow-up. Certain alternative medicines carry a risk of exacerbating existing heart failure, and are not recommended. This includes aconite , ginseng , gossypol , gynura , licorice , lily of the valley , tetrandrine , and yohimbine . Aconite can cause abnormally slow heart rates and abnormal heart rhythms such as ventricular tachycardia. Ginseng can cause abnormally low or high blood pressure and may interfere with
4485-503: Was born at the Istana Jahar in Kota Bharu , Kelantan on 11 November 1949. He was the youngest child and only son of Sultan Yahya Petra by his first wife, Raja Perempuan Zainab II . He grew up with four siblings, Tengku Merjan, Tengku Rozan, Tengku Salwani and Tengku Rohani. Ismail Petra received his secondary education at Sultan Ismail College, Kota Bharu before being tutored by a special English language teacher. On 8 January 2002, he
4554-788: Was commissioned as an honorary major in the Territorial Army Regiment on 1 November 1974. He was elevated to lieutenant colonel on 1 January 1976. On 15 March 1988, he was appointed honorary lieutenant colonel in the Territorial Army Regiment and also honorary major-general and colonel-in-chief of the Royal Artillery Regiment in 1997. Sultan Ismail Petra was proclaimed the first Chancellor of Universiti Malaysia Kelantan on 10 August 2008. Sultan Ismail Petra married Raja Perempuan Tengku Anis binti Tengku Abdul Hamid on 4 December 1968 when they were both 19 years old. The royal couple had four children: Sultan Ismail Petra also had
4623-587: Was conferred an Honorary Degree doctorate of Philosophy in Human Resources Development from the Ramkhamhaeng University, Thailand on 26 February 2005. On 4 December 1968, Tengku Anis married Tengku Ismail Petra , the then-Tengku Mahkota (Crown Prince) of Kelantan at Istana Kota Lama in Kota Bharu. Subsequently, she was bestowed the title of Tengku Ampuan Mahkota (Crown Princess) of Kelantan on 1 January 1969. In 1979, Sultan Yahya Petra (at
4692-543: Was conferred an Honorary Doctorate of Philosophy in Political Science from the Ramkhamhaeng University, Thailand. Ismail Petra was made as the Crown Prince (Tengku Mahkota) of Kelantan on 11 November 1967 at the Istana Balai Besar, Kota Bharu, Kelantan. Additionally, Ismail Petra was appointed as the Regent (Pemangku Raja) of Kelantan on three occasions. The first was from 6 July 1974 to 25 July 1974 when his father performed
4761-491: Was the eldest son of the last reigning King of Jering, which was then one of the seven states in Southern Siam under Malay rule. Her maternal grandfather, Tengku Muhammad Hamzah, was the last Chief Minister of Kelantan appointed by the Sultan and the first post-independence Menteri Besar. She received religious education from a personal tutor and completed her formal primary and secondary education at Zainab English School. She
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