Beta Blocker Heart Failure

Symptoms of congestive heart failure consist of fatigue, dependent edema, fluid build-up in the lungs, increase in urination because of the extra fluid, nausea, vomiting, abdominal pain, and decreased appetite (Fundukian, 2011).  Diagnosis of CHF is done first by physical examination, such as heart rate, and heart sounds or murmurs. If a physician believes more tests are needed, common ones include an electrocardiogram or chest x-ray to detect previous heart attacks, arrhythmia, or heart enlargement, and echocardiogram using ultrasound to image the heart muscle, valves, and blood flow patterns. The physician may also want to do a heart catheterization, to allow the arteries of the heart to be visualized using angiography. Upon getting a diagnosis of CHF, the physician will usually start with asking the patient to change things in their diet, such going to a low sodium diet. They may also want to prescribe medications. Types of medications could include angiotensin converting enzyme (ACE) inhibitors, which block formation of angiotensin II hormone, angiotensin receptor blockers (ARB) to block the action of angiotensin II at the receptor site, and diuretics, just to name a few (Fundukian, 2011).

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

Congestive heart failure patients may need multiple medications. Each medication option treats a different symptom or contributing factor and comes

Heart failure (HF) is defined as a multifaceted clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. In HF, the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion1. In the United States, HF is increasing in incidence with about 5.1 million people suffering from HF and half of people who develop HF die within 5years 2. Over 75% of existing and new cases occurred in individuals over 65 years of age, < 1% in individuals below 60 years, nearly 10% in those over 80 years of age. HF costs the

Heart failure describes a syndrome in which the patient has a dysfunctional heart incapable of sustaining an adequate cardiac output, and this syndrome is responsible for a large portion of cardiovascular-related deaths2. There are two types of left ventricular dysfunction, one is systolic dysfunction which has implications in defective ventricular ejection and contraction, and the other is diastolic dysfunction which has implications in dysfunctional ventricular relaxation and filling2. Heart failure patients with systolic dysfunction have an ejection fraction of less than 40%, and heart failure patients with diastolic dysfunction have an ejection fraction of greater than 40%. In the case study, the patient has a left ventricular ejection fraction of 25% which means that he is suffering from systolic dysfunction.

Well written paper on beta blockers in controlling hypertension. In my experience, I had seen more than 80% of patients are prescribed with antihypertensive drugs in their medical chart. A beta blocker is one of the most common drugs in a geriatric setting especially atenolol. Beta blockers are the standard of therapy for many cardiovascular conditions and it is the main line of treatment in decreasing risk of stroke. According to Ladage, Schwinger, and Brixius (2013) beta blocker was more effective in decreasing mortality and morbidity rate in acute coronary syndrome patients. Atenolol is a water soluble and had longer half-lives with non-metabolized actions and excreted via the kidneys (Ladage et al., 2013). The exercise capacity increases in patients who are on beta-blockers, like bisoprolol, nebivolol, carvedilol (Ladage et al., 2013). A recent meta-analysis study showed patients who are untreated with hypertension, they are at risk of developing chronic kidney diseases, cardiovascular complications, and cerebrovascular complications (Butt & Harvey, 2015). In one study, mainly geriatric population who are taking atenolol had shown greater mortality rate and increase arterial pressure (Testa et al., 2014).

Approximately 2-3 million Americans, more than one percent of the population, are currently affected by this medical problem with numbers increasing frequently (Drug Store News, 1997). Congestive heart failure tends to be more common in the elderly, men, and also African Americans. Congestive heart failure has become the most common cause for current hospital admissions. Among causing prolonged hospital stays congestive heart failure has a very high mortality rate, which has declined since recent medical advancements.

Heart failure (HF) is a chronic progressive disease, arising from structural or functional disorders of the heart, in which incidence increases with age. This review attempts to describe the types and causes of HF while focusing on variable aspects of patient education that have a positive effect on patient outcome and quality of life. Specifically, the potential benefits of this education for a 55 year old male patient diagnosed by transthoracic echocardiogram with chronic systolic heart failure, who has refused physician deemed necessary

Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary

The second step in managing patients with CHF is using evidence-based treatment options. Beta-blockers have proven to be effective at increasing left ventricular function; however, the majority of patients are not receiving adequate dosages of the medication. According to Driscoll et al

Diuretics and digitalis constitute conventional therapy for congestive heart failure, but systemic vasodilators offer an innovative approach in acute and chronic heart failure by decreasing the increase in systolic wall ventricular stress by reducing aortic and/or impedance reduces cardiac venous return. As a result, vasodilators increase cardiac output (CO) by decreasing peripheral vascular resistance (PVR) and/or decrease left ventricular end-diastolic pressure (LVEDP) by decreasing venous

The writing on the role of Beta-blockers in the treatment of heart failure is elaborative and absorbing. The brief explanation about the mechanism Beta blocker is illuminating. Beta blocker use can help to manage heart failure. Beta blockers blocks the effects of the epinephrine (adrenaline). When beta blockers are taken, then the heart rate gets slow and heart demand of oxygen decreases, consequently the blood pressure is reduced (Staff, 2016). Beta blockers have different kinds of with slight differences. Depending on the circumstances, different beta blockers are utilized. The beta blockers can vary in terms of side-effects, as well as in term of the amount that a patient need to take per day. Depending upon the patient condition and treatment

Beta 2 antagonists that can be inhaled are long term asthma control medicines that can be taken every day. They may also have risks for certain people as well. When you are taking these medications it is now recommended they be used along with corticosteroids that can be inhaled.

According to National Clearinghouse Guidelines, several classes of drugs should be considered in the treatment of systolic heart failure. Angiotensin-converting Enzyme (ACE) inhibitors and Beta Blockers are the treatment of choice for systolic heart failure. Some beta-blockers have demonstrated the benefit of improving clinical symptoms, increasing ventricular function, and decreasing hospitalizations and mortality in systolic heart failure patients. If Ms. Boehmer has intolerance to ACE inhibitors, she may benefit from the combination of Hydralazine and Isosorbide dinitrate (especially beneficial for African Americans with heart failure) or Angiotensin II receptor blockers (ARB). Digoxin can improve Ms. Boehmer’s symptoms. Digoxin is beneficial

Rate control is the older therapeutic strategy but it is still a primary therapy for AF. Beta-blockers and calcium channel blockers are both effective and well resistant therapies which can be used in a wide range of acute and long-term clinical conditions, as well as both contribute in controlling hypertension. It's investigated that oral beta-blockers are more favorable than calcium channel blockers for patients with ischemic heart disease, CHF and depressed left ventricular function. Digoxin is effective for controlling heart rate especially in sedentary elderly and concomitant CHF patients due to its effectiveness in improving ventricular function. Other potential advantages of rate control include less adverse drug effects and less hospitalization. However, it has some disadvantages including risk of toxicity, chronotropic incompetence and difficulties in achieving dose adjustments in patients with compromised renal function adding that it is not preferred in younger patients and those with a history of