Congestive Heart Failure: A Case Study

This study is relevant to the research question because they focused on testing n-terminal pro-b type natriuretic peptide and management of Heart Failure patients, however the patients were in a hospital in Canada. The study started with 534 patients from screening but 34 were excluded, and 17 patients did not participate after the first hospitalization, leaving 483 patients that were followed during the course of the study (Moe, Howlett, Januzzi, Zowall, 2007). The study used receiver-operating characteristic curve was used to analyze the data from the two groups (Moe, Howlett, Januzzi, Zowall, 2007). The tools used were clearly defined, reliable and valid. The researchers measured the proBNP level and physician initial diagnosis and then after they used the “logistic regression model” to predict whether knowledge of the proBNP levels aided in diagnosis and management of HF (Moe, Howlett, Januzzi, Zowall, 2007). The statistics used to analyze the date was relevant to the clinical research question. The study did not “perform age-stratified analysis” which may have an impact on the results, there was also a loss to follow up and the study was performed at multiple sites in Canada where as the patients for the clinical research question are located in Dallas service delivery area in United States of America (Moe, Howlett, Januzzi, Zowall, 2007). According to the researchers, the results of their study supported the “recently published HF consensus guidelines’” view that proBNP supports clinical diagnosis and cost effective care of patients (Moe, Howlett, Januzzi, Zowall, 2007). The implication of this study is that knowing the value of proBNP aids practitioners in the diagnosis and management of HF

Congestive heart failure (CHF) is a commonly seen in the hospital setting. CHF results in patients having difficulty breathing and can go in to respiratory arrest. There is decreased cardiac output and labs will show increased BNP. Patients who have CHF history will have chest x-ray and EKG. Therapy for CHF is to correct the abnormal labs and keep the patient from arresting and being placed on a vent. This paper will look at the molecular make up of CHF all the way to how to take care of the patient with advanced CHF. Patients are placed on medications to help with fluid overload and blood pressures. At times patients may have to be placed on cardiac drips. Patients with CHF are prone to pulmonary complications such as pulmonary edema, and

Congestive Cardiac Failure bring an adverse impact on both people’s life and health care systems. Therefore, medication treatment might play an indispensable part in coping with congestive cardiac failure. There are different types of medication could be used to treat CHF, for example, angiotensin- converting enzyme(ACE) inhibitors, β-blockers and digoxin. What’s more, congestive cardiac failure are less likely to accept aspirin, heparin, oral beta-blockers, however, they are more likely to accept angiotensin-converting enzyme(ACE) inhibitors(Garry, Wilson, & Vlodaver, 2017).

Clinical Trial: NEAT-HFpEF “ Nitrate’s Effect on Activity Tolerance in Heart Failure with Preserved Ejection Fraction”. The purpose of this study is to evaluate whether isosorbide mononitrate (ISMN) compared to placebo increases daily activity as assessed by 14-day averaged arbitrary accelerometry units (AAU14). My contribution to this clinical trial was reviewing, comprehending the protocol, preparing IRB and other regulatory submission documents. I was involved in

Patients with cardiomyopathy and CHF are at risk for other related problems, including pulmonary edema, atrial fibrillation, acute or chronic renal failure, and sudden death (Huether & McCance, 2012). Many people living with heart failure require frequent hospitalization and require end-of-life care (McLaughlin, Hoy, & Gacklin, 2015). During their stay, medications should be managed by monitoring the patient’s response and titrating or changing accordingly (McLaughlin, Hoy, & Gacklin, 2015). Address the patient’s symptoms with the use of oxygen, positioning, monitoring intake and output, and administration of

After the H&P test that the provider may want to order are ECG, CXR, troponin, and B-type natriuretic peptide (BNP). These tests are going to help confirm the diagnosis of the acute heart failure due to MI. The treatments that this

“About 5.8 million people in the United States have heart failure. The number of people who have this condition is growing. Heart failure is a leading cause of hospital stays among people on Medicare” (National Heart, Lung, and Blood Institute, 2012). It is very common in individuals who are 65 years old or older, overweight people, and children with congenital heart defects. Heart failure is a chronic condition characterized by the heart’s inability to pump enough amounts of blood rich in oxygen and nutrients throughout the body in order to meet its needs.

I should have educated about healthy diet and daily 30 minutes of aerobic exercises. I should have encouraged to increase fruits, vegetables, reduce salt intake, low fat/cholesterol diet, serving sizes and avoiding canned and fast food. Also, I should have educated about maintaining proper intake of dietary potassium, calcium and magnesium (Madhur, 2014). I should have educated about the increase bBP with decongestants. Regular aerobic exercises can be walking, using bicycles and climbing stairs. Effectiveness of lowering BP increases when diet and lifestyle modification are combined together (Cash, 2015). Also, I should have mentioned about not exceeding 2 drinks of alcohol per day and smoking cessation (Weber et al., 2014). This is because most of the patient with high BP have other cardiovascular risk factors such as diabetes, hyperlipidemia, tobacco use and inactivity. Hence, while treating HTN, we must address all these risk factors and take preventive measures (Dunphy et al., 2015). I should have educated on relaxation techniques and lowering stress level (Cash, 2015). Diuretics, ARB, ACE and calcium channel blocker are the first line therapy for the HTN (Hernandez-Vila,

Mineralocorticoid-receptor antagonists such as eplerenone and spironolactone have shown efficacy in improving mortality and morbidity in patients with reduced left ventricular ejection fraction (LVEF ≤ 40%). The TOPCAT study (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) aims to see if this class of agents is also effective in improving the outcomes for symptomatic patients with preserved

In the 1980s and early 1990s, it was once verified that angiotensin –converting-enzyme inhibitor (ACEi) have been associated with enchancment in the clinical effects for HF patients. Then followed the introduction of the present day HF treatments; beta blocker, angiotensin receptor blockade, mineralocorticoid receptor antagonist, Cardiac Resynchronisation Therapy (CRT), with or without defibrillation therapy, left ventricular aid device and heart transplantation. Regarding the diagnostic possibilities, echocardiography has emerged as an vital device to consider HF patients, alongside with natriuretic peptides (NP). Despite this enchancment in HF medication, the mortality charge is high. Can tailored HF remedy with the assist of biochemical measures such as NP lead to a higher consequence for HF

Patients with heart failure (HF) experience an inability of the heart to effectively pump and thus circulate blood through the body. It is estimated that 5.8 million people in the United States alone have HF and it is one of the most common reasons for hospitalizations over the age of 65 (Hall, Levant, & DeFrances, 2012). It can have a devastating impact on the lives of these patients who experience many hospitalizations due to the overwhelming amount of complications associated with this chronic disease causing decreased life expectancy and lower perceived quality of life. CITATION HERE The key to increasing the life expectancy is through frequent monitoring, traditionally at an office. Many patients with HF are often impeded

In acute heart failure, there are many observational registries that describe the disease characteristics but there are very few successful randomized controlled trials in the field of AHF. The opposite is exactly the situation in CHF where there is a plethora of large randomized controlled trials with paucity of registry data. Many of the questions about heart failure in Saudi Arabia, especially for acute hospitalized patients, have been answered in the HEARTS-AHF registry (5, 6). Saudis were at least one decade younger than their counterparts in in the western countries. They also have high incidence of risk factors especially diabetes mellitus and noncompliance to heart failure diet and medications. The majority of heart failure patients

Congestive heart failure, also called heart failure or CHF, is one of the fastest-growing syndromes in the United States and worldwide. It is a condition with high hospitalization and high mortality rates as well as a compound medical regimen that significantly affects the patient’s lifestyle and that of their family. The term alone, “heart failure”, is enough to scare the bravest client and cause the rise of numberless concerns and questions. Patients may worry and exclaim, “Did my heart stop working? Am I going to die?” Because of the complexity of congestive heart failure and how fatal it may become when it is not well managed, a thorough understanding of the disease process and of evidence-based management guidelines is necessary in order for the nurse practitioner to adequately care for, reassure, and educate the CHF patient, their caregiver and family. This paper aims at providing an overview of heart failure as well as giving the clinician the foundational tools necessary to help improve the quality of life of CHF patients and prolong their days. We will cover the two main types of heart failure (left-sided and right-sided), with a brief look at CHF sub-classifications, systolic and diastolic CHF. We will seek to explain the etiology, pathology, clinical manifestations of this condition as well as explore the current diagnostic tools and pharmaceutical treatments available across the lifespan. We will also look at the dynamic role of the nurse practitioner

McMullen, J.R., Jennings,G.L. Differences between Pathological and Physiological Cardiac Hypertrophy: novel therapeutic strategies to treat heart failure. 2007, April;

The study concluded that BNP had very high negative predictive value at a cut-off value of 100 pg/ml. Subsequently making it appropriate as a rule‐out test for heart failure. The measurement of BNP level provided high accuracy in diagnosis of heart failure as compared to clinical assessment.( Maisel A S, Krishnaswamy P, Nowak R M. et al ) In the N‐terminal proBNP Investigation of Dyspnoea in the Emergency department (PRIDE) study and in the International Collaboration of NT‐proBNP (ICON) study established the role of NT-proBNP in detecting of heart failure. An NT-proBNP level < 40%