Fatigue And Heart Failure

Heart failure may convey that the heart isn’t working anymore, but what it really means is that the heart isn’t pumping as well as it should be (REF). Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body’s needs for blood and oxygen (REF). At first, the heart tries to make up for this by enlarging, developing more muscle mass, and pumping faster. As this happens, the blood vessels narrow to keep blood pressure up and the body diverts blood away from less important tissues and organs to maintain flow to the heart and brain (REF). Eventually, the body and heart cannot keep up and the patient begins to feel fatigue, breathing problems, weight gain with swelling in the feet, legs, ankles or stomach, and other symptoms that eventually leads to a hospital visit. The body’s coping mechanisms give us better understanding on why many are unaware of their condition until years after the heart declines (REF).

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).

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Congestive heart hailure, also known as CHF or heart failure, affects the lives of 5 million Americans each year with 550,000 new cases diagnosed yearly. (Emory healthcare, 2013) CHF is a medical condition in which the heart has become weak and cannot pump enough blood to meet the need for oxygen rich blood required by the vital organs of the body, less blood is pumped out of the heart to the organs and tissues in the body and pressure in the heart increases, it does not mean the heart has stopped working. (Murphy, 2013) Once the heart has become weakened by conditions such as hypertension, abnormal heart

Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.

The U. S healthcare system undergone major changes in the past 100 years. Scientific advancement coupled with increased sophistication of the health care workforce including physicians and nurses have given an international reputation to U.S health system. Even though weakness can be found like lack of primary health access, high infant mortality rate and increased numbers of uninsured people in U.S. A growing demand of patients with chronic illness over the age of sixty-five, is challenging to the health system.

Congestive Heart Failure is a condition in which the heart cannot pump enough blood to meet the needs of the rest of the body (Department of Health & Human Services, 2012). The failure can occur in on either side of the heart. In left-side heart failure, fluid backs up into the lungs, causing shortness of breath, due to the fact that the blood entering the left side of the heart comes from the pulmonary artery, and when the left ventricle cannot pump fluid out of the heart or when the left atrium cannot empty completely into the ventricle it backs up into the lungs. In right-side heart failure, fluid can back up into the abdomen, legs, and feet, causing swelling. The blood being pumped into the right

Heart failure (HF) is a chronic, progressive condition defined as the hearts inability to efficiently pump an adequate amount of blood to meet the demands of the body (Naab, 2011). Heart failure may be the result of the heart chambers not adequately filling, also known as diastolic HF or the decreased contractility of the valves to perfuse blood to the body, also known as systolic HF. “Heart Failure is a progressive disease which arises as a consequence of an abnormality in cardiac structure, function, rhythm or conduction” (Naab, 2011).

Based on Goodman and Fuller (2015), it was estimated that the annual population in the United States with (CHF) congestive heart failure is about five hundred fifty thousand, and approximately five million male and female elderly individual (65 years old and above) is the leading cause of hospital admission. Moreover, heart failure has a significant twenty percent of an estimated death rate and fifteen percent survival rate of patients diagnosed with CHF (Bocchi, Vilas-Boas, Perrone, Caamaño, Clausell, Moreira et al., 2005; Hunt, Abraham, Chin, Feldman, Francis, Ganiats et al., 2005).

Abate, Zucconi, and Boxer (2011) acknowledge that chronic heart failure is very common and a costly disease. The American Heart Association (n.d.) states that heart failure is one of the most common reasons people 65 and older go to the hospital, therefore, promoting ways to manage the disease and live a better life. Abate et al. (2011) knowing that early ambulation has been proven to have a positive impact on patients; lead them to combine it with canine assisted ambulation to further increase chronic heart failure patients outcomes in a study. They were looking to improve patient’s social and emotional states, shorten their length of stay in the hospital, and get them moving more. Sixty-nine hospitalized patients diagnosed with heart failure

“The usual clinical manifestation of heart failure is left ventricular dysfunction that occurs after some index event, such as myocardial infarction” (Chapa et al., 2014, p. 16). With the aging adults, like S.P., we have to be concern when they have presenting signs of heart failure, especially if they have not been diagnosed with one. Questions I may have to ask S.P. are what time of the day her fatigue and swollen ankles are worse. This is to determine if her fatigue and edema are cardiac related. Cardiac related fatigue is “worse in the evening, whereas fatigue from anxiety or depression occurs all day or is worse in the evening” (Jarvis, 2016, p. 472). Does her fatigue is accompanied with shortness of breath on exertion? Patient education

Chronic heart failure is a disease that restricts the quality of life and causes symptoms such as dyspnea and peripheral edema. The daily activities of patients with CHF are often limited and it can cause significant problems socially, physically, and emotionally. The disease usually is accompanied by clinical depression. There is little known about the specific needs of a CHF patients who suffers from depression. A research study was done on 85 patients with CHF to identify the preferences and concerns in regards to psychosocial treatments. A three month study was done to determine what type of treatments patients would be more willing to do. 64.7% of patients preferred supportive talks and low threshold services while only 31.4% wanted

When heart failure occurs, some conditions can be reversed but not all. There are treatment plans that can help an individual live longer and improve the signs and symptoms of heart failure. Some examples of the changes would be routine exercising, manage stress, reduce intake of salt, and lose weight. These changes can help improve one’s quality of life (Diagnosing Heart Failure, 2017). In this case study, the focus on Mr. P focus is managing his stress and educating him on the importance of taking his medication as prescribe.

Furthermore, among older adults, heart failure accounts for one of the leading causes of hospitalizations. The complexity of treating older adults involves co-morbidities, which significantly impacts the progression of management and mortality regarding heart failure (Caughey, Roughead, Shakib, Vitry, & Gilbert, 2011). For the elderly chronic heart failure compromises their activities of daily living. This impact on their health leads to a decrease in independent living activities and increase dependence (Norberg, Boman, Löfgren, & Brännström, 2014). Additionally, psychologically and physically the elderly may experience feelings of powerlessness and hopelessness, distressing symptoms, compromising physical functioning, social and role dysfunction

According to neurochemistry, an appropriate way to understand the role of those factors in the matter of heart failure is the neurohormonal model. The neurohormonal model includes mechanisms such as HPA axis, cytokines-cascades, platelets and the autonomic dysregulation. Initially the hyperactivity of HPA axis has as a result the ever growing activity of sympathetic nervous system and the pour of epinephrine and and norepinephrine. In patients with heart failure those substances were observed commonly by medical doctors (Eisenhofer et al.,1996). Cytokines-cascades which are the TNF-a and interleukin-6 (IL-6), have the authority, when there are in high levels of concentrate to be predictable factors for heart failure (Deswal