Heart Failure Literature Review

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,

Risk factors play a role to cause congestive heart failure, but if having more than one of the risk factors, it increases one's risk. According to Daniel lee Kulick and Benjamin Wedro, Congestive heart failure is often a consequence of atherosclerotic heart disease and therefore the risk factors are the same. Poorly controlled high blood pressure, high cholesterol, diabetes, smoking, and family history are all contributors to being a risk factor of congestive heart failure. Heart valve disease becomes a risk factor of the patient throughout the years. Other causes of heart failure have their own set of risk factors and preferences and it becomes problem to those diseases.

Hobbs et al. (2016) examined current research to determine the efficacy of post-discharge follow-up phone calls in reducing the 30-day readmission rate for patients with HF. They identified that while patients who received calls ultimately had better outcomes, evidence to support that telephone follow-up could independently prevent readmissions was insufficient (Hobbs et al., 2016). Nonetheless, telephone follow-up coupled with other interventions such as clinic follow-up and telemonitoring did prove to have positive effects on post-acute transitions of care in HF patients (Hobbs et al., 2016).

Hernandez, A. F., Greiner, M. A., Fonarow, G. C., Hammill, B. G., Heidenreich, P. A., Yancy, C. W., Peterson E. D., Curtis, L. H. (2010). Relationship between early physician follow-up and 30-day readmission among medicare beneficiaries hospitalized for heart failure. Jama, 303(17), 1716-1722.

The researchers used a single-center randomized controlled trial whereby they compared the outcomes of usual care vs. transitional care. TC patients received a pre-discharge visit, two home visits, and intermittent telephone calls over a 9 month period. TC program focused on promoting self-care education and support, optimized condition surveillance, and facilitation of community services. The results of the study found that TC participants experienced lower mortality and hospital readmission rates compared to patients who received usual care. However, researchers noted that the difference between readmission rates steadily diminished as a patient was father and farther removed from the initial post-discharge period. Other important findings were that program participants were found to have a shorter overall length of stay and demonstrated greater self-care knowledge and improved quality-of-life compared to their counterparts. Although the effect of transitional care programs on readmission rates seemed to attenuate over time, these programs continue to show promise at improving outcomes of care for HF patients.

A new study released March 16, 2016 by Kaiser Permanente found that heart failure patients had a 19% lower risk of being readmitted to the hospital within 30 days when they were followed up within 7 days of being released from the hospital. The Heart Failure Management program aims to provide early follow-up within one week either by telephone or by office visit if necessary. According to the study, 45 percent of the telephone calls were made by non-physician providers who are qualified to adhere to an outpatient heart failure treatment protocol. Protocols have been established and approved by the participating cardiologists in the community and are evidenced-based driven so that patients will be receiving the best care possible.

The chronic disease burden has increased the need for a statewide and national approach in its detection, prevention, and treatment of heart failure. In the state of Indiana heart disease is shown to be leading the way with a total of 13,394 individuals who have died in 2013 (Indiana State, 2013). The health indicators show that although the mortality rate has decreased from 42.3 per 100,000 in 2001 to 37.3 per 100,000 hospitalization rates have increased (Center for Disease, 2011). Heart failure rehospitalization rate has increased from 2007-2011 especially in those who are over the age of 85. In 2011, there were a total of 41.9 per 1,000 hospitalizations due to heart failure. This is gradually increasing from the Healthy People 2020

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

“In the United States alone, 5.8 million Americans have been diagnosed with heart failure” (Mancini & Colombo, 2015, p. 2542). Heart failure is a condition where the heart does not pump as efficiently; therefore, it does not meet the needs of the body. There is a growing number of heart failure patients each year. “More than 300,000 deaths per year are attributed to heart failure, and the annual cost to manage these patients is close to $40 billion” (Mancini & Colombo, 2015, p. 2542). Since the heart failure population is steadily growing in size the progress of therapies and management is continuing to evolve. The greatest improvements have been surgery related. The two major surgical approaches involve heart transplants or receiving a ventricular assist device (Mancini & Colombo, 2015). There are much discussion in regardless to receiving a heart transplant versus a ventricular assist device, destination therapy, as well as future advances in ventricular assist devices.

Congestive heart failure (CHF), also called chronic heart failure or congestive cardiac failure (CCF) is a clinical condition where heart muscle is weakened and cannot pump the blood as well as the normal heart. The ventricle, also known as main pumping chamber of the heart become larger or thicker which leads to inability to contract or relax as it should. “There is no universally agreed definition of heart failure (Denolin et al., 1983). It is the consequence of cardiac disease, diagnosis is clinically based on sign and symptoms manifested due to circulatory and neuro-hormonal response to cardiac dysfunction is heart failure (Poole-Wilson). The major and escalating public health problem in developed and industrialized country with aging population is congestive heart failure. According to Gaves (1991), the indication for hospitalization among adult over 65years of age is congestive heart failure. Over the past two decades admission rate to treat this condition have exponentially increased (Ghali et al., 1990). The quality and quantity of life of the patient of CHF is robbed (McMurry et al., 1998; McMurry & Stewart, 2000; Petrie & McMurry, 2001; Murdoch & McMurry, 2000). The epidemiology of the heart failure remain vast and inadequate. The rate of cardiovascular disease in Australia is highest comparison to rest of the world, despite of its significant advancement and progress in health industry, out of this sizeable portion of group is represented by heart

Mrs. Schafer completed her pulmonary function test prior to the appointment time and she was evaluated by Dr. Theodore J Standiford. Mrs. Schaefer provided an acute report of her injury and symptoms she was experiencing. Dr. Standiford replied that Mrs. Schaefer lung capacity was reduced by a third. (1/3). I inquired if it was the result of the injuries in the MVA. Dr. Standiford replied that they are a contributing factor i.e. flail chest and fluid in her lungs from aggravated congested heart failure. Dr. Standiford noted left crackles breath sounds on his examination and recommended that Mrs. Schaefer return to her cardiologist and that a high resolution CT scan of her lungs be obtained prior to the next appointment to determine if she has

During the study, we faced some difficulties. First, it was difficult to find enough number of participants in heart failure physicians. Second, the time to discuss with the physicians was limited because the physicians had appointments with their patients. Third, two of the physicians took the survey and sent back the results by email, so we could not discuss with them face to face.

Sanford, J., et al. (2011). A Process of Decision Making by Caregivers of Family Members With Heart Failure. Research and Theory for Nursing Practice: AN International Journal. 25 (1): 55-70.

In year 2000 and 2010, an estimated 1 million hospitalizations for Congestive Heart Failure (CHF), of which most of these hospitalizations were for those aged 65 and over, the share of CHF hospitalizations for those under age 65 increased from 23% to 29% over this time period (Hall, Levant, & DeFrances, 2012). According to Held (2009), acute decompensated heart failure (ADHF) ensues when cardiac output fails to meet the demand of the body’s metabolic needs. The fluid volume overload makes the unstable condition necessitates instant treatment for the reason that it impairs perfusion to systemic organs, endangering their function.

The target population was heart failure clients ages 65 years and older, located in the Northern Virginia area. Participants were recruited from local hospital discharge planner’s hospital-affiliated home health agency. According to Lanham (2013), saturation often occurs around 12 participants