Victor Hulsey
Course Professor: Jason Valdez
EMSP 2544: Cardiology
03 August 2014
Treatment of Heart Failure
Abstract: With the numerous discoveries and advances in pharmaceuticals and mechanical implantation devices, heart failure continues to be the leading cause of hospitalization in patients over the age of 65 in the United States and other developed countries. Advances in science and modern medicine have pushed heart failure to the forefront of an emerging crisis in developed countries around the world. The increase in heart failure cases appears to be directly related to the increasing average age within these countries. Richard E. Klabunde’s PhD, research estimates that there are “more than 15 million new cases of heart failure each
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History: What is heart failure? Heart failure is a condition in which the heart has lost its mechanical ability to adequately pump oxygenated blood out of the heart to the body’s peripheral tissues and organ systems; therefore it cannot meet the body’s perfusion needs. Heart failure can generally be divided into left or right ventricular failure and its etiologies may include myocardial, coronary, or valvular disease. The body’s decreased perfusion can lead to reduced exercise ability/endurance, general weakness/fatigue, and shortness of breath. Some additional signs of heart failure may include pulmonary edema, pedal edema and JVD.
Descriptions of heart failure have been around for centuries, with some of the earliest documented accounts originating from ancient Egypt, Greece, India, and the Roman Empire. Initially little was understood about the nature of
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With the advancement microchip technology, many of modern day treatments are including cardiac assist devices to supplement the pharmacological treatments. Although these treatments can be more invasive and the overall prognosis remains poor, these treatments have been shown to increase ones expected life span an average of ~8.5 years.
Despite many new advances in patient care, drug therapy and cardiac assist devices, the prognosis for chronic heart failure remains very poor. One year mortality figures are 50-60% for patients diagnosed with severe heart failure, 15-30% in mild to moderate failure, and about 10% in mild or asymptomatic failure. With gene therapies, and cell implantation/regeneration just on the horizon, the prognosis for heart failure patients is much more promising than just 20 years ago.
Researchers at the Cardiovascular Research Center at Icahn School of Medicine have successfully tested a powerful gene therapy known as “SUMO-1” that is delivered directly into the myocardium to reverse heart failure in large animal models. Although this treatment has yet to be proven in human clinical trials, it may be one of the first treatments that can actually shrink hypertrophied myocardium tissue; thereby significantly improving the damaged heart’s life-sustaining function.
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 progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).
“One in nine deaths in 2009 included heart failure as a contributing cause. About half of the people who develop heart failure die within 5 years of diagnosis” (Heart Failure Fact Sheet). “Researchers have proven that African-Americans are at an increased risk of congestive heart failure. This is due to diabetes and high blood pressure, rather than race alone”. “There is no cure for heart failure. Treatments are used to relieve symptoms of CHF and try to prevent any further damage. The exact plan to help the patient depends on the stage and the type of heart failure the patient has”
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,
The heart is an organ that pumps oxygenated blood to the body and deoxygenated blood to the lungs. Heart failure is when the heart can’t pump blood very well. If the heart fails to work properly, a major system called the circulatory system won’t work properly and therefore the whole human body will fail to work properly because the cells won’t be able get oxygenated blood and use the oxygen to undergo cellular respiration and make energy.
Approximately 5.3 million Americans have heart failure and account for more hospital admissions than any other diagnosis in patients over 65
According to the American Heart Association (2015), heart failure is defined as “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”. Congestive heart failure is a progressive illness that effects millions of Americans every year. Many other illnesses can lead to the development of congestive heart failure. Examples of these diseases include: coronary artery disease, past heart attack, high blood pressure, abnormal heart valve, heart muscle disease such as hypertrophic cardiomyopathy, dilated cardiomyopathy or inflammation such as myocarditis, congenital heart disease, severe lung disease, diabetes, obesity and asthma. (American Heart Association, 2015 (Centers for
According to the Centers for Disease Control and Prevention (CDC), about 5.7 million People in America have heart failure.
Almost every one in the United States knows a person suffering from congestive heart failure. This disease has manifested its way into the lives of so many—the statistics are astounding. According to the National Heart, Lung and Blood Institute, nearly 5 million people are affected and it is the main reason for hospital admission in older adults over the age of 65. This is a great cause for concern. In order to reduce the morbidity and control this epidemic, we must first understand the risks and causes of this condition. It is of the upmost importance to first understand the risks and causes of this condition. Education plays a key role in order to recognize the clinical manifestations and necessary actions to best treat
Heart failure is term that is used to describe the heart’s inability to work efficiently as a pump. In order to decipher if an individual is likely to have heart failure is through their health history. Common backgrounds associated are diabetes mellitus, kidney dysfunction, hypertension, chronic lung disease, angina, myocardial infarction, and ischemic heart disease (Kirk, 2011). It is accompanied by shortness of breath on exertion, decreased exercise tolerance, paroxysmal nocturnal dyspnea, orthopnea, ankle swelling, sudden weight gain, lack of appetite or nausea and difficulty concentrating (Kirk, 2011). In worsening conditions it could progress to fluid buildup, rapid or irregular heartbeat, chest pains , and sudden
Heart failure (CHF) is a chronic illness of the heart where the heart muscles are not able to pump blood efficiently (Lange, 2011). Mrs. Lee is recently diagnosed with Chronic Heart failure and during her one week stay at the hospital has been getting bedside education by the nurse. As she is getting discharged, it is important for Mrs. Lee to review the
Heart failure is a condition in which the heart muscle is unable to pump enough blood through the heart to meet the body’s need for blood and oxygen. Coronary artery disease is a form of heart disease that effects the chambers of the heart. There are four chambers in the heart. The upper chambers consist of a right and a left atrium and the lower chamber consists of the right and left ventricles. The flow of oxygen rich blood travels from the lungs to the left atrium and into the left ventricle where it is pumped into the rest of the body. When the heart functions properly, all four chambers beat and pump blood effectively in an organized way. The Virtual Medical Centre (Centre, 2008) newsletter states that "Management,
“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.
Heart failure is a condition that weakens the heart muscles and makes it very hard for the body to circulate blood. It affects over five million Americans and is one of the leading causes of death. Out of the five million, five-hundred thousand die each year. Only 5,000 out of the millions of cases actually receive a heart transplant, which is the best way to treat the disease. This means that most people with heart failure never receive the treatment they truly need. Now, doctors in Texas have found a treatment that doesn’t rely on a transplant, which are few and far between.
As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)