Mitral Heart Failure

The prevalence of congestive heart failure is on the increase both in the United States and all over the world, and it is the leading cause of hospitalization in the elderly population. Congestive heart failure is a progressive disease generally seen in the elderly, which if not properly managed, can lead to repeated hospital admissions or death. Heart failure means that the heart muscle is weakened. A weakened heart muscle may not be strong enough to pump an adequate amount of blood out of its chambers. To compensate for its diminished pumping capacity, the heart may enlarge. Commonly, the heart's pumping inefficiency causes a buildup of blood in the

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).

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).

The left side of the heart brings oxygen-rich blood from the lungs through the left atrium to the left ventricle, then out into body. When the left side of the heart is damaged or can’t pump as well, it has to work harder to send blood through the body. This causes fluid to build up in the body, especially the lungs. That’s why shortness of breath is one of the most common symptoms of heart failure. Systolic failure happens when the heart doesn’t pump out blood the way it should. Diastolic means the heart doesn’t fill back up with blood as it should. The symptoms of left sided heart failure are tachypnea, increased work of breathing, crackles initially heard in lung bases, but when severe, heard throughout the lung fields, pulmonary edema, and dullness in lung fields to finger percussion, pleural effusion detectable by reduced breath sounds at the bases of the lungs, and cyanosis.

The flow of blood through the heart is controlled by four valves. If any are not working correctly, blood cannot flow or be pumped effectively to the heart. The four valves are: the tricuspid, pulmonary semilunar, mitral, and aortic semilunar. There are many abnormalities or defects that can affect their operation and in this paper, I will discuss the most common one which is a “mitral valve prolapse.” A valvular prolapse is an abnormal protrusion of a heart valve that causes the valve to not close completely. It is also known as “click murmur syndrome” and “Barlow’s syndrome” and is more prevalent in women than men. It has a strong hereditary

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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.

Mitral valve prolapse (MVP) was first characterized by Barlow and Bosman in the 1960s.(Barlow and Bosman) It was first called Barlow’s Syndrome before being called mitral valve prolapse by Criley (Barlow and Bosman),(Criley et al.). Barlow’s syndrome was diagnosed by electrocardiogram, phonocardiogram and chest X-ray.3 The mitral valve apparatus includes tow leaflets, chordae tendineae, anulus, left atrium, papillary muscles and left ventricular wall (Devereux et al.). Mitral valve prolapse involves the leaflets, chordae, annulus and left ventricular wall.(Devereux et al.) The anterior leaflet is relatively long and semi-circular, while the posterior leaflet is shorter in normal patients.(Irvine et al.) Most commonly the posterior leaflet is affected.(Devereux et al.) During systole the leaflet balloons in to the left ventricle.(Devereux et al.) Physically, in a patient with mitral valve prolapse, the leaflet is displaced beyond the mitral anulus.(Levine et al.)

Mr. Javier Escobar, U.S Army Veteran, 50-year-old Latino male and divorced claiming to “not having anyone in his life due to Combat Post Traumatic Stress Disorder”. Mr. Escobar is a newly patient diagnosed with Congestive Heart Failure (CHF). Patient claims to smoke 1 pack of cigarettes a day, also the consumption of 1 bottle (750mls) per night of alcohol. Congestive Heart Failure is due to Chronic high blood pressure that puts great stress on the heart muscle. The muscle of the heart weakens and fails to push the normal amount of blood around the body leading to Congestive Heart Failure. There are multiple symptoms that could by identified before heart failure such as anxiety, restlessness, cyanotic (blue

The mitral valve is located on the left side of the heart between the left atrium and left ventricle. The purpose of the mitral valve is to form a seal between these two chambers of the heart to prevent the back flow of blood. When blood enters the left side of the heart, it is oxygenated and enters through the pulmonary veins. The blood then travels through the left atrium; the bicuspid (mitral) valve then opens to let the blood flow down to the left ventricle. The left ventricle contracts, causing the mitral valve to close (preventing the backflow of blood).When the left ventricle contracts it is pumping the blood out to the remainder of the body. (Jenkins, 2007)

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

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

Left-sided heart failure is a life-threatening condition in which the left side of the heart cannot pump enough blood throughout the body (Left-sided heart failure, 2014). This is a very dangerous condition. If left untreated, it can lead to more problems, even death.

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

Tricuspid regurgitation is a disorder in which the heart’s tricuspid valve does not close properly, causing blood to flow backward into the atrium when the right ventricle contracts. The most common cause of tricuspid regurgitation is enlargement of the right ventricle [1], caused by left-sided valvular lesions. Mitral valve disease is often accompanied by concomitant tricuspid valve disease. The most common indication for tricuspid valve intervention is tricuspid regurgitation (TR), and the presence of significant TR has been reported to be an important prognostic indicator of outcomes following mitral valve surgery [2]. Surgical treatment of tricuspid valve regurgitation (TR) with left-sided valvular disease still remains a challenge for