No Cure For Heart Failure

Symptoms of congestive heart failure consist of fatigue, dependent edema, fluid build-up in the lungs, increase in urination because of the extra fluid, nausea, vomiting, abdominal pain, and decreased appetite (Fundukian, 2011).  Diagnosis of CHF is done first by physical examination, such as heart rate, and heart sounds or murmurs. If a physician believes more tests are needed, common ones include an electrocardiogram or chest x-ray to detect previous heart attacks, arrhythmia, or heart enlargement, and echocardiogram using ultrasound to image the heart muscle, valves, and blood flow patterns. The physician may also want to do a heart catheterization, to allow the arteries of the heart to be visualized using angiography. Upon getting a diagnosis of CHF, the physician will usually start with asking the patient to change things in their diet, such going to a low sodium diet. They may also want to prescribe medications. Types of medications could include angiotensin converting enzyme (ACE) inhibitors, which block formation of angiotensin II hormone, angiotensin receptor blockers (ARB) to block the action of angiotensin II at the receptor site, and diuretics, just to name a few (Fundukian, 2011).

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).

Medications prescribed for heart disease include: ace inhibitors-widens blood vessels to improve amount of blood the heart pumps and helps lower blood pressure.

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,

(Ramani, Uber, & Mehra, 2010). My grandmother had heart failure and I saw how she had a time trying to breath and her ankles were swollen all the time. She thought the medicine was hurting her instead of helping. She took several different medications to try to control her symptoms, but she eventually succumbed to heart disease.

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.

ACE inhibitors such as Captopril block activity of the enzyme ACE and therefore the conversion of angiotensin I to angiotensin II (the most bio active product of the RAAS), thus inhibiting the actions of angiotensin II and leading to decreased aldosterone production, decrease blood volume and reduced hypertension. ACE inhibitors also work to decrease fibroblast activity as a protective measure against remodelling of the left ventricle (19). Side effects of ACE inhibitors include a dry cough due to the inhibition of bradykinin break down, hypotension and hyperkalemia (due to higher levels of potassium reuptake). ACE inhibitors are currently one of the drugs of choice to treat patients with HF.

of the study is to determine the benefits and safety of the drug called Liraglutide in patients with

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).

Reduction of heart failure has been looked at in a number of ways, some with reduction of

All hypertensive drugs lower blood pressure. However, they’re many forms of the drug, all with differing mechanisms of action. Hypertension refers to the constant lingering of blood pressure above the taken normal range of 120/80 mm Hg. Without the proper treatment, hypertension can lead to extreme difficulties such as kidney failure, coronary heart disease or a stroke. Angiotensin converting enzyme (ACE) inhibitors is an antihypertensive drug, which is among the most widely prescribed drug for lowering blood pressure in the United States (Friedman 2004). Angiotensin causes the narrowing of arteries, predominantly in the kidneys. ACE inhibitors assist in producing less angiotensin throughout the body, subjecting the blood vessels to vasodilation,

According to National Clearinghouse Guidelines, several classes of drugs should be considered in the treatment of systolic heart failure. Angiotensin-converting Enzyme (ACE) inhibitors and Beta Blockers are the treatment of choice for systolic heart failure. Some beta-blockers have demonstrated the benefit of improving clinical symptoms, increasing ventricular function, and decreasing hospitalizations and mortality in systolic heart failure patients. If Ms. Boehmer has intolerance to ACE inhibitors, she may benefit from the combination of Hydralazine and Isosorbide dinitrate (especially beneficial for African Americans with heart failure) or Angiotensin II receptor blockers (ARB). Digoxin can improve Ms. Boehmer’s symptoms. Digoxin is beneficial

It is important to remember the ACEI block the production of angiotensin II altogether, which also block the enzyme kinase. This mechanism allows for vasodilation, decreased blood volume, and the suppression aldosterone: allowing for decreased blood pressure and a slight decrease in edema. While the suppression of kinase can cause an accumulation of bradykinin in the lungs, causing a cough, ACEIs are considered the number one go to drug for hypertension and heart failure. ARBS, working in much the same way as ACEIs, block angiotensin II receptor sites. This allows for kinase to work again bradykinin, and does not produce the adverse cough. Diuretics are a must in most hypertensive patients because they decrease edema, lower blood volume, and decrease the workload of the heart. It is important to watch for adverse side effects such as hypokalemia and hypotension in some patients. By combining all of this knowledge with appropriate lifestyle changes, a clinician can successfully manage a patient’s hypertension and heart

Lisinopril and levofloxacin were prescribed for Mr. P. Lisinopril was prescribed to treat Mr. P’s new found hypertension. Lisinopril is considered an angiotensin converting enzyme inhibitor (ACE inhibitor). ACE inhibitors are designed to block the vasoconstrictive properties by angiotensin II (Gutierrez, 2008, p712). By blocking this action, and dilating the arteries, the increased workload of the heart is once again decreased, causing decreased blood pressures again (Gutierrez, 2008, p712). ACE inhibitors also help the kidneys excrete sodium and water, thus decreasing the blood volume and decreasing the workload of the heart (Gutierrez, 2008, p712). ACE inhibitors “are biotransformed in the liver” (Gutierrez, 2008, p713, para 5). Excretion occurs through the urine and stool (Gutierrez, 2008, p713).