Systolic Dysfunction

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).

Systolic heart failure is characterized by enlarged ventricles that are unable to fully contract to pump enough blood into circulation to adequately perfuse tissues. The enlargement in ventricles is due to an increased end-systolic volume. If the heart is not able to sufficiently pump the expected volume of blood with each contraction, which in a normal healthy heart is 50-60%, there will be a residual volume left in the heart after every pump (Heart Healthy Women, 2012). With the next period of filling, the heart will receive the same amount of blood volume from the atria combined with that residual volume from the previous contraction. This causes the ventricles to have to dilate to accommodate this increase in volume. The dilation causes the walls of the ventricles to stretch and become thin and weak. Also the myocardium, the muscle layer of the heart, will stretch and not be able to adequately make a full and forceful enough contraction to push blood from the ventricles (Lehne, 2010).

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.

In systolic ventricular dysfunction or systolic heart failure the heart is not able to produce enough output for adequate tissue perfusion. Heart rate and stroke volume produce cardiac output. Contractility, preload, and afterload influence the heart’s stroke volume. These factors are important in understanding the pathophysiologic consequences of this syndrome and possible treatments. Patients with systolic heart failure usually have dilated, large ventricles and impaired systolic function.

Diastolic heart failure or diastolic dysfunction is when the left ventricle does not relax normally. This pushes the heart to pump too quickly, permitting the heart from filling the chamber with enough blood during the resting period betweens beats (Types of Heart Failure). Right-sided heart failure is usually a consequence of left-sided heart failure. When the heart loses its main source of pumping power, the right side of the heart is affected by blood being pushed into the veins of the body causing swelling. These heart conditions can be ongoing or they can start abruptly which can have a huge impact on the body (Types of Heart Failure).

The physician will order lab tests such as electrolyte panel, creatinine and albumin levels to determine if there are any abnormalities with the liver and kidney functions, a chest x-ray may be performed to determine if the heart is enlarged and an Electrocardiogram to see if the patient has ventricle thickening, abnormal heart rhythm or even a heart attack. Once these tests have been completed the physician may order a MUGA scan or cardiac catheterization to determine the patient ejection fraction or EF, but most common practice is to order an echocardiogram, which is less invasive, to determine the ejection fraction. (Association, American Heart, 2013) Ejection fraction, usually stated as a percentage, determines how well the heart pumps with each beat. A normal heart will pump a little more than half the heart’s blood volume with each beat. Left ventricular ejection fraction (LVEF), measures the amount of blood pumped out of the left ventricle of the heart with each contraction. Right ventricular ejection fraction (RVEF), measures the amount of blood pumped out of the right side of the heart to the lungs for oxygen. A normal EF ranges from 55-77% and will be lower when the heart muscle has been damaged by cardiomyopathy, heart attack or other disease that have weakened the heart muscle. An ejection fraction of 40% usually confirms the diagnosis of heart failure and an ejection fraction of less than 35% puts the patient at risk of life

Heart Smart is a voluntary non for profit organization that is working to bring awareness towards congestive heart failure also known as CHF or heart failure. CHF is a chronic condition in which the heart does not pump blood as well as it should. Heart failure can occur if the heart cannot pump (systolic) or fill (diastolic) adequately. Symptoms include shortness of breath, fatigue, swollen legs, and rapid heartbeat. Treatments can include eating less salt, limiting fluid intake, and taking prescription medications. In some cases a defibrillator or pacemaker may be implanted. Heart Smarts mission is prevention of this disease through increasing knowledge and reducing the number of incidence our county residents face through networking, education

In 2012, my cousin suffered a severe heart attack which lead to heart failure. After witnessing someone I love suffer a life-changing event, it was important to find ways in which I could help. During her time in the hospital I cared for her children, encouraging them to remain positive around their mother, explaining how important their presence was to her recovery. I assisted in organizing a fundraiser that provided financial benefits for medical expenses. An extended hospital stay can create a feeling of isolation, and the fundraiser served as a physical reminder of the amount of support she had behind her during this battle. Childcare and fundraising were both pivotal ways in which I made a difference, but being present with my cousin at

Patient A.S. is 87-year-old female with a diagnosis of Acute onset chronic systolic heart failure, Afib, CHF, and hypothyroidism. She has a past medical history of Hypertension, diabetes mellitus, CAD (Stent 2001). The patient was admitted to Lutheran Augustana Center on January 4, 2016 and was evaluated for therapy on January 5, 2016. Her current medications include Albuterol and Ipratropium via nebulizer to address shortness of breath. A combination of drugs to treat the symptoms of congestive heart failure and other comorbid diagnosis include: Eliquis, Furosemide, hydralazine, and metoprolol. Other medications include Synthroid to treat hypothyroidism, Tradjenta for hyperglycemia, and Zocor for hyperlipidemia. The patient also presented with skin problems. She has bilateral ecchymosis in her lower extremities and abdomen. Lotrisone lotion was prescribed for atopic dermatitis. Edema was also present in her lower extremities.

Heart failure is the inability of the heart to efficiently pump blood to the rest of the body. In left-sided heart failure, it is the faulty left ventricle that is not pumping blood effectively due to anatomical abnormalities or secondary factors that decrease its functionality. The purpose of this research paper is to inform the reader of statistical data on the disease as well as risk factors, usual signs and symptoms, diagnostic procedures, treatment and nursing implications.

The major causes of diastolic heart failure are hypertension-induced myocardial hypertrophy and myocardial ischemia-induced ventricular transformation (coronary artery disease). Hypertrophy and ischemia cause a decreased ability of the myocytes to actively pump calcium from the cytosol, resulting in impaired relaxation. Some of the other causes are aortic valvular disease and cardiomyopathies. Diabetes can also lead to diastolic heart failure (Huether and McCune 2012). Other risk factors for this disease are chronic kidney disease, obstructive sleep apnea, and older age. There are two types of the heart failure: systolic heart failure and diastolic heart failure. In systolic heart failure, the left ventricle has difficulty contracting and ejecting blood into the circulation, which causes reduced left ventricular fraction. On the other hand, diastolic heart failure has a slow and delayed relaxation and increased chamber rigidity, which then causes inadequate filling of blood and

HLHS is referred to as single ventricle. The abnormal mitral valve preventing the blood from entering the left ventricle as a result blood flow is then diverted across ASD and into the

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

Material: We prospectively examined consecutive patients supported with LVAD as a bridge to transplantation. Left ventricular (LV) function was evaluated serially using echocardiography with LVAD turn-down. LVAD induced myocardial functional “response” was defined as a relative increase in left ventricular ejection fraction (LVEF) >50%, a final resulting LVEF>40% and a decrease in LV end-systolic volume >25% (i.e. “Responders”). Gene expression mRNA levels were assessed in LV apical cores at the time of LVAD implantation with Illumina microarray and Affymetrix Quantigene Plex 2.0 platforms.

Left ventricular dysfunction is a condition that happens when the main pumping chamber of your heart (left ventricle) is not working well. The heart is a muscle and needs a constant supply of oxygen and blood. If the arteries that deliver the oxygen and blood are blocked, parts of the heart may become weak and not pump well. The heart may also get weak from having to constantly pump against the resistance of high blood pressure or narrow arteries.