The Agent 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).

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

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).

6. What laboratory tests should be ordered for M.G. related to the order for furosemide (Lasix)? (Select all that apply)

When an asthmatic takes an inhaler “Albuterol sulfate”, the medication works by reducing the inflammation in the airway paths “bronchi and bronchioles” of the lungs, allowing the patient to breath without constriction or symptoms of asthma.

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,

Pharmacological therapy would include; prostaglandin E1 or E2 to maintain the patency of the ductus arteriosus, diuretics, dobutamine to increase contractility of the volume loaded right ventricle. (The Lancet)

Patients who have congestive heart failure and do not respond to diuretics may benefit from a combination of several types of diuretic medication, each with a different system of action. Another medication for someone that has congestive heart failure can take Beta-blockers. Side effects include fatigue, cold hands, headache, upset stomach, constipation, diarrhea, dizziness, and shortness of breath. Data reported from 17 studies, researchers came to the conclusion that the risk of death from all causes was 31 percent lower in patients with heart failure who were treated with beta-blockers than in those not receiving such medications. Aldosterone blockers is a form of medication one may take to help slow down the rate of congestive heart failure.This medication can sometimes affect kidney function and can also increase potassium levels. Aldosterone blockers are prescribed to individuals who develop heart failure after a heart attack. Studies show that these medications can reduce the risk of hospitalization and death from cardiovascular disease. The last form of medication is BiDil (isosorbide

Pharmacological treatments with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or aldosterone antagonist, and beta-blockers are essential for the treatment of heart failure and are effective in improving symptoms of heart failure and patient well-being. Diuretics are administered to help get rid of the excess fluid that helps improve breathing associated with shortness of breath, at rest or on exertion. Diuretics provide relief from symptoms and signs of pulmonary and venous congestion by promotion of fluid loss through the kidneys. Diuretics, for example, Furosemide helps improve breathing status, but monitoring patients for dehydration and kidney problems is crucial. Patient education is essential to ensuring medication adherence and early identification of adverse effects and potential for drug interactions.

It inhibits Na+K+ ATPase active transport raising cytosolic Na+ concentrtion and leading to the increasement of Ca2+ concentration in the sarcoplasmic reticulum by the reversival exchange of Na+ and Ca2+ in the myocardial cell. This increase in the contraction of the heart (32) and improve cardiac outpur , left ventricualr ejection fraction, stroke volume, pulmonary capilary wedge pressure and exercise tolerance (33). Secondly, digoxin produce vagus activation showing negavite chronotropic action in SA node and negative dromotropic action in AV node. This lead to a shift in automatic balance by dominating the positive iontropic action of the drugs digoxin (33). In this way digoxin is cosinder as a only available inotropic drug which increase cardiac output and decreae pulmoary capillary wedge preure with our increasing heart rate and without decreasing blood pressure

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

Heart failure (HF) is a pathological condition that impairs the ability of the heart to keep up with the metabolic demands of the body, resulting in multi-organ abnormalities and eventually death1, 2. This can result from conditions that reduce the ability of heart to pump blood which include decreased contractility of myocardium secondary to reduced coronary perfusion, structural causes like damaged heart valves, cardiac muscle or pericardial diseases etc.3 The understanding of the mechanistic details that drive the progression of heart failure is not well understood but molecular and cellular changes point towards the role of neuro-hormonal activation and ventricular remodeling as primary determinants.4 The sequential and progressive upregulation of renin-angiotensin aldosterone system, increased levels of norepinephrine and endothelin-1 play a significant role in the progression of LV dysfunction. Coronary artery disease (CAD), dDiabetes, and hHypertension are among the leading causes whereas other factors such as genetic, alcohol abuse, infectious myocarditis, chemotherapeutic agents etc. also account for significant number of cases.5, 6 The symptoms of decompensated HF are very non-specific (shortness of breath, fatigue, weakness, etc.) and need evaluation in the context of the overall clinical picture, which includes signs like extremity edema, jugular venous distention, S3).5, 7 Tests like BNP, ECG, CXR, echocardiography, C-MRI allow confirmation of the

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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.