Understanding Heart Failure

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 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,

Risk factors play a role to cause congestive heart failure, but if having more than one of the risk factors, it increases one's risk. According to Daniel lee Kulick and Benjamin Wedro, Congestive heart failure is often a consequence of atherosclerotic heart disease and therefore the risk factors are the same. Poorly controlled high blood pressure, high cholesterol, diabetes, smoking, and family history are all contributors to being a risk factor of congestive heart failure. Heart valve disease becomes a risk factor of the patient throughout the years. Other causes of heart failure have their own set of risk factors and preferences and it becomes problem to those diseases.

Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary

So what is congestive heart failure? A simple definition is the heart 's inability to pump blood to the rest of the body but it goes way beyond that. The body’s natural mechanisms try to compensate for the changes that the heart is failing to do, which in turn starts a cycle that doesn’t end. When decline in cardiac output is recognized the sympathetic system attempts to fix the problem by raising blood pressure which causes the heart to work harder, worsening the heart muscle and starting the whole process over again. It causes a cascading effect on the body that can be devastating. Ischemic heart disease is the most common cause for congestive heart failure. Ischemic heart disease consists of cardiomyopathies, dysrhythmias, valve disease, vascular problems and hypertension along with

One of the main causes of mortality and morbidity is congestive heart failure (CHF). The major causes of CHF are coronary artery disease and hypertension. Other risk factors are occurrence of left ventricular hypertrophy (LVH), valvular heart disease, diabetes, smoking, obesity and dyslipidemia [46, 47]. Diabetes mellitus as an anticipated factor of CHF was explained in some studies [44, 47]. Diabetes is considered as a risk factor for CHF but yet, its relationship with CHF has not been completely understood [47, 48]. Alterations of left ventricular function and structure that are associated with diabetes mellitus or diminished glucose regulation have been described in recent studies [42, 49]. It has been reported that insulin resistance

Some key observations that we found throughout these clinical reports are that patients are offered numerous treatment options when diagnosed with heart failure. However, these treatment options are often restricted due to comorbid disorders/diseased the patients

In patients with symptomatic chronic HF who do not tolerate ACE inhibitors, angiotensin II type I receptor blockers (ARBs) can be used as an alternative to improve morbidity and mortality. However, the higher rate of hypotension, renal dysfunction, and hyperkalaemia with such a combination therapy warrants close monitoring of these parameters. As patients with end stage heart failure frequently show signs of fluid retention or have a history of such, inhibitors of the renin-angiotensin system should be co-administered with diuretics most commonly loop diuretics, which usually leads to rapid symptomatic improvement of dyspnea and exercise tolerance while lacking significant effects on survival. In addition to standard treatment with ACE inhibitors and diuretics, patients with symptomatic stable systolic heart failure should be treated with b-adrenergic receptor blockers unless there are contraindications. Additionally aldosterone receptor antagonists are recommended in addition to ACE inhibitors, b-adrenergic receptor blockers, and diuretics, unless contraindicated.

In the American Heart Association (AHA)/American College of Cardiology guidelines1, heart failure (HF) is defined as a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill or eject blood. A normal healthy heart is a muscular organ with four chambers, two on the right and two on the left, that pumps blood to the lungs and rest of the body2. The two upper chambers are called atria and the two lower chambers are called ventricles. The right atria take in oxygen-poor blood from the rest of the body and sends it back out to the lungs through the right ventricle where the blood becomes oxygenated. Oxygen-rich blood travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body. In a patient with heart failure, the heart muscle has been progressively weakened and unable to pump enough blood through to the body.

Congestive heart failure (CHF), also called chronic heart failure or congestive cardiac failure (CCF) is a clinical condition where heart muscle is weakened and cannot pump the blood as well as the normal heart. The ventricle, also known as main pumping chamber of the heart become larger or thicker which leads to inability to contract or relax as it should. “There is no universally agreed definition of heart failure (Denolin et al., 1983). It is the consequence of cardiac disease, diagnosis is clinically based on sign and symptoms manifested due to circulatory and neuro-hormonal response to cardiac dysfunction is heart failure (Poole-Wilson). The major and escalating public health problem in developed and industrialized country with aging population is congestive heart failure. According to Gaves (1991), the indication for hospitalization among adult over 65years of age is congestive heart failure. Over the past two decades admission rate to treat this condition have exponentially increased (Ghali et al., 1990). The quality and quantity of life of the patient of CHF is robbed (McMurry et al., 1998; McMurry & Stewart, 2000; Petrie & McMurry, 2001; Murdoch & McMurry, 2000). The epidemiology of the heart failure remain vast and inadequate. The rate of cardiovascular disease in Australia is highest comparison to rest of the world, despite of its significant advancement and progress in health industry, out of this sizeable portion of group is represented by heart

Risk factors for developing heart failure are broad. In general, risk factors can include, but are not limited to genetic predisposition, atherosclerosis, hypertension, elevated low-density lipoprotein (LDL) cholesterol, tobacco use, physical inactivity, obesity, diabetes (more specifically Type II), diets low in fruits and vegetables, diets high in salt, and exposure to toxins. Other significant contributions to elevated the risk factors for heart disease and heart attacks is psychological stress and depression (WA State Dept. of Health 2016).

Has anyone ever experienced breathlessness, activity intolerance, fatigue, abdominal bloating and discomfort, constipation, confusion, dizziness and ignored the symptoms thinking that was nothing to worry about? The individual who experienced these symptoms could be one of the thirty-five people who are diagnosed with heart failure, especially if they are between the ages of sixty-five and seventy-four. These symptoms are more generalized to other disease, and it does not aid in identifying heart failure. Therefore, medical history background, physical assessment accompanied by a variety of tests should be performed in order to diagnose heart failure. Nevertheless, health providers should be aware of certain disease that can eventually lead

Heart failure is a chronic, degenerative condition where the heart muscles progressively weaken until the heart is unable to pump an adequate supply of blood to the systemic circulation. The body functions optimally when it has sufficient supply of oxygen and nutrients from the blood. Conversely, a low supply of oxygen will cause severe weakness, fatigue and dyspnea.

Even though tremendous progress in the studies and treatments of heart failure have been made, heart failure continues to be one of the leaders in the cause of death for many people. There are still high medical costs and still poor patient outcomes that are because of this disease. People who have heart failure, are also suffering from things like edema, shortness of breath and fatigue as well as having the quality of their social and emotional aspects of life being affected. (Stavrianopoulas, 2016). When these symptoms go untreated, then this leads to frequent hospital visits and admissions which also causes a rise in hospital costs. There is also a decrease in day to day life qualities for these patients. (Stavrianopoulas, 2016). By reducing exacerbations of these symptoms and cutting down on the number of repeat hospitalizations with follow up visits with their physicians, nursing led phone calls, early education of the disease will help to increase the quality of life in heart failure patients. (Stavrianopoulas, 2016).

Heart failure is a condition in which the heart is unable to pump blood with enough force and speed to meet the needs of body tissues. In some cases, the heart pumps blood fast enough to meet the needs of the body, but at the cost of extra work. It does this by increasing the pressure within the heart and blood vessels. The increased pressure accentuates the wear of heart. This state is known as congestive heart failure or heart failure name.