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 …show more content…
The characteristic beginning signs of HF include inadequate tissue perfusion and signs of volume overload. Inadequate blood flow to tissues can be evident by fatigue, shortness of breath, and exercise intolerance. Volume overload is evident by peripheral and pulmonary edema (fluid collection in the limbs and on the lungs) and venous distention (due to blood pooling in circulation from back flow in the heart) (Lehne, 2010). 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).
Heart failure can be attributed to either right sided, left or both. Left-sided heart failure is of two types, systolic failure and diastolic failure. Systolic failure is the when the left ventricle loses its ability to contract normally. The heart cannot pump with enough force to push enough blood into circulation. Diastolic failure is when the left ventricle loses its ability to relax normally. Which results in the heart not being able to fill with blood during the resting period. Both result in a decrease in cardiac output. (AHA, 2012). A decrease in the cardiac output into the systemic circulation causes blood to accumulate in the left ventricle, left atrium, and pulmonary circulation. This increase
Heart failure develops when there is an abnormality to the cardiac structure that lead to impairment of ventricular filling and ejection of blood to the body (7). Thus, the cardiac output does not meet the body’s oxygen demand.
After a period of time, the heart muscles of the left ventricle begin to weaken. The weakening of the left ventricle will lead to decreased empting of the heart (systolic heart failure) which results in decreased cardiac output again. Since the left ventricle does not empty completely, blood begins to back up into the left atrium and then to the pulmonary circulation thus resulting in pulmonary congestion and dyspnea (Story 2012, 104). If left untreated, the blood will back up and affect the right side of the heart causing biventricular heart failure (both right and left heart failure). In right sided heart failure, the right ventricle weakens and cannot empty completely. This incomplete emptying causes blood to back up into the systemic circulation causing systemic edema (Lewis et al. 2014, 771).
Congestive Heart Failure is a condition in which the heart is unable to pump a sufficient amount of blood for the body to function. If the heart’s ability to pump blood decreases, blood and fluids may start to pool into the lungs and accumulate in the legs, ankles, and feet causing an edema, shortness of breath, and fatigue. (Heart Failure, 2015, para. 2) The American Heart Association and American College of Cardiology defines heart failure as “a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricles to fill with or eject
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.
This assignment will take the form of a case study on a current patient with heart failure being nursed in a community setting. Due to confidentiality and patient privacy, the patient discussed will be referred to as John¹.
Congestive Heart Failure, also known as "cardiac decompensation, cardiac insufficiency, and cardiac incompetence," (Basic Nursing 1111) is an imbalance in pump function in which the heart is failing and unable to do its work pumping enough blood to meet the needs of the body's other organs. To some people, heart failure is defined as a sudden and complete stoppage of heart activityi.e. that the heart just stops beating. This is an inaccuracy. Heart failure usually develops slowly, often over years, as the heart gradually loses its pumping ability and works less efficiently. CHF is a syndrome that affects individuals in different ways and to different degrees. It is usually a chronic disease. It gradually
Congestive Heart Failure is when the heart's pumping power is weaker than normal. It does not mean the heart has stopped working. The blood moves through the heart and body at a slower rate, and pressure in the heart increases. This means; the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up with fluids, it becomes congested. Many conditions can cause heart
According to the American Heart Association (2015), heart failure is defined as “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”. Congestive heart failure is a progressive illness that effects millions of Americans every year. Many other illnesses can lead to the development of congestive heart failure. Examples of these diseases include: coronary artery disease, past heart attack, high blood pressure, abnormal heart valve, heart muscle disease such as hypertrophic cardiomyopathy, dilated cardiomyopathy or inflammation such as myocarditis, congenital heart disease, severe lung disease, diabetes, obesity and asthma. (American Heart Association, 2015 (Centers for
Heart failure describes a syndrome in which the patient has a dysfunctional heart incapable of sustaining an adequate cardiac output, and this syndrome is responsible for a large portion of cardiovascular-related deaths2. There are two types of left ventricular dysfunction, one is systolic dysfunction which has implications in defective ventricular ejection and contraction, and the other is diastolic dysfunction which has implications in dysfunctional ventricular relaxation and filling2. Heart failure patients with systolic dysfunction have an ejection fraction of less than 40%, and heart failure patients with diastolic dysfunction have an ejection fraction of greater than 40%. In the case study, the patient has a left ventricular ejection fraction of 25% which means that he is suffering from systolic dysfunction.
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
abstracts were then read to determine the relevance to the topics in question. Twelve articles were found relevant to the topic selected and deemed appropriate for review. PubMed recovered 29 articles but access to these articles proved difficult and required secondary subscriptions, so the articles from Science Direct were used instead. The full publication of each of the 12 selected articles was printed out from Science Direct and the chosen articles were read with great detail and pertinent data was selected from each one for inclusion in this review paper.
A journey with heart failure has been a difficult one. It started out a few years ago when I turned 66 years ago. It started with what seemed like a bad flu. I went to go see my doctor and he told me that there was a bad flu going around that that I just need to ride it out and give it time to go away. After a few weeks, my breathing got worse so I went back to see it and he ran some tests and told me I had heart failure and not a flu. He gave me some medications that make me go to the bathroom very often and that helped me breathe better. He explained that my heart was weak and that I had extra fluid in my body and that is why my feet were swollen and I was having trouble breathing. The water pills have helped me
Heart is a crucial organ in human body and if the heart does not work properly, the person will die. The human heart is a muscular organ which pumps blood all over the body. In human, the heart size is roughly same as the size of a large fist (Lewis 2016). Heart failure can happen for anyone. However people with anemia, hyperthyroidism and an overactive or underactive thyroid disease are at higher risk (Moore; Roth 2015). Artificial heart can replace as real heart which can save many people from dying while they are waiting for heart transpose. In the past, the majority of artificial hearts have been used for people who waiting for heart transplant whereas, some people use artificial heart as permanent use (Tucson 2014). It is extremely important
It is the time of progress. The time of supercomputers, space shuttles, and many other wonders of technology. We have walked on the moon. We do our shopping at home via Internet navigation.