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Chronic Heart Failure
Transcript of Chronic Heart Failure
Mount Royal University, SN4 What is heart failure? “Heart failure refers to inability of heart to maintain sufficient cardiac output to optimally meet metabolic demands of tissues and organs”.
(Copstead & Banasik, 2010, p. 462) FORWARD AND BACKWARD! Cardiac output: A measure of the amount of blood pumped by the heart in 1 minute, usually expressed in liters per minute.
(Copstead & Banasik, 2010, p. 1294)
Forward effects (insufficient cardiac output)
Backward effects (congestion of blood behind the pumping chamber)
(Copstead & Banasik, 2010, p. 469-472) The left ventricle does not pump blood efficiently, leading to pressure buildup behind the left side of the heart that eventually causes the right side of the heart to fail.
Frequently leads to development of right-sided heart failure
Dyspnea (shortness of breath) on exertion – may be considered a cardinal/primary symptom
Orthopnea (shortness of breath when lying down)
(Copstead & Banasik, 2010, p. 469-472) LEFT SIDED HEART FAILURE Paroxysmal nocturnal dyspnea (difficulty breathing and coughing at night, usually awakening the individual)
Cyanosis (blue or purple coloration of the skin due to low oxygen supply)
Basilar crackles (crackles originating in or near the base of the lung)
Oliguria (low urine output)
Increased heart rate
(Copstead & Banasik, 2010, p. 469-472) LEFT SIDED HEART FAILURE Right-sided heart failure means that the right side of the heart is not pumping blood to the lungs as well as normal.
Backward effects (congestion of blood behind the pumping chamber):
Hepatomegaly (enlarged liver)
Ascites (fluid accumulutation in the perioteneal cavity)
Splenomegaly (enlarged spleen)
Anorexia (loss of appetite)
Jugular vein distention
(Copstead & Banasik, 2010, p. 469-472) RIGHT SIDED HEART FAILURE Forward effects (insufficient cardiac output) manifested as:
Increased heart rate
(Copstead & Banasik, 2010, p. 469-472)
What can you expect if you have heart failure?
Trouble with your heart rhythm (arrhythmia)
Mitral valve regurgitation
Blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism)
(MyHealth.Alberta.ca., 2011) RIGHT SIDED HEART FAILURE Anything that damages your heart or affects how well it pumps can lead to heart failure. Common causes of heart failure are:
High blood pressure
Coronary artery disease
(MyHealth.Alberta.ca., 2011) CAUSES of Heart Failure Other conditions that can lead to heart failure include:
Diseases of the heart muscle (cardiomyopathies)
Heart valve disease
Disease of the sac around the heart (pericardial disease), such as pericarditis
A slow, fast, or uneven heart rhythm (arrhythmia)
A heart problem that you were born with (congenital heart defect)
Long-term alcohol abuse, which can damage your heart
(MyHealth.Alberta.ca., 2011) CAUSES of Heart Failure Blood tests. A chest X-ray.
An electrocardiogram (EKG or ECG) to check your heart's electrical system.
An echocardiogram to see the size and shape of your heart and how well it is pumping.
Cardiac catheterization to check your heart and its blood vessels (coronary arteries).
A stress test to look for coronary artery disease.
(MyHealth.Alberta.ca., 2011) How do you diagnose it? An echocardiogram is the best and simplest way to find out if you have heart failure, what type it is, and what is causing it. Your doctor can also use it to see if your heart failure is getting worse.
It can measure how much blood your heart pumps to your body. This measurement is called the ejection fraction. If your ejection fraction gets lower and you are having more symptoms, it means that your heart failure is getting worse.
(MyHealth.Alberta.ca., 2011) How do you diagnose it? Symptoms of heart failure start to happen when your heart cannot pump enough blood to the rest of your body. In the early stages, you may:
Feel tired easily.
Be short of breath when you exert yourself.
Feel like your heart is pounding or racing (palpitations).
Feel weak or dizzy.
As heart failure gets worse, fluid starts to build up in your lungs and other parts of your body. This may cause you to:
Feel short of breath even at rest.
(MyHealth.Alberta.ca., 2011) SYMPTOMS?! Have swelling (edema), especially in your legs, ankles, and feet.
Gain weight. This may happen over just a day or two, or more slowly.
Cough or wheeze, especially when you lie down.
Need to urinate more at night.
Feel bloated or sick to your stomach.
If your symptoms suddenly get worse, you will need emergency care.
(MyHealth.Alberta.ca., 2011) SYMPTOMS?! Most people with heart failure need to take several medicines. Your doctor may prescribe medicines to:
Help keep heart failure from getting worse. These drugs include ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and vasodilators like hydralazine and nitroglycerin. Treat the cause of your heart failure.
Reduce symptoms so you feel better. These drugs include diuretics (water pills), digoxin, and potassium.
You might have bypass surgery or angioplasty to open clogged arteries, or you may need surgery to repair or replace a heart valve.
(MyHealth.Alberta.ca., 2011) How is it treated? You might need to have a pacemaker or a defibrillator if you have a problem with your heart rhythm. These help your heart keep a steady rhythm. Eat less salt (sodium). Sodium causes your body to retain water and makes it harder for your heart to pump. Your doctor may also ask you to limit how much fluid you drink.
Get regular exercise. Your doctor can tell you what level of exercise is safe for you, how to check your pulse, and how to know if you are doing too much.
Take rest breaks during the day.
Lose weight if you are overweight. Even a few kilograms can make a difference.
Stop smoking. Smoking damages your heart and makes exercise harder to do.
Limit alcohol. Ask your doctor how much, if any, is safe.
(MyHealth.Alberta.ca., 2011) How is it treated? Copstead, L.C., & Banasik, J.L. (2010). Pathophysiology (4th ed.). St. Louis, Missouri, US: Sauders Elsevier.
MyHealth.Alberta.ca. (2011). Heart Failure. Retrieved September 22, 2012, from https://myhealth.alberta.ca/health/pages/conditions.aspx?hwId=hw44415
MyHealth.Alberta.ca. (2011). Right-Sided Heart Failure. Retrieved September 22, 2012, from https://myhealth.alberta.ca/health/pages/conditions.aspx?hwid=tx4093abc& References My personal belief is that health promotion should be of utmost priority by the health care team because there is nothing to treat when the disease is prevented from ever occurring in the first place. If it is inevitable for the disease to be prevented from ever occurring, then delay its onset as far as possible.
Health promotion should take into consideration a person’s quality of life and not just the implementation of care in order for it to be successful. Recommendations by the author to the readers: THE END
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