CONGESTIVE HEART FAILURE
It refers to the inability of the heart to produce adequate pressure to maintain an adequate blood flow for the proper functioning of the body. This results in an anemic blood flow in body, coupled by the building up of pressure inside the heart. Low blood flow deprives the body of adequate oxygen supply, coupled by the possible stretching of the heart chambers in order to cope with the situation (CDC, 2012). The heart is forced to work even harder in order to meet the bodys functional requirements, which compensates for the shortfalls at the outset to keep the pressure sufficiently high.
However, this comes at a huge price, in the form of myocardium and increased coronary perfusion needs that exacerbate the problem further than the heart can cope with it. The stretching of the heart chambers thicken and weaken, while the heart ventricles enlarge, contributing to the expansion and spherical shape of the heart, which is inhibited from relaxing during diastole due to heightened stiffness (CDC, 2012). Eventually, the heart fails even more, bringing on the risk of cardiac arrest, coupled by considerable changes to the body, known as congestion. These changes include reduced arterial blood pressure, low perfusion and secretion of vasopressin by the hypothalamus. Vasopressin, aldosterone and other secretions due to the strain on the heart result in the retention of fluids by the kidney, ankles, lungs and other body organs (edema). Fluid retention damages the myocardium further, besides inducing a high hydrostatic pressure on the capillaries that draws more and more fluids from the blood (The European Society of Cardiology, 2008).
Many of the causes of the disease are difficult to identify owing to the diagnostic and population factors. However, the most common causes include coronary artery disease that narrows or completely blocks the coronary arteries, effectively starving the heart of vital nourishment and oxygen to facilitate proper functioning. Heart attacks and Cardiomyopathy result in the damaging of the heart muscles, effectively undermining the ability of the heart to pump blood to the rest of the body. Ischemic heart disease account for upwards of 63% of the congestive heart disease (Fonarow, Abraham, Albert, et_al, 2008). Other causes include diabetes, obesity, cigarette smoking and valvular heart disease.
The disease manifests through among others, general body weakness, fatigue and sleepiness resulting from the reduced supply of blood and oxygen to the body. In addition, congested lungs cause difficulty in breathing and shortness of breath. Other symptoms include the retention of water due to the inability of the kidney and skin to work properly, resulting in swollen ankles, abdomen, legs and general gaining of weight. The right-sided failure is associated with jugular venous pressure, hepatologaly, ascites and peripheral edema (Fonarow, Abraham, Albert, et_al, 2008).
The earliest diagnosis as well as treatment of congestive heart failure is central to bolstering the quality of life and increasing the patients life expectancy. While there is not a clearly defined diagnostic procedure for the disease, conclusive diagnoses can be made through a physical examination, electrophysiology, blood and stress testing, echocardiography and angiography (CDC, 2012). An echocardiogram and a chest X-Ray are used to determine the heart, lung, kidney and other organs sizes as well as movement to detect the possibility of fluid buildup. On the other hand, blood tests help in the evaluation of the thyroid and kidney functions by checking for hemoglobin and cholesterol levels, besides detecting a substance called B-Type Natriuretic Peptide that is released by the heart in the case of high blood pressure within it (The European Society of Cardiology, 2008).
Treatment and Management
The diseases management involved the re-establishment of sufficient perfusion as well as oxygen circulation, by using vasodilators including diuretics, nitroglycerin and non-invasive positive pressure ventilation. The initial phase of treatment addresses reversible causes of the disease such as smoking, high blood pressure, lipid disorders, alcohol and drug use may be reversed through treatment, cessation or exercise. In addition to these, confirmed cases of systolic left ventricular dysfunction should be treated using angiotensin II inhibitor or angiotensin converting enzyme inhibitor, beta-blockers as well as possible surgery (The European Society of Cardiology, 2008).
Patients who suffer from pre-existing symptoms and confirmed systolic heart failure may in addition to the phase I measures, besides the administration of digoxin, aldosterone, restriction of dietary sodium, cardiac re-synchronization and implanting a cardiac defibrillator. The management of chronically ill patients involves the prevention of severe decompensated heart failure as well as addressing the worst effects of the deformed heart shape. Behavioral modifications including dietary changes and increased physical activity must be encouraged (Fonarow, Abraham, Albert, & et_al, 2008).
Congestive heart failure affects upwards of 5.7 million people in the United States alone, accounting for more than 55,000 deaths every year with 50% of the deaths occurring within five years of diagnosis. The treatment, management of the disease, coupled by losses in productivity costs in excess of $34.4 billion in the US alone (CDC, 2012). This disease is largely preventable through the adoption of healthy lifestyles that include physical activity, coupled by early detection and treatment.
CDC. (2012, Feb 13). Division for Heart Disease and Stroke Prevention. Retrieved May 2, 2012, from www.cdc.gov: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm
Fonarow, G., Abraham, W., Albert, M., & et_al. (2008). Factors Identified as Precipitating Hospital Admissions for Heart Failure and Clinical Outcomes: Findings From OPTIMIZE-HF. Arch. Intern. Med. 168 (8) , 847854.
The European Society of Cardiology. (2008). Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. European Heart Journal 29 , 29092945.
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