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Chamberlain College of Nursing *
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Course
506
Subject
Medicine
Date
Apr 3, 2024
Type
docx
Pages
2
Uploaded by bkpd49
1)
Heart failure is defined as a condition that occurs when the heart is not pumping efficiently enough blood to keep up with the body’s needs. It can either mean that the heart is not filling up with enough blood or it can mean that the heart is weak to pump properly. Systolic heart failure occurs when the left ventricle is not able to contract completely (Inamdar & Inamdar, 2017). In this type of heart failure, the heart is not pumping forcefully enough to move the blood through the body efficiently. It is also known as heart failure with reduced ejection fraction (HFrEF). Diastolic heart failure occurs when the left ventricle is unable to relax between pumping due to stiff tissues. In this type of heart failure, the heart is unable to relax, therefore, it is unable to fill up again with blood prior to next contraction. This type of heart failure is also called heart failure with preserved ejection fraction (HFpEF) (Choi et al., 2019).
2)
This patient is in systolic heart failure.
3)
Pathophysiology of the symptoms is caused by the following mechanisms. In heart failure, the compensatory mechanism is to increase blood volume to further increase ventricular preload and enhance stroke volume which in the end increases cardiac output. This increased volume raises venous pressures and can lead to pulmonary and systemic edema. When the edema occurs in the lungs, it can cause exertional dyspnea. In detail, this edema can be pulmonary or peripheral as this results from activation of humoral and neurohumoral mechanisms that promote sodium and water absorption by kidneys. (Choi et al., 2019). These mechanisms increase venous capillary pressure and decrease plasma oncotic pressure. They further promote fluid extravasation and edema formation. With the increased blood volume, the central venous pressure is also increased, and this increases the pressure in the superior vena cava which causes the jugular vein to bulge and makes it most visible on the right side of the neck. Orthopnea occurs due to pulmonary congestion caused by increased blood volume. When a person lays horizontally, the blood gets distributed from the lower extremities and splanchnic beds to the lungs. In patients with heart failure, this additional volume cannot be pumped out by the left ventricle, and this causes reduction in vital capacity and pulmonary compliance which results in shortness of breath (Inamdar & Inamdar, 2017).
4)
A reduced ejection fraction means the muscle of the left ventricle is not pumping well. This means that the amount of blood being pumped out of the heart is less than the body needs. The third heart sound is also known as ventricular gallop and this occurs when the mitral valve opens, this allows passive filling of the left ventricle and is produced by the large amount of blood striking a very compliant left ventricle., The presence of a third heart sound S3 and ejection fraction of 25% is an indicative of heart failure (Shono et al., 2019). Reference:
Choi, A., Park, M., & Youn, J. (2019). Update on heart failure management and future directions.
The Clinical Journal of Internal Medicine
,
34
(1). https://doi.org/10.3904/kjim.2018.428
Inamdar, A., & Inamdar, J. (2017). Heart Failure: Diagnosis, Management and Utilization.
Journal of Clinical Medicine
,
5
(7). https://doi.org/10.3390/jcm507006256
Shono, A., Mori, S., Yatomi, S., Kamio, T., Sakai, J., Soga, F., Tanaka, H., & Hirata, T. (2019). Ultimate Third Heart Sound.
The Japanese Society of Internal Medicine
,
58
(17). https://doi.org/10.2169/internalmedicine.2731-19
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