Congestive Heart Failure Analysis
Congestive heart failure, sometimes known as the heart failure, happens when heart muscle fails to pump blood the way it is supposed to. Particular conditions, such as coronary heart disease and high blood pressure, make heart too weak to fill and pump blood efficiently. Other causes of the disease include excessive use of alcohol, cardiomyopathy, myocardial infarction and infection. The above mentioned disorders cause heart failure by altering either the structure or functioning of heart. Not all diseases that cause heart failure can be reversed, however, treatment can improve the symptoms of heart failure. The two primary forms of heart failure are heart failure caused by the left ventricular dysfunction and heart failure with regular ejection friction subject on if the capacity of the left ventricle to contract is affected, or the heart’s capacity to relax. Disorder’s severity is categorized by the amount of complications with exercise.
Prevalence of Disease
According to American Heart Association, disease is common among the older persons, usually aged from 65 years and older. This disorder is not limited to elderly persons only. Congestive heart failure is a disease that might also affect children, young adults, middle-aged and elderly. About 1 million persons with heart failure in US are under the age of 60. Over 6% of individuals who are over 60 have congestive heart failure (Adams). The occurrence of congestive heart failure is correspondingly frequent in men and women, and African- Americans are more likely to develop CHF than natives. Congestive heart failure is accountable for millions of medical doctor visits every year, as well as many hospitalizations. Congestive heart failure is the first-recorded diagnosis in 875,000 hospitalizations, and common diagnosis in clinic patients who are aged 65 and above (Adams). Deaths, as a result of heart failure, show a discrepancy by geography. The disease is more common in some parts of United States. Heart failure is an acute disorder with substantial morbidity and mortality rate. In America, about 5 million people suffer from heart failure. One death out of 9 in 2009 was caused by heart failure. In a year, about 55,000 new cases of heart failure were reported in United States (Adams).
About three quarters of those who develop congestive heart failure die within five years after the diagnosis. According to data collected from the National and Health Nutrition Examination Survey, between 2 million adults are affected. Mortality at 10 and 15 years for people with heart failure increases in a categorized manner with advancing age, with men more probable to die than women. The disorder costs US approximately $32 billion every year. The total cost includes the costs of treatment medications, health care services, and lost work days.
In US, approximately 287,000 patients die from heart failure within a year. Unexpected death is common in patients at a rate of 6 to 9 times, that of the overall population. Remarkably, deaths from congestive heart failure have considerably reduced over a decade for both men and women. The prevalence of heart failure increases sharply with age. Framingham Heart Study found an occurrence of heart failure in men of 9 per 1000, aged from 50 to 60 years, rises to 65 per 1000, aged from 80 to 90 years (Adams). Identical values were observed in women.
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Risk Factors of Congestive Heart Failure
Some people have higher chances of developing congestive heart failure than others. It is impossible to predict who will develop heart failure, however, there are certain risk factors. Being cognizant of the risk factors and visiting a physician for early diagnosis are essential steps for controlling heart failure. Disorders that damage the heart similarly increase the possibility of heart failure; some of the conditions include: high blood pressure, coronary heart disease, family history. Diabetes Heart valve disorder becomes a risk factor, as one gets older. Some of the unhealthy behaviors can also increase the possibility of heart failure and, particularly, for persons who have one or both of the above disorders (McMurray).
These unhealthy lifestyle habits include:
- Lack of physical exercise
- Eating habits
Heart failure can be diagnosed through physical examination and history of a patient. Medics frequently enquire about the signs and symptoms, such as inflammation in legs, chest discomfort and shortness of breath. It is paramount to know if these indications occur regularly or after some time. It is important also for a medical care professional to know about the past medical history of a patient, as well as the diet, drug use and medication history. Physical examination usually begins by observing a person, taking note of how comfortable they are at rest, and if a stroll to the exam space caused them to have short of breath. Critical signs include blood pressure, oxygen saturation; pulse rate and body weight may also be useful to evaluate how sick the patient might be (McMurray).
The examination focuses on heart and lungs. Health care professional observes lungs, looks whether there is perfect air passage on all sides of the chest or whether there are further sounds that can be heard when the liquid is present. Percussion can reveal a fluid buildup. Heart exam involves feeling for apex beat. If heart beat is displaced in the direction of the armpit, it may be an indication that heart has grown bigger. Heart sounds expose abnormal rhythms, known as gallops that are perceived in heart failure. The neck may also be scrutinized, looking for jugular venous distention. The jugular venous will expand if there is more liquid in the body and may be an indication of right heart failure.
The physician will usually observe the feet and ankles to see if they are swollen. The abdominal examination may uncover an inflated liver. Heart failure becomes a medical emergency, where a patient presents extremely ill with the inability to breathe adequately. Under this circumstance, Airway Breathing Circulation is addressed and, at the same time, diagnosis of heart failure is carried out. Some of the commonly performed tests to diagnose congestive heart failure include: Electrocardiogram (EKG, ECG) to assist in assessing the heart rate, tempo and, incidentally, the size of the ventricles and blood flow to heart.
Chest x-ray to observe the size of heart and look for the accumulation of fluid in lungs. Blood test may involve a complete blood count, creatinine, electrolytes and BUN. B-type natriuretic peptide (BNP) is of help in assisting to make a decision whether the patient has shortness of breath due to heart failure or for other reasons. The chemical is found in the heart ventricles and is often released if muscles are burdened.
Echocardiography or ultrasound tests are usually suggested to evaluate structure and role of heart. Apart from assessing the heart valves, the test can observe blood flow within heart, look at the chambers of the heart contract, and estimate the discharge fraction.
Other tests may be recommended to assess and observe a person with suspected congestive heart failure, depending upon clinical condition.
Signs and Symptoms of Congestive Heart Failure
Shortness of breath
The most common and widely known symptom of heart failure is shortness of breath and may happen:
- While resting
- While being active
- While lying flat
- May wake the person from sleep
Shortness of breath may be a result of liquid accumulation in lungs or the incapacity of heart to be effective enough to pump blood to the body when called upon in times of anxiety.
Chest pain may be linked, particularly if the causal source of the failure is atherosclerotic heart disorder. Patients with right heart failure leak liquid into the organs that transport blood to the right heart via vena cava. Back pressure in capillary blood vessels makes them break water into the spaces between cells, so that water can be found in the lowest organs. Depending on the causal of the illness and clinical condition, patients may have signs of heart failure or left failure or even both. Ascites and hepatomegaly can make patients feel bloated, suffer from abdominal pain and feel nauseated. Water can accumulate in patient’s liver, making them swell and also in the abdominal cavity (McMurray).
Congestive Heart Failure Treatment
The primary goal for treating congestive heart failure is to make heart beat more forcefully, so as to assist it to meet the energy requirements of the body. Specific treatment is dependent upon the cause of the congestive heart failure. Treatment can reduce the amount of water within the body, so that the heart does not necessarily need to work so hard to pump the blood to various organs of the body. Water limitation and reducing the amount of salt intake can be very useful. Diuretic medications can be recommended, if appropriate. Commonly used Diuretic include hydrochlorothiazide, bumetanide and furosemide. Drugs that might cause heart to beat more forcefully and increase expulsion fraction are available. ACE inhibitors and ARBs are medications that can also help prolong life by decreasing systematic resistance and favorable varying the hormonal milieu, which distresses the cardiac functioning, these drugs are generally used in combination with other drugs. Beta blockers can control heart beat and intensify cardiac output and ejection fraction, providing a positive reaction to circulating adrenaline (McMurray).
Digoxin is also a drug that can assist in increasing cardiac output and control symptoms. Cardiac risk factor alteration is the keystone of prevention, nonetheless, can also help patients with discovering congestive heart failure. Weight loss, starting a workout program, regulating high blood pressure, quit smoking, reduce high cholesterol intake may be beneficial in the control of congestive heart failure. End phase congestive heart failure patients require aggressive treatments, comprising left ventricular assist devices, an implanted pump that contributes to increasing heart’s capacity to squeeze, or alternatively heart transplantation.
Lifestyle that can Assist in Treating Congestive Heart Failure
When diagnosed with congestive heart failure, treatment must be started immediately. Change of lifestyle is one of the most imperative aspects that a patient can include to treat congestive heart failure. Some of the lifestyle modifications include:
Sodium: Sodium is a leading cause of an increase in the liquid buildup in the body’s tissues. Since the body is frequently overfilled with excess fluid, patients become sensitive to the amount of ingestion of sodium and fluids. Limiting salt and fluid intake is often commended because of the propensity of fluid to build up in lungs. A patient should not consume salt, although the diet may contain a maximum of 6 grams of sodium per day. Reading food labels and paying attention to the levels of sodium consumption is very important. Restriction of alcohol intake is recommended.
Aerobic exercise has been shown to be helpful in preserving overall functional ability, and quality of life. Every individual’s body has its own exclusive capacity to compensate for heart failure. Given a similar degree of heart muscle weakness, persons may show widely varying levels of function restriction. Consistent exercise, when tailored to the individual’s tolerance level, seems to offer significant benefits and must be used only when the patient is compensated.
Addressing Possible Mutable Factors
Depending on the fundamental cause of the congestive heart failure, possible adjustable factors may be explored. For instance, in certain patients, whose heart failure is caused by deficient blood flow to the heart muscle, coronary artery surgery or catheter processes or restoring blood flow may be considered. Congestive heart failure that is caused by a severe disorder of the valves can be repaired by valve surgery in proper patients. Congestive heart failure due to uncontrolled hypertension, blood pressure control may alleviate the condition. The condition of heart muscle weakness caused by alcohol intake, may improve considerably with abstinence from drinking. Congestive heart failure caused by other disorders can be also partially or entirely reversible.
The level of liquid intake should be regulated. While many patients with congestive heart failure take drug diuretics to assist in getting rid of excess water, the actions of these drugs can be overcome by an excess intake of fluids. The rule of drinking eight glasses of water in a day does not apply to patients diagnosed with congestive heart failure. Persons with advanced cases of congestive heart failure are regularly advised to restrict their daily levels of fluid intake. Patients should get guidelines from their doctor on the levels of Sodium and fluid intake.
A significant tool for monitoring proper fluid equilibrium is following the patient’s body weight. An initial sign of fluid buildup is an increase in body weight. This may happen earlier than shortness of breath or even swelling of legs is discovered. Abnormal weight gain should be consulted with the physician who may prescribe diuretics and other ways of stopping the early stages of fluid buildup before it develops into a serious condition (McPhee & Papadakis).
Long-term Prognosis for Persons with Congestive Heart Failure
Congestive heart failure is usually a progressive condition with phases of stability, interposed by episodic medical exacerbations. The course of disease in each patient is exceedingly variable.
Factors involved in determining the long-term outlook for a particular person include:
- The nature of causal heart disease;
- The reaction to drugs;
- The extent to which other body parts are engaged and the severity of other associated illnesses;
- Patient’s indications and the extent of impairment
- Other factors that have not been clearly understood.
With the accessibility of newer medicines to possibly favorable affect the advancement of condition, the outlook in congestive heart failure is more favorable than perceived one ten years ago. In certain cases, particularly where the heart muscle dysfunction has lately developed, a substantial impulsive improvement is not unusually observed, even to the degree where the heart function becomes usual (McPhee & Papadakis).
Heart failure is graded on a scale of I to IV, based on individual’s capacity to function:
- Class I is individuals with a weakened heart but without restriction or indications;
- Class II is only restraint at weightier workloads;
- Class III is restraint at daily work;
- Class IV is severe indications at rest or with any amount of work.
An imperative concern in congestive heart failure is the risk of rhythm instabilities. In deaths that happen in patients with congestive heart failure, about half are connected with the advanced heart failure. Significantly, the rest of the 50% deaths are associated with the serious rhythm disturbance. The most important development has been the discovery that nonsurgical placement of automatic implantable cardioverter in patients with severe congestive heart failure can considerably increase survival levels, and has developed to be the standard of care in most such patients. In some patients with serious heart failure and particular ECG abnormalities, the left and right side of the heart do not beat in rhythm, and implanting a device called a biventricular pacer can considerably lessen symptoms (McPhee & Papadakis).
Prevention of Congestive Heart Failure
Congestive heart failure is often caused by an underlying disorder, frequently atherosclerotic heart disease. Monitoring those risk factors, can assist in prevention of congestive heart failure. These include lifetime control of diabetes, high blood pressure, high saturated fat and smoking. High blood pressure and diabetes are independent risk factors for heart failure. Alcohol and substance abuse can be causes of heart failure (McMurray).
Congestive heart failure is prevalent in United States of America, with substantial morbidity and mortality, both of which increase with advancing age. Congestive heart failure in children is minimal. Notably, a bigger percentage of population, suffering from congestive heart failure include the elderly and the middle-aged. Symptoms of disease vary, depending on the underlying cause. The treatment also depends on the degree of severity of illness and the cause, mostly established during the diagnosis by a physician. During the diagnosis, health care professional asks questions as to the medical history and observes a patient for physical signs and symptoms.
Tests can also be performed to establish the cause so that effective treatment is prescribed by the physician. In addition to drugs, change of lifestyle is significantly helpful in treatment of Congestive heart failure. Prevention of the disease is also paramount and patients are advised to eat healthy, exercise and avoid smoking or abuse of drug that may lead to congestive heart failure. Mitigating the risk factors is also a key factor in reducing chances of developing congestive heart failure. Remarkably, the current developments are significantly improving the survival of patients with congestive heart failure. It is advisable that if a person observes any sign or symptom that is associated with the heart failure to consult a physician promptly in order to reduce the risk of developing congestive heart failure.
The US government is working hard to reduce the amount of deaths resulting from congestive heart failure. There is a considerable amount of money spent for treating the disease and also lost days at the work place impacting heavily on the United States economy. Living healthy, seeking early treatment, and being aware of congestive heart failure are some of the practices that are encouraged in order to reduce the amount of people suffering from the disease. New developments, including newer medicines and sophisticated machines for treatment, are helpful in reducing the number to a greater extent.
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