Heart Attack

? Heart failure makes people think that their heart is no longer working and there is nothing that can be done to correct it, but heart failure really means the heart is not pumping as good as it should be. The weakened heart cannot supply the body’s cells with enough blood. This usually results in fatigue and shortness of air. Activities of daily living, such as walking or carrying groceries, become extremely difficult. Heart failure is a very serious condition and usually there is no cure. But many people with heart failure have enjoyable lives when it is controlled with heart medications and healthy lifestyle.

Alone, any single sign of heart failure may not be alarming. But if someone has two or more of these symptoms, they should get an evaluation of the heart by a healthcare physician. The most common symptoms of heart failure include shortness of air, during activity, at rest, or while sleeping, a persistent cough or wheeze, feeling of fatigue or tired, lack of appetite and nausea, increased heart rate, edema, and impaired thinking. Some of the common tests ran for heart failure includes an electrocardiogram. It is a machine that records the hearts frequency of beats, the rhythm, and the electrical conduction.

Another common test is an exercise stress test. This is where the patient is hooked up to a monitor and slowly walks on a treadmill. The speed increases to a faster pace and the treadmill is tilted to produce the effect of going up a small ramp. The patient may be asked to breathe into a tube for a couple of minutes. The heart rhythm and rate, breathing, blood pressure, and tiredness are monitored. Afterwards, the patient will lie down or sit while the heart and blood pressure are checked. A more invasive test is a cardiac catheterization.

It is a test that shows blockages in the coronary arteries and any parts of the heart that are blocked, damaged, or weakened by lack of blood. Heart failure is a chronic, progressive problem in which the heart muscle is unable to pump the blood needed through to meet the body’s needs for blood and oxygen. It cannot keep up with its workload. First, the heart tries to make up for this by enlarging itself. When it enlarges, it stretches more and can contract more strongly, pumping more blood. Then, it develops more muscle mass.

This occurs as the contracting cells of the heart get enlarged. Other ways the body tries to compensate include the blood vessels narrowing to keep blood pressure up, and the body channels blood to the most vital organs. These measures cover up the problem of heart failure, but they do not resolve it. It continues and worsens until these processes are no longer effective. Treatment includes a variety of things, including lifestyle changes, such as quitting smoking, losing weight, avoiding alcohol, eating a balanced, heart-healthy diet, managing stress, and monitoring your blood pressure.

Treatment also includes different medications, such as anticoagulants, antiplatelets, beta blockers, etc. Surgery is also an option. These range from surgical procedures without devices to implantable medical devices. Prognosis of heart failure depends on compliance by the patient. There are several things the patient and the caregiver watch closely after the diagnosis of heart failure. This includes shortness of air, increased swelling, trouble sleeping, weight gain, increased fatigue or feeling tired all the time. If these symptoms are monitored, keeping in mind the stage of disease, prognosis will vary.

The key to preventing heart failure is reducing risk factors. Lifestyle changes along with any medication needed will control many of the risk factors for heart disease, such as coronary artery disease and hypertension. Smoking cessation is big way to prevent heart failure. Another prevention of heart failure is patient education. In trying to improve patient education on heart failure and risk factors, the staff nurses from Riverside Methodist Hospital in Columbus, Ohio, developed a research study to identify patients needing heart failure education.

“The six elements for the diagnosis of heart failure established by the American College of Cardiology Foundation/American Heart Association became their method of identifying patients with heart failure. These elements included (1) dilated cardiomyopathy or history of left-ventricular systolic dysfunction, (2) markedly reduced ejection fraction, (3) placement of an ICD for an ejection fraction of 30% or less, (4) an ejection fraction of 35% or less and cardiac dyssynchrony, (5) B-type natriuretic peptide greater than 100 pg/mL, and (6) drug classifications.

These six elements became their triggers for identifying patients who needed heart failure education. ” (cited in Nursing 2012) “Before collecting data, they provided a one hour continuing education program on heart failure and principles of adult learning to all nurses on the unit. Then, they collected baseline data for three months. ” (cited in Nursing 2012) In conclusion of this study, the number of nurses who taught patients about heart failure went from 16 to 23, making the number of patients taught about heart failure increase from 20 to 44.

“The goal is to include heart failure trigger prompts in the electronic medical record as the clinical information system evolves. Any nurse working with adults may encounter patients who need heart failure education. ” (cited in Nursing 2012).

References: Dunlap, C. L. , Upper, T. M. (2012 “Increasing patient education for heart failure. ” Nursing 2012. 12-13. Burke C. A. (2010) “Reducing admissions for patients with heart failure. ” Nursing 2010. 13-15. American Heart Association. http://www. heart. org.

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