Myocardial Infarction and Left Ventricular Failure

Myocardial infarction and left ventricular failure are two types of heart illnesses that can severely impair a human body’s ability to breathe normally, and, in effect, affect a person’s normal function. If left untreated, both can ultimately to lead to death. Basically, myocardial infarction (MI), which is also commonly called heart attack, is mainly characterized by the interruption of blood supply to a certain area of the heart. Usually, this is caused by a blockage in a coronary artery after the bursting of a plaque within the artery’s wall (Carelock & Clark, 2001).

Generally, the main trigger in MI is atherosclerosis which is the buildup of plaque or fibrous material and cholesterol within the wall of the heart’s arteries. The plaque can become unstable and become ruptured, causing the formation of a blood clot or a thrombus, which in turn blocks the passage of blood in the artery (Carelock & Clark, 2001). This would then result in the death of heart cells in the coronary artery and permanently damage the heart. On the other hand, left ventricular failure (LV) happens when the heart’s left ventricle is unable to pump sufficient blood to the systemic circulation (Carelock & Clark, 2001).

In this condition, the cardiac output decreases and the pressure in the left ventricle, pulmonary vasculature, and left atrium rises. Intracellular fluid can also accumulate within the pulmonary capillary bed, which can result in pulmonary congestion or clogging up of the lungs. This is subsequently followed by right ventricular failure, which causes the same pressure increases in the right side of the heart but also peripheral edema, growth of the gastric and hepatic vessels, and vein distention (Carelock & Clark, 2001).

Moreover, systolic heart failure and diastolic heart failure are also conditions associated with LV. Systolic heart failure is a condition in which the heart cannot contract sufficiently, resulting in a decrease in the ejection fraction, which is the amount of blood that the ventricle pumps out with each hear beat, and also a decrease in cardiac output (Carelock & Clark, 2001). On the other hand, diastolic heart failure happens when the ventricles are unable to fill properly and are stiff.

It is also commonly related to systemic hypertension and ventricular hypertrophy. In addition, the ventricles also fail to relax which is why it cannot fill properly. Despite the severity of MI and LV, both conditions have good prognosis as long as there is proper intervention and treatment. One good way of diagnosing both conditions and heart failure in general is to detect and identify risks factors such as coronary artery disease, hypertension, diabetes, alcoholism, valvular heart disease, and congenital heart disease (Ammon, 2001).

In general, obtaining the patient’s history and conducting a physical examination are the key bases of diagnosing heart failure. After the clinical diagnosis, it is crucial to measure the heart’s ability to pump blood through echocardiography or radionuclide ventriculography. When asking the patient questions about their signs and symptoms, it is important to be specific such as inquiring how, when, and where did they experience symptoms such as shortness of breath, nausea, weakness, and oliguria, among many others (Ammon, 2001).

Finally, at present, managing patients with heart failure includes several pharmacologic and nursing interventions. Pharmacologic interventions include diuretics, neurohormonal antagonists, beta-blockers, digoxin, and aldosterone antagonists (Ammon, 2001). Nursing intervention is extremely crucial in the management of patients with heart failure as it provides them comfort, reminds them to take medication, and ensures that their painful symptoms are relieved in every way possible.

It is also the nurse’s role to educate patients thoroughly regarding their disease, measure their weight as this is indicative of body fluid status, assess their dietary changes and habits, ensure that they adhere to the proper medical procedures such as medicine intake, and constantly follow-up on them through telephone (Ammon, 2001). References Ammon, S. (2001). Managing Patients with Heart Failure. American Journal of Nursing, 101, 34-40. Carelock, J. & Clark, A. P. (2001). Heart Failure: Pathophysiologic Mechanisms. American Journal of Nursing, 101, 26-33.

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