(Solution) NR 507 Week 2 Discussion: Heart Failure

Course  

NR 507 Advanced Pathophysiology

Instructions  

Case Scenario:

A 72-year-old male presents to the primary care office with shortness of breath, leg swelling, and fatigue. He reports that he stopped engaging in his daily walk with friends three weeks ago because of shortness of breath that became worse with activity. He decided to come to the office today because he is now propping up on at least 3 pillows at night to sleep.

He tells the NP that he sometimes sleeps better in his recliner chair. PMH includes hypertension, hyperlipidemia and Type 2 diabetes.

Physical Exam:

BP 106/74 mmHg, Heart rate 110 beats per minute (bpm) HEENT: Unremarkable

Lungs: Fine inspiratory crackles bilateral bases

Cardiac: S1 and S2 regular, rate and rhythm; presence of 3rd heart sound; jugular venous distention. Bilateral pretibial and ankle 2+pitting edema noted

ECG: Sinus rhythm at 110 bpm

Echocardiogram: decreased wall motion of the anterior wall of the heart and an ejection fraction of 25% Diagnosis: Systolic heart failure, secondary to silent MI

Discussion Questions:

  • Differentiate between systolic and diastolic heart
  • State whether the patient is in systolic or diastolic heart
  • Explain the pathophysiology associated with each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and
  • Explain the significance of the presence of a 3rd heart sound and ejection fraction of 25%.

SOLUTION 

Definition and Epidemiology of Heart Failure

Heart failure is a health disease that occurs following the inability of the heart to pump sufficient blood and oxygen that meets the metabolic demands. Heart failure is characterized by reduced cardiac output and tissue perfusion, a forward failure, and the venous blood’s inability to return to the heart. Heart failure is a severe health condition that develops slowly, and usually, there is no cure for the disease. Still, there are medications administered to relieve the symptoms of the disease.

The global prevalence of heart failure is estimated to be more than 6.3 million individuals. Among the adult populations in developed countries, the prevalence of known heart failure is approximately one to two percent. Based on the self-reported data among United States citizens, the prevalence of heart failure is estimated to be 2.5 percent (Groenewegen et al., 2020). According to Groenewegen et al. (2020), the incidence of heart failure among the US and European countries ranges from 1-9 per 1000 person-years.

Causes of Heart Failure

Several factors are implicated in increasing the risk of developing the disease condition.

Most of the co-morbid conditions do not occur independently, and there are individuals with more than three chronic diseases which lead to heart failure. Factors that increase the risk of heart failure weaken the heart muscles, which entails obesity, smoking, sleep apnea, and certain medications. In addition, diabetes and diabetic medications are associated with the risk of heart failure in some individuals. The causes of heart failure include damage to the heart muscles, coronary artery disease, congenital heart defects, heart attack, inflammation of the heart muscles, abnormal heart rhythms, faulty heart valves, and high blood pressure.…..please click the purchase button below to access the entire solution at $10