Concerning the case study of a 64-year-old woman with systolic heart failure, first of all, it is essential to define this health issue, its causes, and mechanisms. According to the American Heart Association and the American College of Cardiology, heart failure is “a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill or eject blood” (Rivera & Menaker, 2017, para. 2). Thus, it derives from the heart’s inability to provide an appropriate and sufficient blood flow to accommodate the venous return or meet metabolic requirements.
Its main pathophysiology is a considerable reduction of the heart muscle’s efficiency caused by overloading or damage. In other words, heart failure may result “from injury to the myocardium from a variety of causes including ischemic heart disease, hypertension, and diabetes” (Kemp & Conte, 2012, p. 365). Less common factors include valvular disease, myocarditis, cardiomyopathies, systemic toxins, cardiotoxic drugs, and infections. When heart failure occurs, patients develop multiple symptoms, such as fatigue, nausea, lack of appetite, ascites and peripheral edema resulting from the impaired venous return, and dyspnea from pulmonary congestion (Kemp & Conte, 2012).
As a matter of fact, in the United States, heart failure remains the most common reason for hospital admissions, especially among senior patients. With a prevalence of almost 6 million, approximately 500,000 new cases are reported every year (Rivera & Menaker, 2017). In addition, minority groups, including Native Americans, Latinos, and Blacks, are more vulnerable to heart failure due to the highest rates of type 2 diabetes and hypertension.
In general, heart failure may be systolic and diastolic, and their epidemiology and pathophysiology differ. Systolic heart failure is traditionally associated with congestive symptoms and the symptoms of low cardiac output caused by impaired ventricular pump function (Rivera & Menaker, 2017). In other words, the ventricle cannot relax adequately. In turn, the occurrence of diastolic heart failure occurs implies the heart’s increased resistance to its diastolic filling. The function of the heart related to blood pumping is corrupted. In addition, it is frequently accompanied by left ventricular hypertrophy and hypertension.
Individuals with heart failure frequently experience shortness of breath when lying down or resting. The feeling of inability to breathe may occur suddenly and even wake a person from his or her sleep. This symptom is called paroxysmal nocturnal dyspnea and it is caused by waking up wheezing or coughing and a highly rapid heart rate complicated by a heart failure. In addition, patients require several pillows to prop them up and ease their breathlessness. This condition is connected with the lungs’ fluid, or congestion, that moves with gravity and makes the lungs wet.
In addition, in the case of a flat position, the blood that usually pools in the legs’ veins has to reenter the body’s bloodstream. With heart failure, the heart cannot pump the blood’s increased amount and causing the formation of congestion in the lungs. As a result, the flatter an individual lies, the more he or she feels shortness of breath. Moreover, the number of pillows needed indicates the severity of heart failure. The treatment of heart failure includes medication, the implantation of heart rhythm control devices, and sometimes surgery. In addition, a patient should consider healthy lifestyle changes that presuppose doing exercise, smoking cessation, and a balanced diet.
Kemp, C. D., & Conte, J. V. (2012). The pathophysiology of heart failure. Cardiovascular Pathology, 21(5), 365-371. Web.
Rivera, L. A. J., & Menaker, J. (2017). Systolic and diastolic heart failure. Emergency Medicine Reports. Web.