This is a case study of a 76 year old female patient who is suffering from congestive cardiac failure. She has past medical history of hypertension, chronic renal failure, type 2 diabetes mellitus and hyperlipidaemia. She has been admitted in hospital several times recently and she was discharged 11 days ago from emergency department. Now she is suffering from dyspnoea and she feels like she can not catch her breath due to congestion of lungs. Her lower limbs feel like tree trunk due to oedema. These changes are manifestations of congestive cardiac failure. She is also not following fluid and salt restriction and gained 2 KG weight. All her chronic conditions and presenting complains are connected with each other. M. G’s all current assessments
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Cardiac failure is defined as complex syndrome as a result of structural or functional cardiac disorder that impairs ability of heart to function as pump to support systemic circulation (Jenkins & Kirk, 2010, p. 127; Swearingen, 2016). Congestive cardiac failure is complex syndrome in which there is high risk of clinical signs and symptoms of decreased cardiac output and/or pulmonary or systemic congestion (Williams, 2014, p. 3). Congestive heart failure is characterised by hypertrophy and weakness of left ventricle, low cardiac output, decreased tissue perfusion and pulmonary and peripheral congestion. Presenting symptoms are dyspnoea more prominent at night or in lying down position, cough (dry or productive), weakness and decrease activity tolerance, oedema of lower limbs, irregular or rapid heart rate, abdominal distension, nocturia and weight gain.
In this case, Patient has few chronic diseases which are precipitating factors of congestive heart failure. Now, we will discuss relationship of chronic conditions of patient with congestive heart failure and risk factors for developing congestive heart failure.
• Prevalence of heart failure is 1 to 3% in developed nations while it increased up to 10% in elderly patients (75 years or more) (Sahle, Owen, Mutowo, Krum, & Reid, 2016). Thus, M. G’s age (76 year old) is one of risk factor for heart failure.
• Heart failure is directly connected with coronary …show more content…
It will increase oxygen demand of heart which will further activate neurohormonal response. High blood pressure increase preload and afterload which is responsible for further impairment of ventricular function. Increase in preload and afterload causes backflow of blood to lungs which is cause of pulmonary congestion. In this case study, pulmonary congestion is evident by shortness of breath and X-ray result. Pulmonary congestion is responsible for ineffective oxygenation of blood and hypoxia. That is why patient is suffering from tachypnoea (RR 24/minute). Creps on auscultation is evidence of pulmonary oedema. Patient is diaphoretic because of activation of sympathetic nervous system to compensate demand of oxygen of body. Heart failure can increase risk of atrial fibrillation by rising ventricular filling pressure, activation of autonomic and neurohormonal mechanisms (Anter, Jessup, & Callans, 2009). Chronic heart failure can cause interstitial fibrosis which is responsible for atrial fibrillation (Anter et al., 2009). Thus, we can conclude that atrial fibrillation in M. G’s case may be due to autonomic and neurohormonal mechanism or chronic pressure rise in chambers and interstitial
Cardiac failure is defined as complex syndrome as a result of structural or functional cardiac disorder that impairs ability of heart to function as pump to support systemic circulation (Jenkins & Kirk, 2010, p. 127; Swearingen, 2016). Congestive cardiac failure is complex syndrome in which there is high risk of clinical signs and symptoms of decreased cardiac output and/or pulmonary or systemic congestion (Williams, 2014, p. 3). Congestive heart failure is characterised by hypertrophy and weakness of left ventricle, low cardiac output, decreased tissue perfusion and pulmonary and peripheral congestion. Presenting symptoms are dyspnoea more prominent at night or in lying down position, cough (dry or productive), weakness and decrease activity tolerance, oedema of lower limbs, irregular or rapid heart rate, abdominal distension, nocturia and weight gain.
In this case, Patient has few chronic diseases which are precipitating factors of congestive heart failure. Now, we will discuss relationship of chronic conditions of patient with congestive heart failure and risk factors for developing congestive heart failure.
• Prevalence of heart failure is 1 to 3% in developed nations while it increased up to 10% in elderly patients (75 years or more) (Sahle, Owen, Mutowo, Krum, & Reid, 2016). Thus, M. G’s age (76 year old) is one of risk factor for heart failure.
• Heart failure is directly connected with coronary …show more content…
It will increase oxygen demand of heart which will further activate neurohormonal response. High blood pressure increase preload and afterload which is responsible for further impairment of ventricular function. Increase in preload and afterload causes backflow of blood to lungs which is cause of pulmonary congestion. In this case study, pulmonary congestion is evident by shortness of breath and X-ray result. Pulmonary congestion is responsible for ineffective oxygenation of blood and hypoxia. That is why patient is suffering from tachypnoea (RR 24/minute). Creps on auscultation is evidence of pulmonary oedema. Patient is diaphoretic because of activation of sympathetic nervous system to compensate demand of oxygen of body. Heart failure can increase risk of atrial fibrillation by rising ventricular filling pressure, activation of autonomic and neurohormonal mechanisms (Anter, Jessup, & Callans, 2009). Chronic heart failure can cause interstitial fibrosis which is responsible for atrial fibrillation (Anter et al., 2009). Thus, we can conclude that atrial fibrillation in M. G’s case may be due to autonomic and neurohormonal mechanism or chronic pressure rise in chambers and interstitial