The heart is a complex and vital organ that pumps around 6,000 quarts of blood through the body and beats around 100,000 times a day. Risk factors for congestive heart failure include coronary artery disease, myocardial infarction, heart valve disease, cardiomyopathy, cigarette smoking, obesity, hypertension, and diabetes.
Congestive heart failure is a syndrome of a ventricular dysfunction, where the heart is not able to pump enough blood with each beat to meet the oxygen requirements of the heart and other body tissues. The heart starts pumping weaker than normal and the blood moves through the heart at a slower rate and pressure in the heart increases and becomes congested. Signs and symptoms of congestive heart failure are often related to which side of the heart is failing. In left-sided heart failure, pulmonary congestion occurs when the left ventricle cannot effectively pump out of the left ventricle into the aorta and the systemic circulation (Brunner, 2014 p.798). These clinical manifestations include pulmonary edema, dyspnea, paroxysmal nocturnal dyspnea, orthopnea, and a decreased forward perfusion that activates the enzyme renin leading to fluid retention. The right-side heart failure, the right ventricle fails, congestions in the peripheral tissues and the viscera predominates. This occurs because the right side of the heart cannot eject blood efficiently and cannot accommodate all of the blood that normally returns to it from venous circulation (Brunner, 2014 p.799). Right sided heart failure usually happens after left sided failure occurred. These clinical manifestations are dyspnea, ascites, pitting edema, hepatomegaly, and jugular venous distention. In chronic heart failure, patients may have signs and symptoms of both left and right ventricular failure (Brunner, 2014 p.798). Diagnosis of congestive heart failure can be done with a variety of tests. A chest X-ray may be used to look for cardiomyopathy and the presence of fluid in the lungs. An echocardiogram can help distinguish systolic from diastolic dysfunction by measuring the ejection fraction. An electrocardiogram (EKG), is helpful to identify arrhythmias, ischemic heart disease, and right or left side hypertrophy. To help diagnose and determine the severity of heart failure is a brain (B-type) natriuretic peptide (BNP), which is a neuro-hormone that helps regulate blood pressure and fluid volume. It is primarily secreted from the ventricles in response to increased preload with resulting elevated ventricular pressure (Brunner & Suddarth, 2014, P.115). A level over 100pg/mL signifies heart failure. Other labs are helpful such as complete blood count, blood urea nitrogen, creatinine, but the BNP is the most significant indicator. Treatment of congestive heart failure consists of lifestyle changes and medications. Lifestyle changes such as exercise, weight loss, smoking cessation, limit of alcohol intake, and dietary changes can have a significant impact on the heart and its. Function. Medications that are commonly used to treat congestive heart failure are angiotensin-converting enzyme inhibitors (Lisinopril), angiotensin receptor blockers (Losartan), beta-adrenergic blocking agents (Metoprolol), diuretics (Aldactone), and digitalis (Digoxin). These medications can be used in a combination with each other or alone depending on the severity of the