Heart Failure is a complex disease that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill or eject blood (Heart Foundation, 2012). Heart failure is a condition or process where the heart is unable to pump enough blood to meet the body’s needs. As opposed to a cardiac arrest, the heart doesn’t cease to beat; it becomes weaker, usually occurring over several months or years. The heart becomes unable to pump adequate blood to fill the chambers. Consequently, this causes fluids to build up in the lungs and tissues, causing congestion. Efforts are made by the body to compensate for the heart failing either on the left or right side. In either forms of heart failure, the heart is unable to pump an adequate blood supply to the body’s organs, therefore not receiving a sufficient amount of oxygen and nutrients, and waste products are slowly expelled. Eventually, the body systems begin to shut down (University of Maryland Medical Centre, 2011). Mr. Smith has been diagnosed with acute left ventricular heart failure. This essay will discuss the pathophysiology and relevant assessments linked to Mr. Smith’s signs and symptoms, in conjunction with the appropriate nursing interventions and pharmacological therapy for Mr. Smith.
The heart is divided into two chambers. The left side receives oxygenated blood from the lungs and sends it out to tissues and cells of the body. The right side of the heart receives the deoxygenated blood from the body and pumps it to the lungs to gather oxygen, and the cycle continues (Heart Failure Online, 2010). Problems can arise with either the right or left side of the heart alone, but this will ultimately lead to complications for the other side of the heart. It is evident with the symptoms Mr. Smith is portraying, he is suffering from acute pulmonary oedema secondary to acute left ventricular heart failure. Left sided heart failure occurs as a result of ineffective left ventricular contractile function. As the pumping ability of the left ventricle fails, cardiac output falls (Farrell & Dempsey, 2011). The failure can be a result of abnormal systolic (contraction) or diastolic (relaxation) action (Bibbins-Domingo et al, 2009). It is concluded that Mr. Smith has systolic heart failure. In systolic heart failure, the heart muscles weaken and cannot pump enough blood throughout the body. The left ventricle is usually stretched or dilated (Brown & Edwards, 2012).
As blood is no longer effectively pumped out into the body, it backs up into the left atrium and then into the lungs, causing pulmonary congestion, dyspnea and activity intolerance, symptoms displayed by Mr. Smith. If the condition persists, pulmonary oedema and right-sided heart failure may occur. Common causes of left ventricular heart failure include left ventricular infarction, hypertension, and aortic and mitral valve stenosis. Overtime these conditions increase the workload to the heart itself, reducing the force of contraction. In heart failure the ventricle is loaded with blood to the point where the heart muscle contraction becomes less efficient. In an attempt to improve contractility, hypertrophy (increase in physical size) is possible. This may contribute to an increased stiffness and decreased ability to relax during diastole. In addition, enlargement of the ventricles also causes a reduction in stroke volume due to the mechanical and contractile inefficiency (Farrell & Dempsey, 2011).
Since the heart has to work harder to meet the metabolic demands, for example exercise, there becomes a reduced spare capacity. This is evident with Mr. Smith as he suffers from activity intolerance, meaning his heart is not capable of meeting the metabolic needs. This translates to the loss of one’s cardiac reserve. Increased heart rate that is stimulated by the sympathetic nervous system is activated in order to maintain cardiac output,...
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