Chronic Heart Failure Essay
Treating Heart Failure
When a patient’s heart is no longer able to pump a sufficient amount of blood around the body, they are referred to as having heart failure. The heart muscle has been damaged or overworked and is therefore unable to pump as effectively as before. Coronary heart disease is the most common cause of heart failure, cardiomyopathy and hypertension are also implicated (Peterson et al, 2002). Heart failure can present acutely or chronically. Chronic heart failure tends to worsen over time and symptoms, such as breathlessness and swollen ankles, will develop over weeks or months. An acute condition will present rapidly as a sudden worsening in those already with chronic heart failure or in those previously undiagnosed with cardiac …show more content…
Side effects such as renal impairment and hypotension can arise, as well as a dry cough (NICE, 2014). If the patient is being affected by this, angiotensin II receptor blockers (ARBs) can be prescribed instead. ARBs, such as candesartan and losartan, have a similar action to ACE inhibitors, but they do not usually cause the persistent cough (NHS, 2016). They may also cause hypotension and hyperkalaemia. An aldosterone antagonist should be prescribed alongside the ACE inhibitor or ARB, these help reduce swelling and breathlessness as potassium-sparing diuretics (NICE, 2014). Eplerenone and spironolactone are the most commonly used (NHS, 2016). The patient’s renal function, heart rate, electrolytes and blood pressure should be monitored and, if they remain stable for 48 hours, they can be discharged from hospital (NICE, 2014). It is important that comorbidities, such as diabetes mellitus, angina and chronic obstructive pulmonary disease, are managed effectively and that the patient is appropriately followed up in primary care. They should be screened for depression and anxiety induced by their heart failure and also advised on exercising, managing their diet, receiving annual influenza vaccinations and quitting smoking if required (NICE, 2016).
Surgical intervention may be necessary in patients whose heart failure is due to severe aortic stenosis. They can undergo aortic valve replacement or transcatheter aortic valve implantation (NHS, 2016). Extracorporeal membrane oxygenation can be used after surgery to aid the transition from cardiopulmonary bypass to ventilation (NICE,
When a patient’s heart is no longer able to pump a sufficient amount of blood around the body, they are referred to as having heart failure. The heart muscle has been damaged or overworked and is therefore unable to pump as effectively as before. Coronary heart disease is the most common cause of heart failure, cardiomyopathy and hypertension are also implicated (Peterson et al, 2002). Heart failure can present acutely or chronically. Chronic heart failure tends to worsen over time and symptoms, such as breathlessness and swollen ankles, will develop over weeks or months. An acute condition will present rapidly as a sudden worsening in those already with chronic heart failure or in those previously undiagnosed with cardiac …show more content…
Side effects such as renal impairment and hypotension can arise, as well as a dry cough (NICE, 2014). If the patient is being affected by this, angiotensin II receptor blockers (ARBs) can be prescribed instead. ARBs, such as candesartan and losartan, have a similar action to ACE inhibitors, but they do not usually cause the persistent cough (NHS, 2016). They may also cause hypotension and hyperkalaemia. An aldosterone antagonist should be prescribed alongside the ACE inhibitor or ARB, these help reduce swelling and breathlessness as potassium-sparing diuretics (NICE, 2014). Eplerenone and spironolactone are the most commonly used (NHS, 2016). The patient’s renal function, heart rate, electrolytes and blood pressure should be monitored and, if they remain stable for 48 hours, they can be discharged from hospital (NICE, 2014). It is important that comorbidities, such as diabetes mellitus, angina and chronic obstructive pulmonary disease, are managed effectively and that the patient is appropriately followed up in primary care. They should be screened for depression and anxiety induced by their heart failure and also advised on exercising, managing their diet, receiving annual influenza vaccinations and quitting smoking if required (NICE, 2016).
Surgical intervention may be necessary in patients whose heart failure is due to severe aortic stenosis. They can undergo aortic valve replacement or transcatheter aortic valve implantation (NHS, 2016). Extracorporeal membrane oxygenation can be used after surgery to aid the transition from cardiopulmonary bypass to ventilation (NICE,