Heart failure Health, Medicine, Nursing Coursework
A 64-year-old woman presents to the primary care office with shortness of breath, leg swelling, and fatigue. She has a history of type 2 diabetes and hypertension. She reports that recently she had been able to go for daily walks with her friends, but in the past month, the walks have become more difficult due to shortness of breath and fatigue. She also sometimes awakens in the middle of the night due to shortness of breath and has to prop herself up on three pillows. On physical examination, she is tachycardic (110 beats per minute) and has a blood pressure of 106/74 mm Hg. Fine crackles are noted on inspiration in bilateral bases. The cardiac exam reveals the presence of a third and fourth heart sound and jugular venous distension. 2+ pitting edema is noted in the knees bilaterally. An ECG shows sinus rhythm at 110 bpm with Q waves in the anterior leads. An echocardiogram shows decreased wall motion of the anterior wall of the heart and an estimated ejection fraction of 25%. She is diagnosed with systolic heart failure, secondary to a silent MI.
1. Discuss the pathophysiological mechanisms that can lead to heart failure.
2. Differentiate between systolic and diastolic heart dysfunction
3. Discuss the causes of the patient’s shortness of breath, awakening in the middle of the night and the need to prop herself up on three pillows. Include pathophysiological mechanisms that causes each of these signs and symptoms.
4. Include two points of teaching for this patient
Support your response with at least one current evidence-based resource. (Scholarly source)
Heart Failure
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Heart Failure
Question 1
Heart failure is caused by injury of the myocardium from several diseases, including hypertension and diabetes. Usually, patients develop several symptoms, such as dyspnea from pulmonary congestion. Usually, patients with preexisting conditions are at higher risk of heart failure. With the insufficient venous return, symptoms such as dyspnea, cough, and shortness of breath are common. Myocardium dysfunction can also be systolic or diastolic. When heart failure occurs, there is inadequate blood flow to allow proper metabolism, which is the leading cause of fatigue and shortness of breath (Kemp & Conte, 2012).
Question 2
Systolic heart dysfunction occurs when the left ventricle is unable to contract, which implies a lack of pressure to pump blood throughout the...
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