Congestive Heart Failure - Research Paper Example

Congestive Heart Failure The heart is made up of two chambers; the lower chamber comprising of the left and the right ventricles, and the upper chamber made of the left and the right atria. The contraction of the heart occurs in the ventricular muscle and therefore causing leading to the pumping of the blood through the aorta to the various parts of the body. Systole is the name given to the contraction of the ventricular muscles. This can be defined as the inability of the heart to meet the demands of the body, most particularly; the ability to pump blood to all the organs of the body fails. This means that eventually, the heart fails to supply enough oxygen to all the parts of the body. When this happens, the heart is not capable to provide adequate blood to visceral organs including; the kidneys, brain and liver. This condition can be caused by the failure of either the left ventricle or the right ventricle or both to function. This ineffective functioning of the heart muscle can be caused by: 1. Diseases that weaken the heart muscles or; 2. Diseases that cause the inflexibility or more particularly the stiffening of the heart muscle. These infections of the cardiac muscles are called Myocarditis, additionally; heart attacks can weaken the heart muscles; 3. Coronary heart diseases play a significant role in weakening the heart muscles and more often than not cause heart attacks; 4. Viral infections and toxins like prolonged alcohol exposure contribute significantly to the development of Congestive heart failure; 5. Once the heart valves suffer damage or are blocked, blood leaks profusely and this mostly cause the weakening of the heart muscle leading to congestive heart failure; 6. High blood pressure on the other hand reduces the effectiveness of the heart muscles and therefore people suffering from hypertension are at more risk of suffering from CHF than their healthy counterparts. High thyroid hormone level (hyperthyroidism) and vitamin deficiency are rare causative agents of CHF; Apart from affecting the cardiac muscles, the body may be affected by diseases that increase the oxygen demand of the body therefore limiting the heart from satisfying the high oxygen demand (McKee, 137). Symptoms and Signs of Congestive Heart Failure There are various symptoms that characterize or define that one may be suffering from Congestive Heart Disease and therefore likely to develop CHF. These symptoms range from abnormal morphology of some organs of the body to psychological disturbances. Some of the morphological symptoms include: unintentional weight gain, swelling of the feet, the ankles and the abdomen and visible veins in the neck region. Other symptoms include: anorexia and indigestion, vomiting and nausea, lack of breath with or without activity, lack of sleep, general body weakness, and increased frequency of micturation especially at night, coughing and low level of concentration at work. While these symptoms may not occur simultaneously, caution should be taken in case of any of the signs in order to address the ailment before it escalates to a fatal case. As mentioned previously, there are various risk factors that contribute to the development of CHF and these include: obesity, drug abuse especially excessive alcohol intake and high salt intake (McKee, 137). Development and Sequence of the Symptoms Though the above symptoms may be observed in patients, there is a certain sequence in which the disease can be manifested. First, patients may complain of fatigues and general body weakness; while this may be a nonspecific symptom, it is advisable that the victims seek medical advice soonest possible. With the progress of the disease, the accumulation of fluid from the CHF condition leads to edema. This may affect the lower limbs of the body but sometimes, the abdomen may be involved. Shortness of breath occurs due to the accumulation of the fluid to the lungs; this is mostly noticeable during exercises or more surprisingly at night when the patient is lying flat on the bed. This is eventually followed by lack of sleep unless while sitting upright, increased frequency of micturation due to fluid accumulation in the abdomen and the kidney and ultimately anorexia occurs due to accumulation of fluid in the intestines (Harlan, 57). The lack of specificity of the above symptoms has greatly led to many sudden deaths attributed to heart failure. Patients seeking diagnosis are actually not aware that they are suffering from a high risk fatal condition and most of them visit the hospital when the disease is at a critical stage (Harlan, 57). Diagnosis Just like any other disease CHF can be diagnosed clinically by recording the history and the development of the disease, laboratory practice and careful physical examination. For a successful diagnosis, the history of the patient should be clearly indicated and the above symptoms indicated where observed. Additionally a history of coronary heart disease, excessive consumption of alcohol, hypertension and diabetes can be significant clues for a successful diagnosis. In physical examination, the idea is to detect the presence of extra fluid on the various organs of the body; the swelling of the lower limb, the conspicuous veins in the neck region and the sounds that accompany breathing in congested lungs. The condition of the heart is also examined and some of the major aspects checked include: the size of the heart, pulses, heart sound and murmurs. Heart Murmurs is the kind of sound produced by the heart and is detectable using a stethoscope (Larson, 79). The various tests that are run in an attempt to diagnose the heart condition include: electrocardiogram, chest X-ray, ultrasound test, arrhythmia among others. While the X-ray test and electrocardiogram explores the possibility of a previous heart attack, the arrhythmia test is aimed at examining the arrangement of the heart and the fluid affecting the lungs. The ultrasound is one of the most useful tool of diagnosis whereby an echocardiogram is designed illustrating the structure of the heart including the heart valves structures, the muscle structures and the flow pattern of blood. Further, the ultrasound can help detect the weaknesses of the heart muscles as well as demonstrate the cause of such muscle weakness. Ideally, all the patients undergoing a heart test should undergo echocardiography early in their examination. With nuclear development in medicine, it is possible to assess the capability of the heart to pump blood as a whole to the various organs of the body and any inadequacies in the blood flow. The flow of blood into the heart from the arteries can be observed using a technique referred to as Heart catheterization. The technique employs the use of angiography where a dye is introduced into the blood arteries and its flow observed using the X-ray. In catheterization, the pressure in and around the heart can be examined and its performance examined (Larson, 79). Laboratory techniques are also helpful in this examination; heart biopsy can be recommended for instance while detecting other infections that have accelerated the occurrence of the CHF. In this case, a special device called the catheter is employed and is actually inserted into a vein and moved around the right hand side of the heart. Brain Natriuretic Peptide level commonly known as BNP is a significantly helpful tool in blood test. Though the level of the peptide varies with age, it elevates in people with heart failure conditions. All the diagnostic tests mentioned above are useful and the choice of any depends on the suspected symptoms of the individual patient (Harlan, 57). Congestive Heart Failure Treatment After a successful diagnosis test and upon confirmation that the patient is indeed suffering from CHF, treatment should be prescribed immediately. In combating the escalation of this disease, the patients lifestyle needs a review and a diversion and reduction of intake of various substances. As an aspect of lifestyle, sodium chloride which is a major compound of the table salt should be used in minimal amount and if need be, its use should be eliminated in positive patients for CHF. Sodium in the table salt causes an increase in the accumulation of the congestive fluid in the body. Surprisingly, the patients are also required to reduce their water intake so as to reduce the amount of fluid accumulated in the body. The actual level of salt intake in any patient should be less than two grams of sodium per day. Most foods on the contrary contain between four and six grams of sodium and this posse a threat to the use of this method as a way of controlling the disease. Reading the food labels before deciding on what to eat to check on sodium content therefore becomes important to the patients. Similarly, the maximum amount of fluid intake should be reduced and diuretics should be accompanied in the daily food intake to help regulate the amount of fluid in the body (McKee, 137). The idea of taking "eight glasses of water per day" certainly is not applicable to patients suffering from CHF. In extreme cases, the patients are actually advised to take a total fluid intake of less than quarter a liter daily. Anyway, the actual amount of fluid to be taken by the patient greatly depends on the individual patient, the level of the disease and the agreement of the physician and the patient (McKee, 137). Aerobic exercise on the other hand has proved significantly important if controlling the disease. Though beneficial, this should be prescribed when the patient has gained stability and the muscles of the heart have indicated strength. When not prescribed, such exercise may be fatal as the oxygen demand at that time is more than the heart can supply. Regular exercise when tailored to the patients tolerance level can significantly assist the patient in gaining stability. Reversible Remedies Certain causes of congestive heart failure disease can be reversed in an attempt for the patient to regain normal life. Coronary artery surgery for example can be used to restore the flow of blood in patients whose condition was initiated and escalated by the blocking of the coronary artery. In the case of hypertension, where the control of blood is abysmal, the aggressive control of blood pressure is a viable option. Furthermore, in the case of CHF that was escalated by excessive consumption of alcohol, total abstinence against it can significantly improve the condition (Raphael, 205). Use of Medications Angiotensin Converting Enzyme (ACE) inhibitors - this enzyme inhibits the formation of Angiotensin II which adversely affects the heart and blood circulation in patients suffering from heart disorders. These drugs have proved to improve the blood circulation of patients and more so prevent heart failure. Examples include: captopril, enalapril, lisinopril, benazepril and ramipril (Raphael, 205). Some patients are highly hypersensitive against angiotensin and this has led to the development of angiotensin receptor blockers (ARBs). Though they work on the same pathway as the angiotensin , they allow the formation of the angiotensin but prevent their effect. Some of the specific drugs that make up the blockers include: Iosartan, Candesartan, Telmisartan, Valsartan and Irbesartan. Like any other drug, these drugs manifest a variety of side effects that comprise of: drying of the mouth, low blood pressure, kidney dysfunction and nonspecific hypersensitivities.other drugs that have been developed fluid retention, low fatigue and general body weakness (Bryan, 18) Beta blockers on the other hand have also demonstrated to be useful in controlling CHF condition. This category of drugs acts by blocking the action of certain hormones that binds onto beta receptors of various body tissues and causes the heart to contract. Though this may appear as suppressing the heart, its usage gradually, strengthens the cardiac muscles. Its side effect include: retention of fluid, low blood pressure, low pulse and general body weakness. This category of drug is prohibited in patients suffering form asthma. Digoxin is another alternative that have been used for many years; it is produced naturally, by the foxglove flowering plant. It acts by stimulating the contraction of cardiac muscles and more so prevents the further heart failure. It exhibits; nausea, vomiting, kidney dysfunction, heart rhythm disturbances and electrolyte abnormalities as its side effects. Finally, the treatment of CHF cannot be successful without diuretics. They help prevent the fluid from accumulating in the lungs and other tissues by supporting the flow of the fluid into the kidney. Although the diuretics do not demonstrate a long time effect, they are important in eliminating the swelling effect to the affected organs of the body. Low potassium levels are always prescribed because they cause rhythmic disturbances to the heart. The specific drugs that are altogether categorized as diuretics include: furosemide, hydrochlorothiazide, bumetanide, torsemide, spironolactone and metolazone (Bryan, 18). Heart Transplant More often than not, the therapies may not treat the patient. When the condition continues to be detrimental, a heart transplant remains the best option. In order for one to undergo a successful heart transplant, one need to be less than seventy years old and the patient should not be suffering from irreversible diseases. Additionally, a heart transplant is recommended when the other therapeutic measures have failed. Close monitoring of the patients is always recommended due to the eruption of coronary heart diseases or rejection of the heart organ (Allan, 175). Other Therapies Due to the increased risk and the cost of heart transplant, various devices that assist the heart in pumping of blood to the various organs of the body have been developed. For instance, the left ventricular device can permanently be introduced into the patients while waiting for a transplantation. The biventricular pacemaker can also be used without a surgical intervention. The limitation of these devices is the infection they cause especially to the areas attached to the body (Allan, 175). Finally, CHF as a disease depends on various factors as if progresses from early development to a severe illness. A variety of factors like the response to medications, the degree of impairment among others are quite important in the treatment and the recovery of the patient. As search for a lasting solution is underway, lifestyle stands as the best option in controlling the heart disease (Allan, 175). Works Cited Allan, D. F. David, S. Congestive Heart Failure Chicago, Rosalind Franklin University of Medicine and Science Publishing, pp 175. nd. Bryan M. N. Effects of Heart Failure Ands the Causes of Congestive Heart Disease. n.p. 2008. Harlan, W.R. Oberman A. G. Congestive Heart Disease in Coronary Artery Disease. New York, University of New York Press. 1977. Larson, L. and Gerbert, D. Congestive Heart Failure. Journal of American School of Cardiology. Amsterdam, College of Cardiology Press, pp 79. 2006. McKee, P.A. Castelli, W.P. McNamara P. K. The Discovery and Progress of Congestive Heart Failure pp 137. 1971. Raphael, C. and Briscoe, C. 2007. Factors Contributing to the Increase of Congenital Heart Diseases. Viewed 3rd June, 2010 http://www.americanheart.org/presenter.jhtml?identifier=4585 Read More