Pathophysiology of Heart Failure
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The most common aetiology of systolic heart failure is ischemic heart disease. Pure diastolic heart failure may be caused by hypertension, ischemic heart disease, and both hypertrophic and restrictive cardiomyopathies. Clinical manifestation of heart failure includes weight gain, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, peripheral edema, JVD, tachycardia, hepatosplenomegaly, ascites, fatigue, weakness, nausea, poor appetite, renal hypoperfusion, and chachexia.
Neurohormonal responses to heart failure are adaptive at first, and then become deleterious when they are sustained. Modern treatment of heart failure is based on neurohormonal modulation. (Steimle, 2007) Management of heart failure is a very complex issue which is why heart failure care needs to be delivered in a multi-professional manner. Although the standard of practice of managing heart failure has some consensus among healthcare providers, I based my heart failure disease management on the clinical guidelines that I developed at my organization.
Using the clinical guidelines I was able to identify, summarize, and evaluate the highest quality evidence and most current data about prevention, diagnosis, prognoses, and provide therapy including medications and cost-effectiveness. Using the clinical guidelines that I developed in the place I worked, I noted that there are four stages in heart failure development namely stage A, B, C, and D. According to McDonagh et al. (2011), those patients who are in stage A and B usually do not have heart failure.
However, they have risk factors that predispose them towards heart failure development. Patients in stage C comprise of those people with current or past .symptoms of heart failure that is associated with underlying structural heart disease. Patients in stage D have refractory heart failure. These patients can be treated by hydralazine, atrial fibrillation and sinus rhythm, cardiac resynchronization therapy, and hospitalizing the patient. .After treatment, I ensured that there was follow-up care. .