Congestive Heart Disease
The principal function of the heart is the pumping of blood to different parts of the body. Congestive heart failure, one of the various types of cardiovascular diseases, is a cardiac condition in which the heart is unable to sufficiently pump blood to the different parts of the body. With no clear causation, this public health issue whose incidence is constantly on the rise in the world over is believed to arise as a consequence of an abnormality in the cardiac structure, function, rhythm and conduction (Figueroa & Peters, 2006). The National Institute of health, while insinuating that the condition, though treatable but incurable, purports that the condition has several causes including alcoholism, abnormal pregnancy, heart attack and high blood pressure. Risk factors associated with congestive heart failure (or congestive cardiac failure as it is sometimes known) include age and health conditions especially the presence of diseases such as diabetes mellitus, valvular heart disease, coronary heart disease and cardiomyopathies (Reddy, Bahl & Talwar, 2009).
Signs and Symptoms
Congestive heart failure is symptomatically expressed in the form of sudden weight gain, swelling of the hands and legs, breathing problems that occur during rest or while undertaking an activity, excessive fatigue, incessant coughing and irregular heartbeats (National Institute of health, n.d). Other symptoms include exertional dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea (Reddy, Bahl & Talwar, 2009) and excessive fluid retention in the heart that most commonly lead to peripheral edema and abdominal girth (Figueroa & Peters, 2006) and a. Additionally, about 20% of congestive heart failure victims also exhibit crackles with another small percentage showcasing lower-extremity edema (Figueroa & Peters, 2006).
Evaluation and Diagnosis
Evaluation of congestive heart failure patients is in most case based on the patients’ history and physical examination. Physical examination, as done by physicians, is based on the symptoms of the condition as exhibited by the patient. Figueroa & Peters (2006) uphold that history, even though not sufficient to warrant the diagnosis of a congestive heart failure, is indispensable in giving clues about the cause and severity of the congestive heart disease. Diagnosis of the disease is commonly done with the help of lab tests that involve electrocardiogram (for viewing the ventricular functioning of the heart), chest x-ray, blood count and investigation of the renal and hepatic function. Other methods according to Reddy, Bahl & Talwar (2009) include echocardiogram, which also helps in viewing the functioning of the hearts ventricles, CT scan, Magnetic Resonance Imaging and Radionuclide cardiac imaging that are jointly utilitarian in the assessment of ventricular volumes.
Notably, ameliorative models available for the treatment of congestive heart disease are based on the ability of the model to eliminate or reduce the symptoms of the condition. The models can be widely categorized as non-pharmacological and pharmacological. Non-pharmacological treatment of the condition encompass exercise training and dietary therapy; exercising, especially aerobic exercises, and proper calorie and nutrients are known to meliorate the heart conditions of individuals who have suffered heart failure (Reddy, Bahl & Talwar, 2009). Pharmacological treatment majorly involve the use of drugs which can be classified as Diuretics (loop diuretics, Thiazide diuretics and Metalozane), β-blockers, Angiotensin Converting Enzyme (ACE) inhibitors and Digoxin, just to mention a few (Reddy, Bahl & Talwar, 2009; Aschenbrenner, & Venable, 2009). Diuretics help in reducing the amount of water and electrolytes in the blood stream by increasing urinary output and electrolyte lose like in the case of loop diuretics. Similarly, while ACE inhibitors are used to prevent the progression of ventricular dilation, beta blockers help in reversing hypertrophy, as well as the improvement of systolic function. Beta blockers are in most case given to patients in low doses, which are then increased as the patient progresses with treatment. Diuretics, on the other hand, are given in minimal quantities. Since the essence or most congestive heart treatment is increasing electrolyte loss, patients taking medication should be put in low electrolyte, for instance Na, diet.
Aschenbrenner, D. S., & Venable, S. J. (2009). Drug Therapy in Nursing. Philadelphia, PA: Lippincott Williams & Wilkins.
Figueroa, M. S & Peters, J. I. (2006). Congestive Heart Failure: Diagnosis, Pathophysiology, Therapy, and Implications for Respiratory Care. Respiratory Care, 51(4); 403-412. Retrieved from http://www.rcjournal.com/contents/04.06/04.06.0403.pdf
National Institutes of Health (n.d). Understanding Congestive Heart Failure. Patient Education; 1-5. Retrieved from www.cc.nih.gov/ccc/patient_education/pepubs/chf.pdf
Reddy, S., Bahl, A. & Talwar, K.K. (2010). Congestive Heart Failure In Indians: How Do We Improve Diagnosis & Management? Indian J Med Res 132; 549-560. Retrieved from http://icmr.nic.in/ijmr/2010/november/1112.pdf