pa tho physiology of chf

8/4/2019 Pa Tho Physiology of Chf

1/3

Pathophysiology

According to Smeltzer and Bare (2010) Congestive Heart Failure is

the inability of the heart to pump sufficient blood to meet the needs for

oxygen and nutrients. Hudson explained that when the when

congestive heart failure occurs and there is a drop in cardiac output;

the sympathetic nervous system (SNS) is stimulated. Stimulation of the

sympathetic nervous system activates the following compensatory

changes in an attempt to increase venous return to the heart:

increased heart rate, increased force of contraction, vasoconstriction,

increased preload (left end diastolic pressure), increased afterload, and

increased systemic vascular resistance. Hudson also explained that the

kidneys also attempt compensate for the initial decrease in cardiac

output by decreasing renal perfusion and activating the renin-

angiotensin-aldosterone-system (RAAS). When RAAS is activated the

following compensatory process begins: Angiotensin II and Aldosterone

are released which lead to sodium retention and vasoconstriction. This

release activates the release of increased anti-diuretic hormone (ADH).

The release of ADH causes the kidneys to reabsorb more water. The

combination of increased sodium and water leads to a further increase

preload.

According to American Heart Association (AHA) the chances to have

congestive heart failure is by having one or more conditions that


2/3

causes the diseases. As AHA stated, the conditions that leads to

congestive heart failure are coronary artery disease, past attack of

myocardial infarction, high blood pressure (hypertension), abnormal

heart valves, heart muscle disease, heart defects present at birth,

severe lung disease, diabetes, sleep apnea, and other conditions such

as low red blood cell count (severe anemia), an overactive thyroid

gland (hyperthyroidism), abnormal heart rhythm (arrhythmia or

dysrhythmia). Since A.M.G. has high blood pressure (hypertension) for

about 10 years and has diabetes for about 1 year she is highly at risk

to develop this disease.

The sign and symptoms of congestive heart failure according to

AHA are shortness of breath (also called dyspnea), persistent coughing

or wheezing, buildup of excess fluid in body tissues (edema), tiredness,

fatigue, lack of appetite, nausea, confusion, impaired thinking, and

increased heart rate. Prior to admission of A.M.G. she experienced

difficulty of breathing (32 cpm) and tachycardia (103 bpm).

According to Manriquez (2011) out of 86,241,697 people in the

Philippines, 1,521, 912 have congestive heart failure. It is also the 6 th

leading cause of mortality in the Philippines. As umm.edu explained

that heart failure have a higher risk in people over age 65, men are at

higher risk for heart failure than women but women tend to develop

heart failure later in life than men do, African-Americans, people with a

family history of cardiomyopathies, obesity, different lifestyle factors


3/3

(smoking, sedentary lifestyle, and alcohol and drug abuse), and long

term use of anabolic steroids. Although A.M.G. has not known if there

is a history of congenital heart disease in her family and she is non-

smoker, non-alcoholic and not a drug abuser she is likely at risk to

have congenital heart failure because she is 68 years old. Although this

disease is highly to occur in men, A.M.G. is at risk because according to

med.yale.edu one in three women above 65 years old has some form

of cardiovascular disease.

http://www.med.yale.edu/library/heartbk/19.pdf

http://www.umm.edu/patiented/articles/what_symptoms_of_congestive_heart_failure_000013_3.htm

Congestive Heart Failure-2 Nursing CEsAuthor: Kristi Hudson RN MSN CCRN

http://dynamicnursingeducation.com/class.php?class_id=130&pid=23

http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsp
http://www.med.yale.edu/library/heartbk/19.pdfhttp://www.umm.edu/patiented/articles/what_symptoms_of_congestive_heart_failure_000013_3.htmhttp://www.umm.edu/patiented/articles/what_symptoms_of_congestive_heart_failure_000013_3.htmhttp://dynamicnursingeducation.com/class.php?class_id=130&pid=23http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsphttp://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsphttp://www.med.yale.edu/library/heartbk/19.pdfhttp://www.umm.edu/patiented/articles/what_symptoms_of_congestive_heart_failure_000013_3.htmhttp://www.umm.edu/patiented/articles/what_symptoms_of_congestive_heart_failure_000013_3.htmhttp://dynamicnursingeducation.com/class.php?class_id=130&pid=23http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsphttp://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsp

pa tho physiology of chf

Documents