Cardiomyopathy is a condition in which the heart is enlarged and the muscle is thick and rigid (Mayo Clinic, 2015). These characteristics impair the hearts ability to fill or contract, which subsequently impairs circulation and deprives the body of oxygen necessary for healthy cellular function. Cardiomyopathy may be acquired or hereditary, but regardless of cause, it may lead to congestive heart failure if not properly managed (Mayo Clinic, 2015). Common symptoms of congestive heart failure include breathlessness, fatigue, edema of legs and feet, and ascites. While these symptoms can be managed through the use of pharmaceuticals and behavior modifications, high rates of hospital readmissions are trending for patients with congestive heart …show more content…
P. and his wife should be educated regarding the causes and effects of congestive heart failure, strategies for medication management, dietary limitations, physical activity, and coping mechanisms. This case study revealed that both he and his wife are succumbing to depressive tendencies due to Mr. P.’s disease. Therefore, it is important to provide them with strategies for developing effective coping mechanisms. Furthermore, a multi-modal approach to education should be used to improve their understanding and retention of information. Providing them with printed materials will allow them to reflect on the information that was imparted on them once they return home, because increased levels of stress may impair their ability to process and recall information that is only presented verbally. Video presentations may also serve to increase understanding and retention. The education provided to both Mr. P. and his wife should not be limited solely to congestive heart failure, but should encompass such topics as depression, anxiety, and coping strategies as …show more content…
The treatment plan should include the following (Jaarsma, 2005):
A. Comprehensive overview of congestive heart failure
a. Explanation of disease process – The heart’s job is to circulate blood throughout the body, but the pump is defective in one or more ways. This causes blood to back up into the lungs and blood vessels resulting in shortness of breath and fullness of the legs and abdomen. This may also make you feel tired easily.
b. Daily monitoring – It is important to weigh yourself daily, because a sudden increase in weight may be a sign that fluid is collecting in the body. It is also important to monitor your blood pressure each day to make sure that your medications are working like they should.
c. Warning signs and seeking medical care – You should go to your doctor, or emergency room, if you experience a sudden increase in weight (2-3 pounds in a day, or 5 pounds in a week), difficulty breathing, or increased swelling in your legs, feet, or abdomen (Group Health, 2014).
B. Medication
The aim of this report is to provide an overview of chronic heart failure, examining signs symptoms and treatment related to the case study, and the anatomy and physiology of the heart will be discussed, and the pathophysiology of chronic heart failure.
Cardiomyopathy, by definition, means the weakening of the heart muscle. The heart is operated by a striated muscle that relies on the autonomic nervous system to function. Cardiomyopathy is diagnosed in four different ways based on what caused the illness and exactly what part of the heart is weakened. The four main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. One other category of cardiomyopathy that is diagnosed is “unclassified cardiomyopathy.” Unclassified cardiomyopathy is the weakening of the heart that does not fit into the main four categories.
Heart disease is the leading cause of death in the United States and the estimated cost of treatment is $32 billion yearly. Approximately 5 million people living in the United States suffer from congestive heart failure (CHF) and half of those diagnosed will die within 5 years. An individual may present to the hospital with weakness, short of breath (SOB), swelling of the extremities, ascites, and breathing difficulties while lying down. The quality and length of life for someone suffering from heart failure can be improved with early diagnosis, medication, physical activity, and diet modification (CDC, 2013).
Hypertrophic cardiomyopathy is a genetic disease of the heart, making the cardiac muscle is thick and strong. The thick muscle causes a decrease in cavity size, forcing the heart to pump less blood. Hypertrophic cardiomyopathy is one of the primary causes of sudden death as the prevention of blood flow causes cardiac arrest. More successful research is being conducted on HCM, including research on the genetics associated and the heredity of the genes. Unfortunately this disorder effects many young athletes due to their increased stresses of training on their heart. However, despite the use of new technology such as the electrocardiogram and transthoracic echocardiogram, the strategies are limited, restricting new answers.
These causes will change the heart significantly. The pathophysiology of heart failure is described differently as: (1) an oedematous disorder, by means of which the deviations in renal hemodynamics and excretory ability lead to salt and water holding; (2) a hemodynamic disorder, considered by peripheral vasoconstriction and decreased cardiac output; (3) a neurohormonal disorder, mainly by stimulation of the renin-angiotensin-aldosterone system and adrenergic nervous system; (4) an inflammatory syndrome, related with amplified local and circulation pro-inflammatory cytokines; (5) a myocardial disease, started with an damage to the heart trailed by pathological ventricular transformation. In heart failure, the heart sustains either a sudden or longstanding structural injury. When damage occurs, sequences of firstly compensatory but consequently maladaptive mechanisms follow (Henry & Abraham, ).
For the purpose of this assessment I have chosen to focus upon cardiomyopathy which have commonly been subdivided into a specific diagnosis of either hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), restrictive cardiomyopathy (RCM) and arrhythmogenic right ventricular dysplasia (ARVD). HCM and DCM are commonly ‘diagnosed’ separately and as an individual diagnosis but there is suggestion that a single gene defect can result in the syndrome of heart failure.
As cardiomyopathy worsens, the heart becomes weaker. It 's less able to pump blood through the body and maintain a normal electrical rhythm. This can lead to heart failure and rhythm problems. In turn, heart failure can cause fluid to build up in the lungs, ankles, feet, legs or abdomen.
Congestive Heart Failure is when the heart's pumping power is weaker than normal. It does not mean the heart has stopped working. The blood moves through the heart and body at a slower rate, and pressure in the heart increases. This means; the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up with fluids, it becomes congested. Many conditions can cause heart failure, and they are Coronary artery disease, Heart attack, Cardiomyopathy, and conditions that overwork the heart.
“Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body's needs for blood and oxygen” (American Heart Association, 2012, para 3). What this basically means is that the body is functioning in a way that the heart cannot keep up with. Although heart failure can be acute and occur suddenly, it usually develops over time and is a long-term or chronic condition. There are two different types of heart failure, left-sided and right-sided, and they can be caused by other diseases such as diabetes, coronary heart disease, or high blood pressure (National Institutes of Health, 2012). In most cases, both sides of the heart are affected simultaneously.
Congestive heart failure represents the end product of the many conditions that reduce the thrusting ability of the heart. Congestive heart failure is not a detailed disease but a illness that is measured by the inability of the heart to pump blood adequate with the metabolic needs of the body. Heart failure is accompanied by overcrowding of the body tissues. For instance, heart failure may be shown as an acute condition as in pulmonary edema or as a chronic condition as in congestive heart
Approximately, 1 of every 500 people is affected with hypertrophic cardiomyopathy, it is important for patients to understand the dynamics of the disease as it could potentially be life threatening. In most cases, the patients quality of life is not affected, but a few will experience symptoms that cause significant discomfort or undetected complications that could lead to sudden cardiac death. With that in mind, it would be beneficial to recognize what it is, specific causes, the steps of diagnoses, and the options for treatment.
The primary concern for Mr. Miller would be preventing further ischemia and necrosis of the myocardial tissues, preventing serious complications such as cardiac dysrhythmias and heart failure, as well as relieving his chest pain that radiates to his left arm. Preventing further ischemia and necrosis of the myocardial tissue will help prevent the development of heart failure due to myocardial infarction, whereas relieving his pain will help reduce his episodes of shortness of breath, and will also help to reduce any anxiety and restlessness he may be having from being in pain and short of breath.
Dilated cardiomyopathy accounts for approximately 15% of heart failure cases in the under 75s (“Chronic Heart Failure”). Patients with Dilated cardiomyopathy are usually unaware of the disease until they experience the signs and symptoms of heart failure or they develop an arrhythmia.
Just as breast cancer is killing our African American women, heart disease is also one of the major diseases killing our women. Heart disease is one of the nation’s leading causes of death in both woman and men. About 600,000 people die of heart disease in the United States (Americas heart disease burden, 2013). Some facts about heart disease are every year about 935,000 Americans have a heart attack. Of these, 610,000 are a first heart attack victim. 325,000 happen in people who have already had a heart attack. Also coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and loss of productivity. Deaths of heart disease in the United States back in 2008 killed about 24.5% of African Americans.
Wilkinson, Emma. (2000). “Knowledge and Communication Difficulties for Patients With Chronic Heart Failure”. British Medical Journal, 96, 77 – 82.