Drugs That May Cause or Exacerbate Heart Failure

Running Head: HV3
Assessment
Student Name:....
Student ID:...
CONCEPT MAP
ECG
Chest X Ray
BNP
NT-ProBNP
Digoxin-
elevates
contraction
Diuretics-
Preload
reduction and
removal of
Control Risk Factors,
Stop Alcohol, tobacco
use, Treat CAD &
Ischemia, Treat
Hypertension,
Hyperlipidemia, Thyroid
and Diabetes, Excercise,
Healthy Diet & Active

HV3 2
(Fibrotic, abnormal
and dead myocytes) Diuretic
ACE Inhibiitor
Beta Blocker
(Chronic Pressure Overload,
Resisting forward flow)
Systolic Heart
Failure
Causes
High BP,
Severe
Hypertension
Coronary Artery
Disease( Ischemi
a)
Dilated
Cardiomyopath
y
Chronic Volume
Overload
Pathogenesis
Advanced Aortic
Stenosis
Reduced
Contractility
Increased Afterload
Systolic
Dysfunctio
n
Clinical
Manifestations
Diagnosi
s
Orthopnea
Dyspnea, High
Blood Pressure
Managemen
t
Course of
Treatment
Assess the Fluid
Retention
Retentio
n
No Retention
Prevention
Spironolactone,
ARB, Dogoxin,
Hydralazine and
Isosorbide

HV3 3
Guided Questions
Pathogenesis causing Clinical Manifestations
The systolic heart failure involves a complex mechanism of abnormal function of ventricular
pump and the external factors reducing the use of oxygen in metabolically active muscle cells
(Katz, 2018). According to American Heart Association, the heart failure may be defined as a
complex condition that emerges from any functional or structural cardiac disorder, impairing
the ability of heart to eject or fill the blood (Rivera & Menaker, 2017).
In systolic Heart Failure the heart is unable to pump blood normally so does not squeeze out
enough blood to meet the requirements of body (Colucci, 2018). Systole is the phase of
cardiac cycle in which the heart contracts to eject out blood to the lungs or the body (Thomas
& Wright, 2018). In Systolic Heart failure the heart has extremely lower force of contraction
and ventricular inotropy. Smaller and weaker muscles find it harder to squeeze the blood out
of heart due to which the stroke volume gets reduced. The muscles weaken due to underlying
diseases (like cardiomyopathy, coronary artery disease, development of plague, or valve
diseases) causing death of cardiac muscle cells (or cardiomyocytes) (Howard, 2017). The
walls of the heart get thinner and the ventricles get bigger in size. Due to reduced blood
supply the cardiac muscle cells die off, due to regurgitation and stenosis of the heart valves,
they remain for longer time allowing the reverse flow of blood (Diwakaran & Loscalzo,
2017). The condition may result into abnormal heart rhythm leading to breathlessness.
It becomes harder for the heart to maintain the normal blood supply and the muscle cells
work harder to balance it. This requires more oxygen demand by the cells. However, as the
blood cannot be supplied so efficiently to meet the demand, more muscle cells die off further
reducing the pumping ability of the heart. Ejection fraction of a normal heart is between 55-
70%. However in the patients of heart diseases, it can be between 40-55% . The ejection
fraction below 40% increases the risk of heart failure (Katz, 2018).
In this case study, the patient is very old age and had a history of heart failure two years ago.
Due to underlying cardiac diseases, her heart muscles would be weaker and susceptible to
recurrent dysfunction. She reports breathlessness, severe dyspnea. It shows she had been
suffering from heart diseases. Her oxygen saturation is 85% which shows very reduced level
of oxygen is passing through the body. Her high Blood Pressure and high pulse rate reflect
Tachycardia. It shows a disruption in normal blood flow due to heart abnormalities. The