Cardiovascular Diseases: Screening, Diagnosis and Treatment

This article discusses the screening, diagnosis and treatment of common cardiovascular diseases such as congestive heart failure, valve disorders, angina and peripheral valve disease. It includes information on symptoms, screening tools, diagnostic tests and pharmacological and non-pharmacological interventions.

Running head: CARDIOVASCULAR DISEASES
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Cardiovascular Diseases
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Cardiovascular Diseases
Congestive heart failure, valve disorders, angina and peripheral valve disease are some of
the most common cardiovascular diseases among adults and geriatric patients. Early screening,
correct diagnosis and prompt treatment of these diseases can improve their prognosis.
Congestive Heart Failure (CHF)
The common symptoms of CHF include: difficulty in breathing, general body weakness,
tiredness and swelling of the feet and abdomen (Inamdar and Inamdar, 2016, p. 3). Signs that can
be elicited are increased heart rate, heart murmurs and leg swelling. Added sounds can also be
heard upon auscultation of the lungs. The main screening assessment tool for CHF is The Heart
Failure Screening Tool (Heart-FaST). During screening, it is important to investigate the
biomarkers linked to CHF, namely: neuro-hormone, myocyte-stretching and inflammatory
biomarkers (Inamdar and Inamdar, 2016, p. 5). Patients can also be screened for congestive heart
failure through assessment of their level of brain natriuretic peptide (BNP). To diagnose
congestive heart failure, a health practitioner should perform a full blood count, urinalysis,
electrolyte levels and blood sugar level. An X-ray of the chest can be done to highlight an
abnormally large heart or fluid build-up in the lungs (Inamdar and Inamdar, 2016, p. 5). A
magnetic resonance imaging (MRI) can also be used to identify congenital defects of the heart
while an echocardiogram can assess the patters of contraction and dilatation of the heart
chambers. Acute patients with chronic heart failure should be started on oxygen. Once stable,
they can be given pharmacological drugs such as diuretics, beta-antagonists, angiotensin-
converting enzyme inhibitors and digoxin (Inamdar and Inamdar, 2016, p. 8). Non-

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pharmacologically, they should be educated on the need to cut down their intake of sodium, quit
smoking and exercise regularly.
Valve disorders
Patients with valve disorders such as aortic valve stenosis present with shortness of
breath, dizziness and chest pain (Patel and Kirtane, 2016, what are the symptoms?). The
commonly elicited signs are heart murmurs, cyanosis and low oxygen saturation. The main
screening tool used for valve disorders is the echocardiogram. To screen for valve disorders, a
health practitioner should assess the circumference of the patient’s waist, their body mass index
and their cholesterol levels. Assessment of blood pressure can also be useful in screening for
valve disorders. The diagnostic tests used are cardiac magnetic resonance imaging and
catheterization. Over the years, valve replacement has proven to be the most effective therapy for
valve disorders (Patel and Kirtane, 2016, how is it treated?). The defective valve can however be
surgically repaired using balloon valvulaplasty, a non-pharmacological approach.
Pharmacologically, these patients also need blood thinners such as heparin, angiotensin-
converting enzyme inhibitors, beta blockers, diuretics and anti-arrhythmic drugs.
Angina
The common symptoms of angina are chest pain that radiates to the arms and jaws,
dizziness, general body weakness and breathlessness (William, 2013, p.710). The patient can
also complain of a tight chest. Screening assessment tools for Angina include the Speak from the
Heart Chronic Angina Checklist, Seattle Angina Questionnaire and Duke Activity Index. The
diagnostic tests performed are: chest X-ray, echocardiogram, nuclear stress test, angiography and

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magnetic resonance imaging. Pharmacological therapies for angina include: beta blockers,
nitrates and calcium-channel blockers. Newer drugs used to prevent angina are ivabradine and
ranolazine (William, 2013, p.713). These drugs relieve symptoms of angina and make patients to
have less frequent attacks. For patients with a medical history of atherosclerosis, statins and
asprin should be given as prophylaxis against angina (William, 2013, p.711). Non-
pharmacological procedures such as insertion of a coronary artery bypass are equally successful
in the treatment of angina. Management of angina should also include advice on healthier
lifestyle habits such as quitting smoking, weight loss, exercise and reduced alcohol consumption.
Peripheral Vascular disease (PVD)
The symptoms of peripheral arterial disease are cold legs, weak pulse, muscle cramp in the
hips and calf, alopecia, foot ulcers. These occur as a result of tissue ischemia. The screening
tools used for peripheral arterial disease are Near-infrared spectrometry and auscultation of the
chest for heart murmurs. Screening should include checking if the patient’s medical history
includes smoking, diabetes or a family member with a cardiovascular disease. Thereafter, the
patient’s legs should be assessed for numbness, tenderness, ulceration or swelling (Walker,
Bunch, Cavros and Dippel, 2015, p.1148). Diagnostic tests include ultrasound, magnetic
resonance imaging, cardiac catheterization, transcutaneous monitoring of oxygen and
angiography. Peripheral vascular disease is managed non-pharmacologically by angioplasty. It is
important to also treat the co-morbidities of the disease which include arthritis, diabetes and
neuropathy (Walker et al., 2015, p.1151). The main pharmacological interventions used for
managing peripheral vascular disease are asprin, clopidogrel and cilostazol.

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In conclusion, it is not sufficient to screen and diagnose the cardiovascular diseases among
the adult and geriatric; the appropriate treatment should also be administered promptly. Both
pharmacological and non-pharmacological agents can be used to treat these diseases.

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Reference
Inamdar, A. A., & Inamdar, A. C. (2016). Heart Failure: Diagnosis, Management and
Utilization. Journal of Clinical Medicine, 5(7), p.62. DOI:
http://doi.org/10.3390/jcm5070062
Patel, A., & Kirtane, A.J. (2016). Aortic Valve Stenosis . JAMA Cardiogyl, 1(5): p. 623.
DOI:10.1001/jamacardio.2016.2060
Walker, C. M., Bunch, F. T., Cavros, N. G., & Dippel, E. J.(2015). Multidisciplinary approach to
the diagnosis and management of patients with peripheral arterial disease . Clinical
Interventions in Aging, 10, pp.1147–1153. DOI: http://doi.org/10.2147/CIA.S79355
William, H. (2013). Angina: management options overview. The Pharmaceutical Journal,
290:pp.710-713. Retrieved from: https://www.pharmaceutical-journal.com/files/rps-
pjonline/pdf/CPD%20June%202013%20online%20pdf.pdf