Case Study on Congestive Cardiac Failure

CASE STUDY 1
CASE STUDY ON CONGESTIVE CARDIAC FAILURE
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CASE STUDY 2
DISEASE
Congestive heart failure refers to a condition whereby the heart is unable to properly
pump blood to the body due to various factors which is generally referred to as cardiac output.
Preload is a term used to refer to the amount of pressure the ventricles exert so as to pump blood
into the blood vessels to the lungs and the body respectively. The preload is increased it
increases the chances of congestive heart failure. Systolic heart failure refers to the inability of
the ventricles to contract causing decreased pressure to pump blood out of the heart while
diastolic heart failure is the inability of the ventricle to relax hence become stiff and unable to fill
accordingly. Left sided heart failure refers to the inability of the left ventricle to contract and
therefore the backflow of blood to the pulmonary vessels which manifests in pulmonary edema,
cough and shortness of breath. Right sided heart failure is the inability of the right ventricle to
eject blood causing a back flow of blood to the tissues and the hepatic system.
The causes of congestive heart failure are coronary artery disease whereby the coronary
arteries supplying the myocardial tissues receive less oxygen causing ischemia due to
atherosclerosis and causing injury to the heart tissues which reduces contractility consequently
heart failure. Hypertension increases the heart workload to eject blood therefore the heart
mechanism is hypertrophy which then causes decreased contractility. Inefficient valves cause
backflow of blood causing heart failure and may be caused by viral infections and post
streptococcal immune reactions. Anemia is also a causative factor of heart failure as it causes
increased heart rate and consequently hypertrophy decreasing contractility of the
ventricles(Moe,et.al ,2015).

CASE STUDY 3
According to the Australian Institute of Health and Welfare(2017) around 4% of the
population aged 45 years and above are diagnosed with heart failure. The Aboriginal and Torres
Strait Islander people are twice likely to encounter increased morbidity and mortality rates than
other Australians. The risk factors of congestive heart failure include hypertension, previous
myocardial infarction, smoking, obesity, age, genetic predisposition and diabetes.
The disease impacts the patient emotionally, physically and mentally. The patient is
unable to perform activities of daily living due to fatigue and shortness of breath. This in the end
may affect their income as they will be unable to work and chronic hospitalizations therefore
losing their jobs. The patient loses may have poor mental health due to depression as the quality
of life decreases in a period of time(Liu, Chang, Wu & Tsai, 2015). Fear and anxiety of the
future such as impending death may worsen the situation. Continuous use of medication and
handling the side effects may be emotional for the patient.
The family of the patient has to deal with the financial implications of managing
congestive heart failure. It’s expensive to undergo medical procedures, buy drugs and accessories
that the patient needs. The family may lose the breadwinner who happens to be the patient
causing change in roles. This may also lead to the need of a care giver who is a family member
which leads to ceasing to go work.

CASE STUDY 4
SIGNS AND SYMPTOMS PATHOPHYSIOLOGY
Increasing shortness of breath, inspiratory
crackles, swollen ankles
Left sided heart failure causes the left ventricle
unable to eject blood therefore blood causes
pulmonary edema in the lungs. This increases
pressure and therefore accumulation of fluid in
alveoli(Lala et.al,2015). There is decreased
gaseous exchange due to lowered surface area
occupied by the fluid causing breathlessness
and decreased oxygen saturation. Lung sounds
heard are inspiratory crackles which signify
presence of fluid in the lungs. In the peripheral
tissues there is accumulation of fluid as the
kidneys trigger the renin angiotensin
aldosterone cascade which leads to the retention
of salt and water. This causes accumulation of
fluid in the extremities and peripheral tissues.
Decreased ability to conduct gardening or go
for a walk. Cold fingers and toes and have to
wear bed socks
Fatigue results from two causes one being the
decreased oxygen saturation due to pulmonary
edema. This causes carbon (IV)oxide
accumulation when excess activities are
attempted. The high respiratory rate is a
compensation mechanism to increase oxygen
levels and decrease carbon (IV)oxide levels.
Secondly there is decreased blood levels being
circulated to the peripheral tissues hence unable
to conduct activities of daily living. The
kidneys release renin once there is a decrease in
glomerular perfusion which activates the
sympathetic nervous system(Mentz et.al,2015).
This causes vasoconstriction of blood vessels
hence cold fingers and toes.