HSNS26 Nursing Assignment: Heart Failure Pathophysiology

This report delves into the pathophysiology and pharmacology of heart failure, focusing on a case study of a patient named Trevor. The report begins by defining heart failure and detailing its underlying causes, such as myocardial infarction, hypertension, and amyloidosis, highlighting how these conditions impact the heart's efficiency. It then analyzes Trevor's medical history, including his impaired ventricular ejection fraction, constricted blood vessels, and symptoms like tachycardia and breathlessness. The report discusses the impact of stent implantation, coronary artery bypass grafts, and the progression of Trevor's condition, including the onset of orthopnea and paroxysmal nocturnal dyspnea. Furthermore, the report links Trevor's symptoms to factors such as increased cholesterol levels and reduced ventricular perfusion. Finally, it references relevant studies and medical literature, providing a comprehensive understanding of the patient's condition and the complexities of heart failure.

Running head: NURSING
Topic: NURSING
Name of the Student:
Name of the University:
Author Note:

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Pathophysiology of chronic heart failure according to the case study of Trevor
There are various factors contributing to the pathophysiology of heart diseases. The
main symptom is a reduction in efficiency of the heart muscles. The limited efficiency of the
muscles of the heart is due to damage or cases pertaining to overloading. Myocardial
infraction is a specific case where the heart muscles are usually starved of oxygen which is
many times fatal. Moreover, hypertension is another cause contributing to hear failure
characterized by hypertension increasing the contraction force for pumping blood as well as
amyloidosis where there is mis-folding of proteins and the mis-folded proteins are usually
deposited in heart muscles ultimately causing stiffening of the heart muscles (Borlaug, 2014).
Regarding the current medical condition of Trevor, the impaired blood flow to
different parts of the body is evident from the limited ventricular ejection fraction. Moreover
the condition of his heart is poor due to the physiological impairment in the blood volume
ratio and tachycardia resulting from congestive artery symptoms (Sapp et al., 2016). Thus
constriction in the blood vessels would be directly linked to the increased breathing rates in
the case of Mr. Trevor. Due to constrictions in the blood vessels of the heart there is difficulty
in the circulation from the heart to all parts of the body thus requiring external measures like
introduction of stent and bypass surgeries for altering the directionality of the blood flow.
From the case study of Trevor it can be seen that he had been suffering from heart
related problems and there has been blockage of the arteries and the ventricles which caused
the incorporation of stent in the left anterior descending artery (Blazek et al., 2015). Thus his
area of blockage was protected and there was usual supply of blood and circulation
throughout his body after the implantation of stent. However, the system deteriorated after
two years and he had to undergo coronary artery bypass grafts. This was done to improve the

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flow of blood due to accumulation of plaque in the arteries which would constrict the blood
vessels and cause limited blood flow.
Post the surgery his condition improved as he reduced his smoking habits. However
his increased cases of breathlessness show that the ventricular perfusion ratio had been
affected as perfusion is affected. There has been a modest increase in the alveolar arterial
oxygen difference tension which would be almost same and this condition coupled with
stable arterial oxygen tension would affect the change in the ventilation perfusion matching
due to the enhanced ventilatory responses to heart failure. Moreover, he had to use three
pillows for lying flat which is an indication of orthopnea. Thus these symptoms of
breathlessness and sleepless nights highlight his medical condition of paroxymal nocturnal
dyspnea (Broadsky, 2014). Trevor’s wife believes that his symptoms of dyspnea on exertion
as experienced by Trevor have been consider not be deconditioned. Thus increased
cholesterol levels have increased the deposition of the fats in the blood vessels thus
narrowing them and affecting their effective circulation throughout the body.

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References
Blazek, S., Rossbach, C., Borger, M. A., Fuernau, G., Desch, S., Eitel, I., ... & Mohr, F. W.
(2015). Comparison of sirolimus-eluting stenting with minimally invasive bypass
surgery for stenosis of the left anterior descending coronary artery: 7-year follow-up
of a randomized trial. JACC: Cardiovascular Interventions, 8(1 Part A), 30-38.
Borlaug, B. A. (2014). The pathophysiology of heart failure with preserved ejection
fraction. Nature Reviews Cardiology, 11(9), 507.
Brodsky, R. A. (2014). Paroxysmal nocturnal hemoglobinuria. Blood, 124(18), 2804-2811.
Sapp, J. L., Wells, G. A., Parkash, R., Stevenson, W. G., Blier, L., Sarrazin, J. F., ... &
Essebag, V. (2016). Ventricular tachycardia ablation versus escalation of
antiarrhythmic drugs. New England Journal of Medicine, 375(2), 111-121.