Report on Congestive Heart Failure

Report on Congestive Heart Failure

Introduction
Congestive heart failure (CHF) is a chronic impulsive condition of the heart that disrupts the heart muscles. The heart muscles have a pumping power and due to CHF, it reduces significantly (Francis  & Tang,2019). This happens mainly because many body fluids collate together near the location of the heart which gives rise to lower efficiency in the pumping of blood by the heart muscles. The ventricles of the heart do not get enough blood to pump into the organs and tissues of the body and as a result of this, blood and other fluids around the abdomen, lungs, lower body and liver. CHF condition endangers the life of the patient and needs immediate medical attention and care (Dokainish et al, 2017).

Problem Statement:- Mr Brown was experiencing swelling of his feet and ankles for ten days. For the last three days, he was suffering from shortness of breath. Today he experienced massive chest pain, extreme fatigue and rapid breathing. Due to the worsening conditions of his heath, he was admitted to a nearby hospital. Mr Brown was diagnosed with Diastolic failure of the heart and was shifted to the Intensive Care Unit.  

Literature Review
Congestive heart failure (CHF) conditions are mainly of 2 kinds -LCHF and RCHF, indicating left and right sides.

Left-sided CHF are categorized as two types again 

Systolic heart failure is frequently reported. There are times when the ventricles on the left side fail to contract under the normal procedure and end up not pumping blood adequately into the body tissues (Maisel, 2019). As the condition gets advanced, fluids build up inside the lungs, which creates difficulty in breathing. 
Another type of failure is a diastolic failure. There are times when the muscles on the left side of the ventricles become rigid and inflexible and hence it cannot relax or contract with ease with the result that the heart does not have enough supply of blood (Masetic & Subasi, 2016).

Right-sided CHF

Sometimes the right ventricle of the heart is unable to push the blood up to the lungs. The blood stays behind in the blood vessels and as a result, it causes the pile-up of fluids in and around the abdomen and other organs.
There can be a lot of complaints of patients suffering from LCHF and RCHF simultaneously. Usually, the deficiency is found on the left side. It can travel to the right side if it is left unchecked and there is no treatment (Crowley et al,2017).
Symptoms related to the disease include fatigue, shortness of breath, hands swelling up, the gaining of weight, wheezing, tanned or blue skin, increased urination at night, cough and rapid breathing with chest pain in extreme cases (Tayal, Prasad, & Cook,2017). 
Methods of Diagnosis and Treatment
The doctor usually considers different treatment paradigms depending on the overall diagnostic reports of the patient. Through the evolution of medical science, the treatment of CHF can be possible with the help of medications. Some of them are:-
The cardiologist generally listens to the heartbeat and detects the abnormal heart rhythm with a stethoscope. An electrocardiogram(ECG) test is conducted to record the patient’s rhythm of the heart. Rapid heartbeat suggests that the walls that surround the heart chamber have become thicker which leads to a high risk of a heart attack in the future (Shah & Shannon, 2019). An Echocardiogram test is also performed to test sound waves of the heart’s motion of its muscles. The test determines if it has had a poor flow of blood and damage of muscle leading to abnormal contraction of the heart. An MRI is also done which takes images of the heart consisting of moving and still pictures and locates the damages to the heart. As a result of taking stress tests, one can ensure that the heart is functioning well. The statistic that stress tests present before the patient is the stress level that the heart goes through. Blood tests have also been performed that check for infections. It also checks for the presence of abnormal blood cells and the level of BNP hormones in the body. It has been medically found that the level of BNP hormone rises in case the patient goes through heart failure. Cardiac catheterization tests show blockages that happen in coronary arteries (Kaya, Raczek, & Rose, 2020). 
Some drugs have the propensity to open up blood vessels. ACE inhibitors are these categories of drugs that had narrowed down due to the deposition of cholesterol or fat and thereby improve the level of blood in the body and blood flow. Another alternative option is Vasodilators. They are the next alternative option if the patient is not able to tolerate ACE inhibitors (Halliday et al, 2019).
Other drugs like trandolapril, lisinopril benazepril, captopril, quinapril, enalapril, fosinopril and perindopril are administered depending upon the type of the patient. (Masetic & Subasi, 2016). Care must be taken while restricting to particular medications as Thiazide diuretics leads to the further lowering of blood pressure. There are certain diuretics, such as triamterene that cause an increase in the level of potassium in the blood. The rhythm of the heart can show a different level of behaviour as a result of this. There are certain Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, and naproxen that cause the body to retain the sodium and water levels. This has the potential to reduce the effect of the ACE inhibitor on blood pressure (Maisel, 2019). There are other elements called beta-blockers that can be used to reduce the blood pressure of the patient. If the heartbeat rhythm of the patient is at a very high speed, beta-blockers can be used to slow it down. The fluid content of the body that increases due to CHF can again be reduced by the application of diuretics. The angiotensin-converting enzyme may be given for correcting functions of the pancreas and liver which had been malfunctioning due to the deposition of fluids.  
Surgeries are an alternative in serious situations. This is when medications aren’t effective any longer (Shah & Shannon, 2019). One of the choices can be angioplasty, a type of surgery that is used to open the blocked-up arteries of the patient. Another choice can be made by the cardiologist regarding valve repair surgery. Such a surgery ultimately leads to the smooth and proper opening and closing of valves.

Technology Recommended being used

Around 20 million people around the world suffer from congestive heart failure, at some point in their life. It is an increasing health care problem worldwide. Many new commercial devices are abundantly available in the international market that can be used in the treatment of heart failure, whether moderate or severe. Mr Brown can be suggested The Optimiser3 care technique.  Optimizer 3 from Impulse Dynamics is an implantable pulse generator that delivers cardiac signals during the period that the patient is under intensive care. It is something that ultimately leads to the strengthening of the heartbeat (Francis & Tang,2019). In a minimally invasive implant procedure, three leads are implanted consequently. Two of these leads are in the right ventricular septum. They sense the presence of activities in the ventricle and through the use of signals they can also detect the auricle activation. While the pacemaker maintains the rhythm of the heart and makes sure it is not fast or slow enough, the optimizer strengthens the heartbeat of the patient which leads to better health for the patient as well (Shah & Shannon, 2019). Hemodynamic measurements show the effect of non-excitatory impulses on cardiac contractility and functions.  A portable Programmer in the device controls the implantable post generator via artillery path enabling easy customization of ccm signal parameters (Merlo et al, 2018).  The device uses transcutaneous energy transfer so that the optimizer systems can do weekly charging of the external batteries at home.  Cardiac contractility modulation is a significant treatment for congestive heart failure.  

Conclusion

It is often said that prevention is better than cure. Hence a healthy routine in life lowers the risks of CHF. A well balanced and healthy diet is always suggested consisting of whole grains, proteins, fruits and vegetables(Merlo et al, 2018). Moderate daily exercises with proper health check-up at intervals is necessary. Similarly, obesity and smoking habits need to be avoided. High blood pressure or any coronary disease of the artery must be cured with immediate effects. Valve conditions of the heart if any, need to be addressed to a doctor on an emergency basis(Dokainish et al, 2017). Other diseases like diabetes, thyroid, and allergic reactions in the body must be administered at regular intervals. These precautionary measures can build up a healthy routine life for an individual.