Blockage of a coronary artery via Wikipedia.org
WHAT IT IS
Heart failure is a serious condition that develops when the heart is no longer able to carry on its normal work. It occurs in most patients with serious heart disease at some time or another in the course of their disease.
The heart has only one function — to pump the blood stream and keep it in circulation through all parts of the body. When the heart is tired or weakened by disease, the blood stream tends to slow down and fluid will gather in certain areas, particularly the ankles and legs. The lungs may begin to fill up with fluid, making breathing difficult.
CAUSE
Mitral Valve Stenosis via wikimedia commons
Heart failure may arise from a number of different conditions, such as:
- High blood pressure
- Coronary thrombosis
- Kidney disease
- Rheumatic fever
- Diphtheria and
- Low thyroid activity
Anything obstructing the normal flow of blood, such as mitral or aortic stenosis, will eventually produce severe heart failure.
This delayed circulation reduces the flow of blood to the kidneys so that water is no longer excreted in sufficient amounts. This failure to excrete fluid produces oedema or swelling of the tissues. The lungs may then begin to fill up with fluid, and this in turn reduces the normal exchange of oxygen and carbon dioxide. This loss of “vital capacity” in the lungs is very serious and must be relieved without delay if the patient is to survive.
As the fluid continues to gather in the lungs, the patient may then suffer from severe spells of coughing and shortness of breath. The skin begins to lose its normal color, turning bluish owing to the condition known as cyanosis. The patient may be forced to sit up at night, or use four or five pillows when trying to rest. At times, he may cough up a frothy, pinkish, blood-tinged material, especially at night. This is PULMONARY OEDEMA.
Major signs and symptoms of heart failure via wikimedia commons
As the conditions gets worse, the patient becomes anxious and fearful for his own future. His liver may be enlarged and tender, and his kidney congested and unable to eliminate excess fluids from the body. There may be Albumin in the urine and also casts. Back pressure on the digestive organs may result in distressing symptoms such as gas, constipation, lack of appetite, and distension of the bowel. All of this lowers the normal nutrition of the individual and interferes with his recovery.
TREATMENT
A standard setup for a ventilator in a hospital room by NIH, 12 November 2013 via wikimedia commons
To treat heart failure successfully requires both skill and experience, for the patient’s body is already overloaded with fluid. In the more severe cases, powerful diuretic medicines, such as Mercuhydrin, are injected into the muscles to aid the kidneys in getting rid of the excess fluids. Chlorothiazide tablets (Diuril) are valuable in maintaining a normal output of fluid from the kidneys. They must be taken once or twice daily to help maintain proper fluid balance.
For many years digitalis has been the chief stimulant for the heart. Most patients need one tablet a day. Because there is already too much salt in the tissues, the patient must avoid the excessive use of salt. Potassium in some form should be given daily. A glass of orange juice will usually provide enough potassium to meet the body’s needs.
In the more severe cases, oxygen may be needed, particularly during the night. If the patient is restless, he should be given a mild sedative. He should be relieved of anxiety and emotional strain. Many people with mild heart failure can carry on their normal work, provided they have long quiet weekends in which to recover. When the heart is tired from overwork, a few day’s rest in bed will usually bring the body back to its normal activity.
Good nursing care is most essential in more severe cases. The patient should give up smoking permanently…if he be a smoker. He should be protected from colds and other infections so far as possible, for these place an extra strain on the heart and lungs.
After a severe bout of heart failure, the patient should rest as much as possible and only gradually normalise his activities. In the future, he should continue a careful programme of living, avoiding all unnecessary activity and excitement that might overload the heart.
With proper rest, optimism, and well-balanced living, most patients with heart failure can get along fairly well.
References for further read:
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