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Overview (History) of the Disease
The understanding of Congestive Heart Failure has evolved for over 2500 years as explained by Remarkable history Congestive Heart Failure can be traced in Western medicine that gives insightful clinical description as far as the disease is concerned and can be attributed to Hippocrates in the ancient Greece according to Katz (2016). Luiz Katz is mentioned as having played an important role in Congestive Heart Failure science between 1920s and 19 70s. Anasarca, dyspnea, and edema were used to describe heart failure in the ancient Roman and Greek texts. There was a bit of pathological understanding of this disease which made evaluating its clinical description to be difficult.
Performing autopsies for identifications of causes of illness or deaths by physicians started in early 16th century and there was no related clinical finding that could be attributed to heart failure until 1628 when circulatory system was described by Harvey William which gave the basis of understanding the hemodynamic abnormalities related to heart failure. Major breakthrough came about with the coining of the “Law of the Heart” by Starling Ernest in 1918 which made the study of the functions of the heart and its failure more understandable (Pogwizd & Bers, 2004). In 1940s catheterization was introduced by Andre Cournand. Open heart surgery began in earnest in 1960s. Understanding the deterioration of the failing heart was buttressed in 1987 with the coming of molecular biology that made cardiology easy. Indeed, this is what nowadays defines the mechanisms through which cardiac science is performed. With advancement in technology, currently diagnostic tools and treatment of Congestive Heart Failure can be managed well and this gives an impressive future in the world of medicine.
Classification of the Disease
Congestive Heart Failure is classified into three classes which include class I, Class II, and Class III. Class I is where there are no restriction of physical activities and the patient is still able to control the disease. In the Class II, the patients will feel slight restrictions when he or she indulges in every day physical actions. Class III is when the patients experience definite limitations during physical activities and undue fatigue results. Lastly is the class VI where the patient is virtually unable to undertake any physical exercise or activity without feeling discomfort. Significant cardiac problems even occur while the patient is resting.
Signs and Symptoms of the Disease
There are several signs and symptoms that are associated with this diseases that sometimes if one is not keen at first it can be mistaken for another disease altogether. The most obvious sign that normally accompany the disease is the chest pain accompanied by lots of pressure and palpitation. This often comes in occasional stinging pain once in short intervals and disappears. It is thus, advisable for one to immediately seek medical attention once these short stinging chest pains are witnessed. Secondly, the patient would experience fatigue and weakness; is is associated with pressure that comes with the disease. It must be noted that lots of energy is used when there is high pressure used in the circulation of the blood. This drains substantial energy from the patient that would be otherwise used in other metabolic process thereby making the patient to feel weak and fatigued. This symptom is more or less similar to Distention of neck veins which is our third symptom of the Congestive Heart Failure. It is also referred to as the jugular venous distention. It is a situation where there occurs increased intravascular fluid – also known as the hypervolemia which is the reason of distention of the jugular vein. It is all about fluid retention in the intravascular.
The fourth symptom is known as the Central or peripheral cyanosis, pallor. It must be appreciated that one of the most important functions of the circulatory system is transportation. The transportation includes those of the important gases for respiration such as the oxygen and the transportation of carbon dioxide out of the system. Whenever there arises a hitch in transportation of these gases, it means that there would be increased accumulation of carbon dioxide gas in the body system while at the same time the oxygen would grow less in concentration in the system. Cyanosis comes as a result of less concentration of oxygen in the system and high accumulation of carbon dioxide in the body system a situation that makes the skin to have a bluish discoloration. This kind of discoloration is most notably seen in the beds of the finger nails and toe nails together with the skins of the tongue. It must be noted that blood that is rich in oxygen is normally red colored; a typical association with the blood while on the contrary a blood with lower levels of oxygen appears bluish or purple in color. This how cyanosis comes about to be recognized in those patients who are taken down with Congestive Heart Failure.
The Fifth symptom is that of the anorexia, weight loss, and nausea which are tied to the preceding fourth example of the symptoms of the disease. This is because whenever there is lack of proper supply of oxygen in the body system, there would be curtailment in the respiratory processes. The body system will thus not be in a position of making good use of the nutrients which have been taken in. This therefore results in the body trying to reject more supply of the nutrients which is normally manifested by feeling of nausea. This means that there will be lack of appetite in such kind of a person – a condition that is referred to as anorexia. this automatically would lead to loss of weight as we know that it is only through constant supply of food for the body that makes it have energy and at the same time repair and develop.
The sixth sign is that of oliguria that is a term that has been used mostly to refer to a situation where there is less urine formation and subsequent passing out of the same. We know that urine formation is a subset function of blood circulation. This means that whenever there is a hitch in the blood circulation, there would be a subsequent hitch in urine formation which results into oliguria. This is for sure a manifestation of multiple organ dysfunction syndromes (MODS) which means that the Congestive Heart Failure results to the malfunctioning of other organs such as the kidney; Kidney fails to form enough urine as a result of the poor supply of the blood.
The seventh symptom is the increased intensity of P 2 heart sound. The heart sound normally has two audible components, the aortic closure sound (A2) and the pulmonic closure sound (P2), which are normally split on inspiration and virtually single on expiration. Because of the body’s need of circulation the pulmonic closure will be rapid and this often associated with the increased pressure of the heart.
Causes of the Disease
There may be several causes of the disease such as the past heart attack of the coronary heart disease which can lead to scaring in the heart muscle and cause the Congestive Heart Failure. The second one is the high blood pressure; this is known to clog the blood vessels thus, making the heart to fail in its function of pumping the blood to various parts of the body. Thirdly, when the heart valves are affected by diseases, they result into heart failure as they will not function well as required. Fourthly, is the defective thyroid glands; Thyroid is the glad that releases the hormone thyroid (T3 and T4) that works in regulating the rate of heart beat. This test targets the level of this hormone in the blood and the fewer hormones or high hormonal level in the blood cause alteration in the heart rate.
The fifth cause is may be viral or other infections that come about to attack the heart – a condition that is normally called myocarditis. Lastly, there may be some congenital heart diseases that may persist with the growth of an individual and later develops into Congestive Heart Failure.
Pathophysiology of the Disease
These include the physiological/ physical indicators of the disease that can be depicted even without diagnostic procedures such as increased edema in the joints. There would also be a subsequent hitch in urine formation which results into oliguria.
Diagnosis of the Disease
Due to advancement of technology, several means of diagnosis have been developed that aids in managing the disease if detected well in advance before it catapults to high advanced levels. One of such technologies is what is termed as the echocardiography. It is a technique that uses sound waves to create the moving pictures of the heart. The importance of the picture is to show the size, the shape, and any deformity within the heart. Doppler ultrasound is a type of special echo produced by this technology that gives a picture on how well or bad the blood flows through the four heart chambers and the valves. It is also able to detect blood clots inside any part of the heart, fluid buildup in the pericardium (the sac around the heart), and problems with the aorta which carries oxygenated blood from the heart to other parts of the body (MedlinePlus, 2016).
Another important technology which is kind of similar to the first one is the use of electrocardiogram; a machine that has been specifically built to detect the efficiency of the heart’s functioning. A part from that, it helps the cardiologist to understand the intricate of how the heart works. The main important things this machine can show are: how fast the heart beats, whether the rhythm of the heart is steady or regular, and the strength and timing of the electrical signals as they pass through each part of the heart. This is because it is designed in such a way that with every heart beat, an electrical signal spreads from the top of the heart to the bottom. As it travels, the signal causes the heart to contract and pump blood. The process repeats with each new heartbeat. And this is how it helps to detect if there is any hitch in the heart function.
Another technology by which Congestive Heart Failure can be diagnosed is through the administration of the chest X-rays. X rays simply mean electromagnetic waves that are channeled to the area of interest in the body. They use ionizing radiation to create pictures of the inside of your body. A chest x ray is designed to take pictures of the inside of the chest where the heart is located. The different tissues in the chest area absorb different amounts of radiation; thus a disease in the chest that changes how radiation is absorbed also will appear on a chest x ray and be detected (MedlinePlus, 2016). X- Rays could be likened to another diagnostic technology of the heart called the Cardiac MRI. The MRI means the Magnetic resonance imaging and it employs the use of radio waves, magnets, and computers to form pictures of the tissues of the heart. This technology does not use any ionizing radiation, thus rebuffs the fear that it can cause cancer to the patients that the procedure is done on. IT is therefore, a safe, noninvasive (no instrument needed to be inserted in the body as well as there is no surgery done to the patient in this procedure) test that creates detailed pictures of of the tissues of the heart and thus helps in detecting areas that are abnormal.
Another important diagnosis procedure is the cardiac catheterization which uses a long, a long, thin, flexible tube called a catheter that is placed into a blood vessel in the arm, groin (upper thigh), or neck and threaded to the heart of the patient. The function of this catheter is to give the doctor a view of the inside of the coronary (heart) arteries as he looks though the loop/ catheter. In this procedure, the doctor can check the pressure and blood flow within the heart chambers; he or she can also collect blood samples, and also applies the use of x rays to look at the coronary arteries if there is in abnormality that may result in the cause of any heart disease.
Another diagnostic technique used is what is termed as the nuclear heart scan which also shows the way the blood flows through out the heart. This procedure employs the use of a safe, radioactive substance called a tracer that is inserted or injected into bloodstream of a person who is examined through a vein. The tracer is caused to travel to the heart and as it releases energy that helps in detection of abnormalities is the heart through a reflection or emission to special cameras. The special cameras that are in the outside of the body detect the energy and use it to create pictures of heart giving any detail of what the heart looks like and if there is any abnormality as it shows where the heart muscle is healthy and where it may be damaged (MedlinePlus, 2016). An example of nuclear heart scan is the positron emission tomography (PET); a scan that shows the level of chemical activity within the heart and the areas surrounding the heart. This test can also be employed to help physicians to see whether enough blood is flowing well within the heart to different areas of the body. A PET scan can show blood flow problems that other tests might not detect.
The last diagnostic technology that can be used is that thyroid function tests. Thyroid is the glad that releases the hormone thyroid (T3 and T4) that works in regulating the rate of heart beat. This test targets the level of this hormone in the blood and the fewer hormones or high hormonal level in the blood cause alteration in the heart rate. The test includes imaging of the glad as well as blood tests to ascertain the levels of this hormone in it.
Prevention of the Disease
One of the important ways of preventing this disease is to ensure that one goes for frequent medical check-ups. Medical check-ups are important as they would give one his or her medical – health position. Secondly, there is the need to ensure that one remains physically active throughout his life. This is to ensure that the excess calories are burnt and the right weight and health is maintained.
Water is also an important component of diet. In fact water forms the basic component of diet by virtue of vital roles it plays in the diet though many are times people fail to discuss it as the diet. It provides form and structural support in the intracellular part of the cell. The main point is that it is the only medium for biochemical reaction. It also creates a means of transport and exchange of biochemical materials. According to Stone (2014), thirst is a sign for the body’s need for water. It is advisable for one that needs to lead a healthy life and keep Congestive Heart Failure at bay to also consider taking water.
Management of the Disease
Proper management of this disease revolves around lifestyle such as dietary measures and exercise. For energy to be in constant supply for the endurance exercises that patients are needed to undergo, the muscle cells must undergo anaerobic respiration that turns glucose to lactic acid. This often targets the stored energy in the muscle in form of glycogen. A process called glycolysis that provides two molecules of ATP per glucose. This means that proper dietary discipline must be observed by not only the Congestive Heart Failure patients, but everyone that needs good healthy life. A lowcarbohydrate diet is often used in an effort to reduce body fat, however, most nutritionists consider carbohydrates to be one of the most important components of a diet, for both health and sports performance. The major role of carbohydrates is to provide energy especially for the endurance physical activities that the patients need to put themselves in on a daily basis.
Fat is also another major dietary requirement for the body, but it needs to be taken in low quantity or be avoided completely by the Congestive Heart Failure patients. Both monosaturated and polysaturated fats are important especially from the sources such as fish, vegetable oils, and avocados. Intake of saturated fat sources such as the bacon and butter together with the trans types of fats should be minimized or avoided if possible. The high fat foods should be avoided by all means by Congestive Heart Failure patients. Lastly it is advisable for everyone to be visiting the medical specialists for occasional medical check-ups in order to manage this disease well.
Prognosis of the Disease
There are imminent outcomes as far as the disease is concerned based on how best or how worst it is managed. For instance, if the disease is detected earlier enough and treatment and the management of the disease starts immediately it is detected, it is a fact that the disease cannot cause great harm and can be managed well and even treated till the patient comes to normal and healthy. It must be underscored her that this depends in the management of the disease and at the same time the treatment and adherence to doctor’s prescription. On the contrary this disease cannot allow one to leave for long if its diagnosis is done late and if the management issues to it are not adhered to by the patients. A patient that has been diagnosed late in the advancement of the disease has a very short time to live as compared to one that has been diagnosed earlier enough to enable the treatment and proper management to take place.
Source: Research on Congestive Heart Failure
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