Congestive Heart Failure

Cardiovascular disease is a disorder that affects the heart or blood vessels. For decades, CVDs have been one of the most common causes of death, not only in the United States but throughout the world. 17.9 million people die of this type of disease each year (World Health Organization [WHO], 2017).

Congestive Heart Failure (CHF) is a heart disease in which the heart muscle loses its contractile function, which leads to a decrease in blood flow, blood congestion (stagnation) in the veins and lungs and/or other changes that can lead to loss elasticity of the heart. Stagnation of blood and other body fluids can occur not only in blood vessels and lungs but also in the liver, abdomen and lower body (Macon & Cherney, 2018). CHF may be the result of other diseases (hypertension, coronary artery disease, cardiomyopathy) but the main cause of development is inhibition of ventricular function. All this may be the result of an improper lifestyle.

At an early stage of the disease, the individual may not feel any unpleasant symptoms that interfere with life. Sometimes a person may develop weakness and weight gain. If treatment is not started on time, then the symptoms become more serious. Shortness of breath appears with heart palpitations and coughing. When the skin and mucous membranes acquire a bluish tint and chest pain appears, this indicates a severe heart condition (Macon & Cherney, 2018).

Even children can suffer from CHF (in the presence of congenital heart disease) but for the most part it occurs in older people. Currently, 5 million Americans are living with this disease. 550,000 new cases occur each year. CHF is the most common disease in people over 65 years old. Most of the people who suffer from this disease have died within 5 years of diagnosis. CHF is more susceptible to men than women. And African-Americans are more likely to develop heart failure than Caucasians (“Heart Failure Statistics”, n.d.).

The degree of complications of heart failure depends on the severity of the disease, the general health of a person, age and other factors. If treatment is not started on time, the disease can lead to the following complications: kidney damage or failure, anemia, heart valve problems, heart rhythm problems, and liver damage. Heart failure leads to insufficient blood flow to the kidneys. In this state, they will not be able to fulfill their main function of removing excess fluid. With kidney damage, the body does not produce the right amount of new red blood cells (“Congestive Heart Failure and Heart Disease”, n.d.). The functions of the heart valves may be impaired due to an increase in the heart or high pressure in it. The accumulation of blood leads to the formation of blood clots. A blood clot can enter the brain and block a blood vessel, leading to a stroke. The accumulation of excess fluid in the body puts too much pressure on the liver, which leads to a violation of its functions (Macon & Cherney, 2018).

To make a diagnosis the clinician uses the physical exam. To confirm the diagnosis, certain diagnostic tests are used, such as electrocardiogram, echocardiogram, MRI, Chest X-ray, and blood tests. Echocardiogram shows the structure and movement of the heart, Chest X-ray shows the size of the heart and lungs, MRI makes it possible to see if there is damage to the heart. A blood test is needed to determine the presence of impaired renal function, cholesterol levels, as well as the presence of anemia (“Congestive Heart Failure and Heart Disease”, n.d.).

For the treatment of CHF, ACE inhibitors, Beta-Blockers and Diuretics are used. ACE inhibitors are needed to open blood vessels, Beta-Blockers to lower blood pressure, Diuretics to rid the body of excess fluid. The PICOT question is: In elderly patients with congestive heart failure (P), does treatment with ACE inhibitors (I), when compared with treatment with Diuretics (C), lead to a decrease in hospitalization (O) within 30-days from the start of overmedicating (T)?