Congestive Heart Disease (Chf)

Congestive Heart Disease

The main function of a healthy heart is to ensure proper blood flow throughout the body and supplying all the organs with the nutrients that are necessary for survival. Congestive heart failure (CHF) is also known as Congestive heart disease, but for this paper we will use failure, Consistent with the research. Congestive heart failure is a disease that primarily causes the heart to be compromised. This leaves the heart unable to perform the main function of pumping blood throughout the body to maintain homeostasis. Congestive heart failure affects mostly individuals 65 years and older; however it can happen at any time. (Anderson, et al 2010). According to Goldberg & Konstam, “It is also one of the most common forms of heart disease. Approximately 4.9 million Americans suffer from CHF, with about 400,000 new cases diagnosed annually.” (as cited in Mithal, Mann, & Stone, 2002, p. 46). Prevention methods are important factors for avoiding this disease. There are several treatments available for congestive heart failure that focus on reducing fluids from the body to remove congestion from the heart or reduce blood pressure in the arteries. The heart can be described as muscular pump; it’s primary function is to pump blood. The heart consists of four chambers. The upper two chambers are called the atriums and the lower two chambers are called the ventricles. As the heart contracts, blood is pumped through the body with the assistance of four heart valves. Blood that is low in oxygen flows back to the heart after circulating through the body. The blood enters through veins and enters the right atrium. This chamber empties blood through the tricuspid valve into the right ventricle. The right ventricle continues to pump the blood under low pressure through the pulmonary valve into the pulmonary artery. The blood is now directed to the lungs where it gets fresh oxygen. After the blood is oxygenized, the blood will have a bright red appearance, and it is now considered rich with oxygen. The blood will now return to the left heart through the pulmonary veins to the left atrium. From there it passes through the mitral valve and enters the left ventricle. The left ventricle pumps the oxygenated blood out through the aortic valve into the aorta. The aorta takes blood to the body’s general circulation. Congestive heart failure is the inability of the heart to sufficiently supply the body with oxygenated rich blood adequately. The hearts primary function is to move blood throughout a network of vessels. The blood provides the cells of the body with oxygen and nutrients needed while also removing waste products of the body and releasing carbon dioxide. Organs such as the brain, liver, lungs, intestines and kidneys are also compromised. When the weakened muscles of the heart is unable to supply the kidneys with the necessary amount of blood the kidneys are compromised. The kidneys are now unable to perform their function of excreting sodium and water. This causes the body to retain fluid, which directly affects the lungs. The lungs now become congested with fluids known as pulmonary edema. The liver is similarly affected with the accumulation of fluids due to the inability to excrete wastes. This causes a huge accumulation of toxins in the body. The intestines will also be affected and will not be able to absorb the necessary nutrients for daily function. Without treatment CHF will eventually corrupt and attack every organ of the body. Common symptoms include swollen legs or ankles and difficulty breathing. Weight gain is often seen due to the accumulations of fluid within the body. (American Heart Association, 2010 ; Anderson, et al 2010). There are several factors that commonly contribute to congestive heart failure. Coronary heart disease is an accumulation of plaque resulting in a narrowing or hardening of the arteries that supplies blood to the heart muscle known as the myocardium. This is the most common type of heart disease resulting in the leading cause of death for men and women in the United States. (MedlinePlus, 2010). Another factor is hypertension (high blood pressure), which refers to high pressure found in the arteries. Approximately one in three adults in the United States (73 million people) are estimated by The American Heart Association (2010) to be diagnosed with high blood pressure. A myocardial infarction, producing a thick scar tissue and interfering with the heart muscle 's normal function is another factor which could result in a heart attack. Heart valve disease has been linked to congestive heart failure as well. This could be a result of an outbreak of rheumatic fever or some other causes. Another factor contributing to congestive heart failure would be an infection of the heart lining known as endocarditis causing damage to the heart valves or possibly a myocardium of the heart known as myocarditis. Other common causes are alcohol and drug abuse, arrhythmias, obesity, cardiomyopathy and congenital heart defects. (American Heart Association, 2010). There are several ways to prevent congestive heart failure. Diet management is a key factor in securing a future without congestive heart failure. Maintaining a proper diet is crucial. Being overweight will act as a burden to the heart causing it to work harder to pump blood throughout the body. It is necessary to reduce sodium intake to avoid retaining fluids. The next step would be to increase potassium intake. Individuals who have congestive heart failure are usually prescribed diuretics to help excrete fluids causing a loss of potassium. Potassium can be found in green leafy vegetables and most fruits, particularly bananas, oranges, and dried fruit. Other factors for congestive heart failure prevention would involve exercise, no smoking and limited alcohol consumption. (Health-cares, 2010). There are many factors used for treatment for congestive heart failure. Various drugs are incorporated into treatment for congestive heart failure. The uses of drugs are intended for reducing fluids within the body or to reduce blood pressure in the arteries of the body. Typical drugs used for treatment are Ace inhibitors, beta-blockers, digitalis, diuretics and vasodilators. Beta-blockers are intended to improve function for the left lower ventricular pumps. Diuretics are intended to assist in eliminating products that primarily contribute to congestion such as salt and water. Digitalis serves a very important role in strengthening the heart so it can serve as a more efficient, reliable, and effective pump. Treatment may involve surgery if the failure is a result of a poor functioning heart valve. Surgery could involve repair or replacement of a heart valve or in drastic cases, replacement of the heart itself. General treatment will also consist of exercise, weight loss, rest and specific attention to maintaining a suitable diet plan. (American Heart Association, 2010). The Practice Framework of a person that has congestive heart failure is

greatly affected. Individuals must reduce the amount of exertion on their bodies

to prevent over stimulating the heart. The limitations caused by the failure make

performing even routine tasks more difficult. Some of the activities of daily living

(ADL’s) that this individual might have issues with might be, getting dressed and

undressed, toileting, personal hygiene, bathing and eating. Some Instrumental

activities of daily living (IADL’s) that might be affected could include preparing

meals, taking medications, shopping (food or clothes), using the phone, house

work, managing money and bills. As an Occupational Therapist (OT), One can

educate patient/individual on the importance of reduced fluids and stress will

make for a better heart and a healthier individual. The individual needs to learn

that sucking or chewing on an ice cube is better than drinking a glass of water.

Due to the increasing amount of fluids the medications are trying to get out of the

body, drinking would be just adding more to the body and also adding more

stress on the body. The roles/routines/habits will have to change because of the

congestive heart failure and how the individual now has to take it slower and

easier to get the job done. OT addresses any shortness of breath (SOB) and

fatigue that might accrue during any of their daily living activities, routines, habits

ect. Individuals learn to use adaptive equipment to help decrease the energy

used to get the job done. Examples would consist of using a shower instead of a

tub (if applicable), have grab bars inside and outside the shower, have a bath

bench/chair with a hand-held shower head and a long handled sponge for easier

bathing. Less bending over for easier dressing/undressing by using open front

garments with buttons/snaps, using a button hook if need be; use a dressing

stick to put on lower extremities (LE) garments. Use a lighter comforter for less

weight; use a step stool to reach things to reduce straining. Keep the house

cooler and if the patient/individual is SOB outside have a portable pocket hand

held fan/fan with mister. To reduce strain and stress have a garbage can with

wheels would be very useful. One more example might be to have a recliner to

keep legs up as well as change positions frequently for circulation. OT’s also

teach how to break down the tasks into small components to make the task at

hand more manageable. For instance laundry is a big task for anyone, so instead

of doing all the laundry in one day, do smaller loads spread out or one load a

day. Pull the laundry out of the drier and hang it up as soon as laundry is done to

save the wrinkles and then having to iron in addition too. Use lighter pots and

pans to cook with. Having the appliances at arm’s length, waist level, within easy

to reach to help with saving body energy. OT’s do whatever it takes to get the

individual back to independently living a healthier life to the best of their ability.

Congestive heart failure is a condition that needs to be specifically addressed and treated. The condition can be managed by complying with lifestyle changes, following a treatment plan, and taking prescribed medications. Without following a treatment plan the disease will consume the organs of the body causing irreversible damage. It is important to be aware of limitations concerning the disease to avoid over exertion which can be fatal. “Early intervention in the treatment of Congestive heart failure is crucial in providing the best outcome.” (Ciccone, 2007).
References

American Heart Association. (2010). Congestive heart failure. Retrieved on June 15,

2010 from http://americanheart.org/presenter.jhtml?identifier=4585

Anderson, R., Joy, S., Carkido, A., Anthony, S., Smyntek, D., Stewart, D. . . . Butler, E.T.

(2010 January-February). Development of a Congestive Heart Failure

Protocol in a Rehabilitation Setting. Rehabilitation Nursing 35 (1) pp. 3-7,30.

Retrieved on June 15, 2010 fromhttp://www.rehabnurse.org/pdf/rnj313.pdf

Ciccone, C. (2007). Treatment of Congestive Heart Failure. Pharmacology in

Rehabilitation. New York. FA Davis.

Health-cares. (2005). Congestive heart failure. Retrieved on June 15, 2010 from

http://heart-disease.health-cares.net/congestive-heart-failure-

prevention.php

MedlinePlus. (2010). Coronary Artery Disease. Retrieved on June 15, 2010 from

http://www.nlm.nih.gov/medlineplus/coronaryarterydisease.html

Mithal, M., Mann, W. & Stone, J. (2001). Functional Limitation and Disability

Associated with Congestive Heart Failure. Physical & Occupational Therapy in

Geriatrics. 18 (3) p. 45-56. Retrieved June 15, 2010 from

References: American Heart Association. (2010). Congestive heart failure. Retrieved on June 15, 2010 from http://americanheart.org/presenter.jhtml?identifier=4585 (2010 January-February). Development of a Congestive Heart Failure Protocol in a Rehabilitation Setting Retrieved on June 15, 2010 fromhttp://www.rehabnurse.org/pdf/rnj313.pdf Ciccone, C Health-cares. (2005). Congestive heart failure. Retrieved on June 15, 2010 from http://heart-disease.health-cares.net/congestive-heart-failure-