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Heart Failure

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Heart Failure
Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of care for both individuals, assuming symptoms necessitate treatment. Include realistic lifestyle changes that would be appropriate in your plan of care and evidence-based pharmcotherapy.

About 1 in 3 or 68 million U.S. adults have high blood pressure (CDC, 2012). Of those with hypertension only 50% have it under control. Risk factors associated with this disease are congestive heart failure, heart disease, stroke, and kidney disease (CDC, 2012). The patients at the clinic in this scenario presented with hypertension and two different types of heart failure, systolic and diastolic. The difference between the diseases and treatments used to manage them will be discussed further with particular focus on ACE inhibitors, ARBs, and diuretics.

Heart failure is a condition that occurs when the heart’s ability to pump has become compromised and can no longer properly meet the body’s oxygen demands (Lehne, 2010). This failure in the heart’s ability as a pump may be due to multiple causes and is divided up into two main categories: systolic and diastolic heart failure. Systole and diastole are two different phases of heart contraction. Systole is the portion of the cardiac cycle when the ventricles are contracting;

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