Heart Failure Literature Review

Heart failure (HF) is a progressive disease which affects more than five million Americans (Yancy et al., 2013). HF negatively impacts quality of life and it is associated with frequent hospitalizations and high mortality. Evidence-based practice guidelines aid health care professionals with treatment management and provide pathways to optimize individual patient care. The main goal of treatment is to slow the progression of the disease and control its symptoms. These pathways address all stages of the disease beginning with the early recognition of patients at risk and ending with the need for end-of-life care.
Pathophysiology
Heart failure (HF) is a condition in which the heart is not able to sustain sufficient cardiac output to perfuse the
Congruency existed regarding the importance of proper management of patients who are at risk of developing HF such as patients with HTN, diabetes, dyslipidemia, arrhythmias, valvular disorders, renal disease, and patients with previous myocardial infractions (MI) (Yancy et al., 2013). Early recognition and proper management of underlying diseases can prevent or delay remodeling of the cardiac muscle and progression of HF. A diagnosis is made based on a patients’ symptoms and testing. Laboratory studies should include a complete blood count, chemistry, troponin, thyroid function, lipid profile, and B-type natriuretic peptide (BNP) (or N-terminal pro B-type natriuretic peptide) (Kransdorf & Kittleson, 2012). Other tests include a chest x-ray (to determine the size of the heart and pulmonary congestion), 12-lead electrocardiogram (to assess conductivity and arrhythmias), and a 2-dementional echocardiogram (to obtain information about the heart’s structure and function, including EF). Yancy et al. (2013) stated that in some cases, magnetic resonance imaging can provide a more precise determination of the EF; invasive evaluation such as monitoring with pulmonary artery catheter and endomyocardial biopsy should not be routinely
Many patients can benefit from referrals for home telemonitoring and outpatient HF clinic (Manning, Wendler, & Baur, 2010). This aids not only with management of HF, but it also provides patients with an additional support system. Conway (2015) states that changes in behavior and proper self-care are crucial, and involvement of a patient’s family in the teaching process can result in increased adherence. Education should include information regarding the diagnosis, progression of the disease, prognosis, treatments, and monitoring symptoms such as weight, edema, and dyspnea. Teaching about life modifications such as smoking cessation, use of alcohol, proper diet (limitation in sodium intake), and possible fluid restrictions is important. Preventive measures, such as immunizations, are recommended for HF patients. Patients with mild to moderate HF should exercise regularly and proper cardiac rehabilitation resulted in 11% decreased of mortality rate (Conway, 2015). A decrease in the quality of life associated with the progression of HF increases the risk of depression and early recognition of depression and social support is