Heart failure (HF) is a clinical syndrome caused by structural and functional defects in myocardium resulting in impairment of ventricular filling or the ejection of blood Inamdar & Inamdar (2016). The common cause for heart failure is reduced left ventricular myocardial function, pericardium, myocardium, endocardium, heart valves or the great vessels of the heart (aorta, pulmonary artery, inferior vena cava, superior vena cava, pulmonary vein, brachiocephalic artery. Other causes are cardiac overload, ischemic heart condition, structural injuries to the heart, predispositions due to uncontrolled hypertension, diabetes, obesity, renal failure etc. Inamdar et al,. (2016).
Heart failure is classified according to variety of factors: The New York Heart Association classified heart failure into four categories based on the symptoms and efforts required to aggravate them, such as:
The other classification was from The American College of Cardiology/American Heart Association (ACC/AHA) heart failure guidelines, heart failure is classified in four:
Heart failure can also be classified according to the left ventricle ejection fraction (EF), and the different between these types are very important in diagnosis and treatments. A normal left ventricular ejection fraction (LVEF) ranges from 55% to 70%. An LVEF of 65%, for example, means that 65% of the total amount of blood in the left ventricle is pumped out with each heartbeat. EF can go up and down, based on one’s heart condition and how well one’s treatment works Cleveland Clinic (n.d.). Ejection fraction (EF) % of 55% to 70% indicates that the heart’s pumping ability is normal and that the patient might have heart failure with preserved ejection fraction HF-pEF).
This patient with EF of 30% per echocardiogram with the above stages of heart failure, it shows that she has severe heart failure with symptoms of orthopnea (sleeps with two pillows), tiredness, shortness of breath walking 2-3 blocks, bilateral edema, creatinine level of 1.1 shows that the renal function has not been affected and as such it is an acute condition and she needs appropriate treatment to halt the progression Hypertension/Heart Failure Discussion Essays.
Patient has evidence of volume overload and is on HCTZ 12.5 daily, thiazides are used at the initial period of heart failure, studies showed that kidneys become less responsive it and it should be changed to loop diuretics such as furosemide and patient’s weight monitored daily. Any weight gain of 2 pounds per day or 5 pounds in one week should be reported cardiologist Hamilton (n.d.). Studies showed that patient with heart failure benefit from Angiotensin-converting enzyme inhibitors (ACEIs) and the therapy reduces left ventricular function ejection fraction of less than 40% Hamilton (n.d.). Patient should benefit changing the verapamil to Lisinopril 20 mg daily to hold if Systolic blood pressure is less than 110mmHg or diastolic blood pressure less than 60 mmHg.
NSAIDs can cause sodium and water retention, as well as reduce formation of the vasodilator prostacyclin in the vessel wall. The risk of increased blood pressure during treatment with NSAIDs has long been known. This side effect seems to be present in all NSAIDs except low dose ASA Varga et al., (2017). As such this patient’s Ibuprofen should be discontinued, and she will bene
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