Natalia Zander posted Nov 11, 2020 7:35 PM
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Heart failure occurs when the heart fails to properly pump blood to the body causing reduction in the efficiency of the heart muscles (Heinzel et al., 2015). This mostly occurs due to damage in the heart muscles. Common causes include hypertension and myocardial ischemia.
Symptoms of heart failure vary from person to person. Common symptoms are: dyspnea or shortness of breath, increased heartbeat, and tiredness or fatigue (Heinzel et al., 2015).
Symptoms and pathophysiology principles
Shortness of breath occurs when the heart muscles become less efficient to pump blood to the body. The blood backs up and fluid accumulates in the lungs which reduces oxygen movement resulting in dyspnea.
Heart failure causes low cardiac output; therefore, the heart compensates by increasing heart beat to pump blood in and out of the heart (Bozkurt & Khalaf, 2017).
Fatigue occurs in heart failure patients due to decrease in tissue and organ perfusion which is caused by low cardiac output (Bozkurt & Khalaf, 2017).
Hypertrophy in heart failure
Hypertrophy of the heart is the hardening and thickening of the heart wall. The most common cause is high blood pressure. It occurs due to chronic and increased stress on the heart. Persistent increase in the workload of the heart results in thickening and hardening of the heart muscles, the heart muscles loses its elasticity which causes the heart to fail pumping blood effectively to the body (Bozkurt & Khalaf, 2017).
This patient might have the underlying ischemic disease that caused heart failure. The most common causes of heart failure are coronary artery disease and hypertension (Dlugasch & Story, 2021). Ischemic heart disease (coronary artery disease and myocardial infarctions) causes the cardiac remodeling manifesting as an advanced alteration in the heart’s form and size contributing to poor prognosis at patients with heart failure (Center for Disease Control and Prevention, 2020).
According to Dlugasch and Story (2021), Virchow triad is the combination of three causes of thrombus formation. Those are endothelial injury, sluggish blood flow, and increased coagulopathy (Dlugasch & Story, 2021). An injured vessel wall attracts platelets and inflammatory mediators resulting in the clot formation (Dlugasch & Story, 2021). The clot with the slow blood flow adheres to the vessel wall while coagulopathy contributes to inappropriate clot formation (Dlugasch & Story, 2021). Virchow triad may result in embolus formation and, as consequence, in pulmonary embolism, ischemic stroke or transient ischemic attack.
Bozkurt, B. & Khalaf, S. (2017). Heart failure in women. Methodist DeBakey Cardiovascular Journal, 13(4), 216–223. https://doi.org/10.14797/mdcj-13-4-216
Center for Disease Control and Prevention. (2020, September 8). Heart failure. https://www.cdc.gov/heartdisease/heart_failure.htm
Dlugasch, L. & Story, L. (2021). Applied pathophysiology for the advanced practice nurse. Jones & Bartlett, MA.
Heinzel, F. R., Hohendanner, F., Jin, G., Sedej, S., & Edelmann, F. (2015). Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. Journal of Applied Physiology, 119(10), 1233–1242. https://doi.org/10.1152/japplphysiol.00374.2015
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