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Running head: Congestive Heart Failure

Jonathan Bland
Pathophysiology
March 4, 2011
Congestive Heart Failure
Prof. McGowan

Congestive Heart Failure

The patient, Dr. Ally, was diagnosed with hypertension twelve years ago and was on
antihypertensive drugs. However, within the last year he has not taken any medication because
he was feeling fine and was also busy with his work. Nevertheless, he still felt tired after work
and developed dyspnea while climbing the stairs. Recently, he had a bout of epistaxis (severe
nose bleed) with dizziness and blurred vision. He went to his doctor for a follow-up. His blood
pressure was 180/110 and the doctor found rales or crackles on his chest upon auscultation.
The doctor ordered rest and asked him to start his medication again.
The patients problems start with when he stopped taking his medication for high blood
pressure. The medication that was prescribed was designed to allow his heart perform better
with less stress on it, BP medications very from dilating arteries to lowering the plaque levels.
The next problem the patient has dizziness and blurred vision. These two items can be related
from the higher blood pressures. The nose bleed is a way the body relieves pressure within the
body. The rales and crackles in his chest are from left side congestive heart failure, where fluid
has built up and it pushes fluid back to the lungs. The pathophysiological changes that are
happening in his eyes and heart could be the built up pressure from his arteries and veins.
What the patient is suffering from is left sided congestive heart failure. The evidence is
the fluid buildup in his lungs. When the left side of the heart starts to fail, fluid collects in the
lungs (pulmonary edema). This extra fluid in the lungs (congestion) makes it more difficult for
the airways to expand as you inhale. Breathing becomes more difficult, and you may feel short
of breath, particularly with activity or lying down. When the right side of the heart starts to fail,
fluid collects in the feet and lower legs. As the heart failure becomes worse, the upper legs
swell and eventually the abdomen collects fluid (ascites). (Kulick, 2010)

Congestive Heart Failure

Medications that will be used to treat this patient start with Lasix or another form of
water removing medication. Lasix is a medication used to get rid of the extra fluid buildup
within his lungs. The medication is hard on the kidneys because it helps remove the excess salt
and accompanying water from the bloodstream, thereby reducing the amount of blood volume
in circulation. With a lower volume of blood, your heart does not have to work so hard. The
number of red and white blood cells is not changed. The end result is an improvement of the
ability to breathe (clear out water in the lungs) and a lessening of the swelling in the lower
body. (Kulick, 2010). Inotropes are stimulants that increase the pumping ability of the heart.
Digoxin drug improves the pumping ability of the heart, causing it to pump more forcefully, a
so-called positive inotrope. However, digoxin is a very weak inotrope and is now only an add-on
therapy to ACE inhibitors and beta-blockers. (Kulick, 2010) The doctor can give vasodilators
which enlarge the small arteries or arterioles to help relieve the systolic workload of the left
ventricle thereby lowering the blood pressure. Calcium channel blockers are useful in lowering
blood pressure. Nitrates can be given orally, IV, or paste in efforts to lower your pressure by
dilating your blood vessels. Beta blockers slow the heart the down.
Congestive Heart Failure (CHF) is a terrible diagnosis for a patient. Although there are so
many drugs on the market that help control it a patient can live a long and healthy life. There is
no cure for CHF only treatments.

Congestive Heart Failure

Works Cited
Gould, B. E. (2006). Pathophysiology for the Health Professionals, 3rd Edition. Philadelphia:
W.B. Sauders.
Kulick, D. M. (2010). Congestive Heart Failure. Retrieved March 3, 2011, from
MedicineNet.com: http://www.medicinenet.com/congestive_heart_failure/article.htm