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Heart Failure vs COPD

Joshua LaGraff 5/23/2012

Heart Failure and COPD are two diseases that can be misunderstood and can seem very similar.

Joshua LaGraff

Heart Failure VS COPD

Heart failure and chronic obstructive pulmonary disease are diseases that cannot be overlooked in the field of ems. Each disease has its own significant signs and symptoms but the two can easily be interpreted as the other. Simple listening to such problems sometimes cannot lead the provider with enough information which in turn leads to electrical help as well as respiratory testing. When trying to determine between the two careful consideration and direct diagnosis is necessary. As an ems provider distinguishing the between the two diseases together or separate could mean life or death depending on how the patient is treated. When looking at heart failure the definition can cause someone to think that the heart is actually dead. It is actually a condition that the heart is not pumping the blood of the body in the proper amounts for the body to sustain life. This improper pumping can cause congestion or fluid buildup in the heart which is one reason COPD can be mistaken. (Nordqvist, 2009 ) Patients that have been diagnosed with heart failure can show a variant of signs and symptoms. The first being fatigue or tiredness. This is due to the demand of the body and the body not receiving the amount of nutrients or blood that is needed. The body shunts blood from accessory areas and pushes the blood that it is able to push out to the main organs of the brain and the heart. Heart failure can also be side specific as to what signs and symptoms you can visualize. If you have heart failure on the left side of the body you can expect to see a patient exhibiting a cough (sometimes with a frothy spit) and a patient with dyspnea. A patient will exhibit dyspnea more often when they are lying down or causing their body to go through more than the daily amount of stress such as working out or being more active than usual. These occur due to the blood in the heart backing up into the pulmonary veins and then leaking in the lungs from the backup. When accessing heart failure on the right side of the body you will generally see fluid retention in different parts of the body such as legs and ankles due to gravity. You will

Joshua LaGraff

Heart Failure VS COPD

also see such things as an enlarged stomach. This is due to the blood in the body backing up into the veins of the body causing fluid retention in which the kidneys cannot dispose of the water and sodium the proper way. (Nordqvist, 2009 ) If you suspect heart failure on both sides of the body it will almost seem like the patient has a typical sickness such as the flu or a virus. The patient will experience nausea along with loss of appetite. Constipation will usually occur from those. The patient could also show signs of confusion due to the levels of electrolytes and other substances in the blood changing. (Michael M. Chen, 2011) Chronic obstructive pulmonary disease also called COPD is considered a group of diseases affecting the lungs. Chronic asthmatic bronchitis and emphysema are the two diseases that make up COPD. These diseases block airflow as your exhale making it extremely difficult for the patient to breathe. These diseases interfere with oxygen and carbon dioxide exchange. COPD is generally caused by patients who have smoked for an extremely long time causing damage to the lung walls and tissue which cannot be reversed. (Staff, 2011) Patients who think they might have COPD can usually have it confirmed with lab testing, history and physical examination. The patient will have a spirometry test done which shows how much expelled volume of air is released. Signs and symptoms for COPD usually but are not limited to cough, dyspnea, and increased mucous production. Wheezing can occur on patients over the long term along with your normal signs and symptoms of respiratory distress. These signs and symptoms include wheezing, longer than normal expiration and in some instances where the patient has gotten so bad with the COPD they will start right sided heart failure. Treating these two diseases is almost the same in a controlled environment by a doctor. The doctor will want his patient to alter his lifestyle for the better usually by diet and exercise.

Joshua LaGraff

Heart Failure VS COPD

Appropriate weight management will go a long way in how these diseases will affect the patient. Heart failure patients will receive medications usually to help them manage their disease also. The medications will help the heart and blood to pump through the body better so that the body doesnt have to work as hard. The doctor will also be inclined to order a medication to help with fluid retention such as Lasix. When medications do not work for heart failure then surgery would be the next step in trying to control the disease. A patient could have either coronary bypass surgery (CABG), heart valve surgery, or have a defibrillator to assist with the disease from furthering itself. (Nordqvist, 2009 ) With COPD a patient cannot undo the damage done to the lungs. The first treatment a doctor will tell a COPD patient is to discontinue smoking. The next step a doctor will assist is with medications to help ease the respiratory need. The doctor will prescribe bronchodilators and steroids. The bronchodilators will relax the airway and reduce stress on exhalation. The steroid will reduce the inflammation caused by the continuous stress from trying to exhale and produce the airflow exchange. The number one therapy that a doctor will require a COPD patient to do is start oxygen therapy if the disease has gotten to a point where there is not enough oxygen in the blood for adequate perfusion. In the most severe of patients a doctor might be inclined to perform a lung transplant if he/she feels that no other therapy will work. (Zab Mosenifar, 2011) Heart failure can be diagnosed by several different means. Usually their PCP will see symptoms that could be associated with the disease. Heart failure can be found with a normal blood and urinalysis test or an x-ray. It can also be found on an ECG machine which measures the electrical activity in the heart. An echocardiogram might also be used for its ultrasound capabilities to see where and how the heart is pumping or not pumping properly. (Nordqvist, 2009 ) COPD is a disease that can be diagnosed fairly easy by a doctor. Usually a doctor will do

Joshua LaGraff

Heart Failure VS COPD

a breath test to see what the peak expiratory flow is. A person with COPD will have a rate of about 150 to 200 ml of air flow. A patient with CHF will generally blow higher due to them not having an expiratory problem. (Staff, 2011) Prevention of these diseases can be fairly easy if a patient can listen to his doctor and what society tells them. Exercise and eating correctly will diminish the starting factors for these diseases and limit the possibilities.

Joshua LaGraff

Heart Failure VS COPD

Works Cited
Juvelekian, G. (2011). Chronic Obstructive Pulmonary Disease. Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/pulmonary/chronicobstructive-pulmonary-disease/. Michael M. Chen, M. P. (2011, July 22). Heart Failure. Retrieved from http://health.nytimes.com/health/guides/disease/heart-failure/overview.html. Nordqvist, C. (2009 , July 9). What is Heart Failure? What Causes Heart Failure. Retrieved from http://www.medicalnewstoday.com/articles/156849.php. Staff, M. C. (2011, March 11). COPD. Retrieved from http://www.mayoclinic.com/health/copd/DS00916. Zab Mosenifar, M. (2011, October 10). Chronic Obstructive Pulmonary Disease. Retrieved from http://emedicine.medscape.com/article/297664-overview.