Hello, dear write! Please respond to the student’s discussion post with a personal perspective. Use US-based scholarly resources and not older 5 years
Hello Professor and class,
Differentiate between systolic and diastolic heart failure.
When discussing heart failure, there are two categories for a diagnosis and this includes systolic and diastolic heart failure. The action that differentiates the two diagnoses is that in systolic heart failure the heart is not contracting well during heartbeats, where as in diastolic heart failure the heart is unable to relax between heartbeats (Swedberg, 2021). Systolic heart failure occurs when the left ventricle in the heart is having difficulty and is struggling to contract completely (Swedberg, 2021). Because the heart is unable to fully contract, this delays the body’s ability to pump blood throughout the body which in turn affects the circulatory system of the body (Swedberg, 2021). The progression and degree of systolic heart failure can be measured through an ejection fraction. An ejection fraction is the measurement of how much blood is pumped out of the heart ventricles at a time (Swedberg, 2021). Systolic heart failure will often also be called heart failure with reduced ejection fraction (Swedberg, 2021). the average ejection fraction ranges from 50-70% but if a patient presents with an ejection fraction of 40% or lower, they will often then be diagnosed with systolic heart failure (Trinh, 2022). Symptoms of systolic heart failure are shortness of breath or difficult breathing, chronic fatigue that cannot be relieved with rest, weakness, inability to sleep lying flat, confusion, weight gain, lower leg or stomach swelling, decrease levels of urine, the feeling of being full affecting adequate appetite, and a clear but frothy cough (Swedberg, 2021). In diastolic heart failure the left ventricle of the heart is unable to relax between heartbeats which causes the heart to be unable to fully fill with blood between the next heartbeat (Swedberg, 2021). The symptoms associated with diastolic heart failure can be vey similar to systolic heart failure but an individual might urinate more frequently, have hypertension, or complain of being dizzy (Swedberg, 2021). The testing is crucial to differentiate which heart failure is being experienced as both categories of heart failure have separate complications associated with the heart and body.
State whether the patient is in systolic or diastolic heart failure.
The patient is in systolic heart failure. The symptoms the patient is experiencing can be associated and aligned with both systolic and diastolic heart failure however, there are a couple indications that provide the ability for an appropriate diagnosis of systolic heart failure. It is important to understand the importance of identifying all symptoms as many symptoms in both diagnoses can be very similar. The patient has a 3rd heart sound and the ejection fraction at 25% provide indicators for systolic heart failure. In systolic heart failure a lower ejection fraction below 40% will be seen compared to in diastolic heart failure, the ejection fraction will most likely be within normal limits (Trinh, 2022). The patient has a history of hypertension which is also an indicator of systolic heart failure (Trinh, 2022).
Explain the pathophysiology associated with each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
Dyspnea on exertion explains a persons inability to effectively breathe and their increased level of shortness of breath during movement or exercise (Rosei & Rizzoni, 2019). When a person is experiencing an increase need for their breathe or an inability to perform an exercise or movement, their blood pressure will rise and this leads to an irregular ejection fraction within the heart (Rosei & Rizzoni, 2019). Increased cardiac output is seen as the heart rate increases and this will then lead to the patient having an increase to their shortness of breath. As cardiac output need increases and the mechanism of cardiac output decreases, dyspnea increases, and the patients pulmonary venous pressure will increase (Rosei & Rizzoni, 2019). The circulatory system is then heavily disrupted so as the patient lies down. The intravascular blood flows from the lower legs to the lungs causing increased discomfort and shortness of breath, which explains the symptoms of the patient needing to sit upright (Rosei & Rizzoni, 2019). The symptom of pitting edema is seen because of the kidneys working in overdrive to enhance salt and water reabsorption as well as developing extracellular tissue expansion (Rosei & Rizzoni, 2019). In systolic heart failure there is an increased blood volume in the vena cava and systemic veins which creates the symptom and assessment of jugular vein distention (Rosei & Rizzoni, 2019). In systolic heart failure blood accumulates in the lungs because of the malfunctioning left ventricle, which all creates the right ventricle to work a lot harder than it is intended to do (Rosei & Rizzoni, 2019). Orthopnea is associated in patients when they attempt to lie flat. Orthopnea is the result of the circulatory system being compromised and incapable of adequately pumping the blood throughout the body effectively and this causes an increase to the pulmonary veins and capillaries (Rosei & Rizzoni, 2019). This results in the severe shortness of breath that can only be relieved, though may not fully, by sitting up or standing (Rosei & Rizzoni, 2019).
Explain the significance of the presence of a 3rd heart sound and ejection fraction of 25%.
The significance of the 3rd heart sound and ejection fraction is that they are the identifying factors associated with diagnosing the patient with systolic heart failure. The 3rd heart sound is identified as a low-frequency, brief vibration that occurs in early diastole at the end of the rapid diastolic filling period of the right or left ventricle (Shono et. al., 2019). The 3rd heart sound is directly related to ventricular malfunction and indicates there is volume overload present (Shono et. al., 2019). The 3rd heart sound is associated with lower ejection fraction because the left ventricle is malfunction, mitral regurgitation, and inadequate diastolic filling (Shono et. al., 2019). This patient exhibits an ejection fraction of 25%. This is a measurement of how much blood is being pumped out of the left ventricle and the hearts ability to deliver the oxygen rich blood to circulate throughout the body (Swedberg, 2021). This patients left ventricle is not functioning properly causing blood to back up and develop dilated ventricles which presents the S3 sound within the heart (Shono et. al., 2019). The patients heart is causing the body to not receive the adequate oxygenated blood it needs to function properly. the 3rd heart sound and the low ejection fraction are significant to this case study because it allows the provider to understand the significance and level of the dysfunction left ventricle within the heart.
