The patient presents with shortness of breath, abdominal swelling, peripheral edema, and weight gain due to the underlying condition of congestive heart failure (CHF). CHF is a medical condition describing the heart's inability to efficiently pump blood due to weak or stiff cardiac muscles (Altan, Kutlu & Allahverdi, 2016). Weak muscles reduce the heart's power to pump blood from the heart to other parts of the body; a condition referred to as diastolic heart failure or diminished ejection fraction. Stiff muscles cause systolic heart failure. As a result, there is difficulty in filling with blood. These two conditions make the heart to be congested or backed up. The congestion initiates an interaction between the cardiovascular system and the pulmonary system to produce signs and symptoms that depict CHF.
Shortness of breath manifests out the body's compensatory actions for pumping CHF insufficiencies (Friedewald, 2016). Through its pacesetter, the heart will beat faster than the average pace to reduce the time it takes to refill upon contraction to meet the body's nutrient demand in time. However, less blood is available for circulation because it failed to fill enough to pump. The extra effort causes heart palpitations as the heart enlarges to accommodate extra blood. In the process, the pulmonary system's lungs fill with fluid impairing normal breath, hence, shortness of breath. Often, CHF patients will stack up pillows when sleeping to help ease breathing discomfort that occurs if they lie flat. Also, the pressure resulting from this fluid build-up causes abdominal swelling and chest pain. The abdominal swelling may result in fluid accumulation in the liver-hepatomegaly, which makes the patient feel bloated, nauseous, abdominal pains, and distension.
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Insufficient blood circulation interrupts the kidneys' physiology as they retain water and sodium (Friedewald, 2016). Heart failure elicits a series of humoral and neurohumoral activities that promote water reabsorption, sodium retention by the kidneys, and expansion of the extracellular fluid. In conjunction with these mechanisms, the starling forces such as improved venous capillary pressure lead to peripheral edema. The condition can be rectified through diuretic therapy, taking more water. The treatment enhances the elimination of water from the body, preventing the retention of sodium. Therefore, the patient should adhere to the diuretic therapy program to alleviate peripheral edema.
Weight gain for CHF patients is accelerated through reduced activity resulting from fatigue. Reduced activity reduces the burning of calories, whose accumulation leads to obesity (Pandey et al., 2017). Exercise therapy is essential to ensure that body utilizes the food available for energy. Improved body metabolism is also vital for the improved physiology of body systems in totality. The imbalance between calory intake and metabolism resulting from fatigue from the heart conditions increases the body mass index (BMI) of the patient.
Notably, CHF has its risk factors among them are the ethnicity or racial related. Durstenfeld et al. (2016) note that African Americans and Hispanic populations have higher incidences of the disease than whites. Additionally, their hospital stays as well as readmissions for CHF were high. The prevalence of CHF among African Americans is attributed to the high prevalence of hypertension and diabetes mellitus compounded by socioeconomic status. Diabetes mellitus and high blood pressure are risk factors for CHF since they interfere with the blood circulatory system. Low socioeconomic status prevents African Americans from getting proper medical care to treat the predisposing diseases of CHF. Apart from limited access to quality care, they have limited access to knowledge about these diseases, preventing early diagnosis, and its prevention strategies. As a result, the conditions such as hypertension become challenging to manage and increase CHF chances.
References
Altan, G., Kutlu, Y., & Allahverdi, N. (2016). A new approach to early diagnosis of congestive heart failure disease by using Hilbert–Huang transform. Computer methods and programs in biomedicine , 137 , 23-34.
Durstenfeld, M. S., Ogedegbe, O., Katz, S. D., Park, H., & Blecker, S. (2016). Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system. JACC: Heart Failure , 4 (11), 885-893.
Friedewald, V. E. (2016). Heart Failure (CHF/Congestive Heart Failure). In Clinical Guide to Cardiovascular Disease (pp. 673-731). Springer, London.
Pandey, A., LaMonte, M., Klein, L., Ayers, C., Psaty, B. M., Eaton, C. B., ... & Berry, J. D. (2017). Relationship between physical activity, body mass index, and risk of heart failure. Journal of the American College of Cardiology , 69 (9), 1129-1142.
