The heart is a delicate muscle in the human body, and it is tasked with maintaining the circulation of oxygenated blood around the body and de-oxygenated blood from the body to the lungs. It is with this continuous cycle that the body’s organs get rid of carbon dioxide while simultaneously getting oxygen. Like every other organ in the body, the heart also experiences life threatening problems and this is a paper that discusses congestive heart failure from myocardial infarctions, their signs and symptoms, treatment and prevention measures to be taken to minimize them.
The heart is comprised of four parts, with the right auricle and ventricle both receiving de-oxygenated blood from the body and pumping it to the lungs to be re-oxygenated (pulmonary circulation), and the left auricle and ventricle receives oxygenated blood from the lungs and pumps it to the rest of the body (systemic circulation). The heart also requires its supply of oxygen and nutrients like every other organ. It has three coronary arteries, with two that deliver oxygenated blood to the heart muscle (Better Health, 2016).
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The pumping effect of the heart is due to the contraction of electrically connected cells, which make up the cardiac or myocardium muscle-the heart muscle. How do these cells contract? Each cell has a calcium concentration which rise to cause a spontaneous depolarization. Because each cell is connected to the other, the series of depolarization and contractions creates a wave commonly known as a heartbeat. The sinoatrial node in the right atrium has a group of cells that control the rhythm of these contractions and depolarizations, called the pacemaker cells. The pacemakers control the heart rate with rhythmic systoles(squeezing) and diastoles (relaxation of the ventricles to let them fill with blood). (University of Leicester, 2017).
Sometimes the heart is not able to pump blood to the rest of the human body as it normally would. This comes about because the heart muscle could be weaker due to a problem or disease that prevents normal circulation. The heart ventricles may involuntarily stretch in order to hold more blood to pump through the body, or they could stiffen. With these adjustments to the heart, blood flow will continue but the heart muscles will grow weaker due to the increasing pressure and stop pumping efficiently. In turn, the kidneys begin fluid retention, and if this fluid builds up in the arms, ankles and other organs, the body will get congested and henceforth the condition is defined as congestive heart failure. Heart failure never means the heart has stopped working, only that it’s slower. People with obesity, over 65 years old and mostly African Americans are usually affected by congestive heart failure (American Heart Association, 2017).
What are the causes of congestive heart failure? This condition occurs when a person survives either or all of these diseases. One is Coronary Artery Disease (CAD), which affects arteries, mostly whose primary function is to supply blood to the heart; and these arteries could become narrower and block sufficient oxygen and nutrients from getting to the heart. Another disease is Cardiomyopathy, damage to the heart through external infections from daily habits such as smoking and alcohol abuse. Various conditions that cause the heart to do more work than it should like kidney disease, diabetes, valve disease and thyroid disease or heart defects present at birth bring congestive heart failure. Congestive heart failure is one of the effects when patients survive a myocardial infarction, popularly referred to as a heart attack. (Johns Hopkins Medicine, 2017). A myocardial infarction occurs when part of the coronary artery that provides oxygen to the heart is blocked, starving a section of oxygen. This particular state is known as cardiac ischemia. When cardiac ischemia persists, it causes death of the heart tissue deprived by oxygen.
Looking at the perspective of a person having subsequent congestive heart failure from the after-effects of myocardial infarction, what are the signs that a person is getting a heart attack? According to the American Heart Association, majority of myocardial infarctions start with chest pains. Chest pains may begin after repeated episodes of angina-a form of ischemia where blood flow is restricted and restored periodically, not damaging the heart fully. In the case of cardiac ischemia itself, symptoms include dizziness, nausea and shortness of breath. Life threatening complications suffered in the hospital are usually strokes, blood clotting in the heart, bulging of one chamber, and irregular heartbeats. (Better Health, 2016).
In the case of congestive heart failure in the aftermath of a myocardial infarction, the symptoms include dry coughs and wheezing when resting due to lung congestion. A swollen abdomen, ankles, weight gain caused by water retention by blood-deprived kidneys. Tiredness, fatigue and general weakness caused by less blood flow to major organs, and irregular heartbeats. Heart failure occurs in these two ways, systolic dysfunction; where the heart does not contract fully and thus, less blood with oxygen is pumped throughout the body, and diastolic dysfunction, where the ventricles stiffen instead of relaxing fully to let blood in, albeit the heart contracts in a normal way. (Johns Hopkins Medicine, 2017).
Prior to tests to determine causes and extent of damage, medical professionals always query about pre-existing conditions that caused the heart attack, such as angina. Behavioral factors such as smoking, drinking, drugs taken and dieting are taken into account (American Heart Organization, 2017). A blood test is then commissioned to check cholesterol levels, kidney function, thyroid gland function and if the patient is anemic. A B-type Natriuretic Peptide (BNP) blood level test is taken. BNP is secreted by the heart during blood pressure changes, and BNP levels in patients with heart failure is usually higher than in people with normal heart function. A chest x-ray is done to show the current size of the patient’s heart, and to check for fluid buildup around it and the lungs. Echocardiogram and electrocardiogram tests record the heart’s structure, movement and electrical impulses cascading through. The Ejection Fraction(EF) is used to determine the type of dysfunction, whether systolic or diastolic. (Johns Hopkins Medicine, 2017).
How is congestive heart failure treated? Heart failure cannot be treated in such a way that the heart reverts to normal. Treatment is aimed at relieving symptoms and reducing further damage. The first aspect is advice on lifestyle changes, where a patient is advised to avoid salt and caffeine (caffeine is known to enhance heartbeat irregularities). Fluid intake is also closely monitored. According to John Hopkins Medicine, medications usually prescribed are Diuretics to correct fluid retention, Vasodilators to expand the blood vessels for easier blood flow, Aldosterone Inhibitors to assist in fluid retention, ACE inhibitors and ARB Drugs to enhance heart function, Digitalis glycosides for stronger contractions in case it’s a systolic dysfunction, Anti-coagulants such as aspirin to prevent clotting of blood and tranquilizers to reduce anxiety.
Surgical procedures to bypass arteries that may be blocked or to replace valves in the heart are also used in severe cases. Biventricular Pacing Therapy is a kind of pacemaker put in some congested heart failure patients that helps both the right and the left sides of the heart work nearly as much as a normal heart should. A cardioverter defibrillator that can be implanted usually electrifies the heart to convert a likely life-threatening fast heartbeat into normal. Ventricular Assist Devices(VAD) is a bridge used for treatment and stabilization before a heart transplant, which is regarded as the last resort.
Congestive heart failure can be avoided at the very beginning by not engaging in certain habits like smoking and avoiding second-hand smoke, which can cause damage in the arteries. Eating healthy foods low on cholesterol, sugar and sodium keeps the heart working normally. Vegetables such as spinach and cucumber, fruits, milk low in fat and lean protein found in chicken and fish should be consumed. Obese people should focus on physical exercise to bring down their weight because they are at a very high risk of cardiovascular disease. People with pre-existing heart conditions should adhere to their treatment programs. Statin therapy, which controls cholesterol intake helps those with heart defects reduce likelihood of myocardial infarction. (Johns Hopkins Medicine, 2017).
In conclusion, this research underlines the fact that myocardial infarctions and subsequent congestive heart failure are serious conditions whose symptoms can be relieved by treatment and most importantly, human beings are responsible for cutting them off at the source by having healthy diets and being physically active.
References
American Heart Organization (2017); Congestive Heart Failure and Congenital Defects , Retrieved from http://www.heart.org/HEARTORG/conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Congestive-Heart-Failure-and-Congenital-Defects_UCM_307111_Article.jsp#mainContent
Better Health Channel (2016); Congestive Heart Failure (CHF) , Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/congestive-heart-failure-chf
Johns Hopkins Medicine (2017); Congestive Heart Failure: Prevention, Treatment and Research , Retrieved from http://www.hopkinsmedicine.org/health/healthy_heart/diseases_and_conditions/congestive-heart-failure-prevention-treatment-and-research
University of Leicester (n.d); Cardiovascular System Anatomy and Physiology , Retrieved from https://www.le.ac.uk/pa/teach/va/anatomy/case1/1_1.html
