Heart Failure Assignment Discussion

Define heart failure as it relates to cardiac output and tissue perfusion. Utilizing evidence-based research, briefly describe two different types of heart failure and explain how they can work together or alone in an individual.

Heart Failure and How It Relates to Cardiac Output and Tissue Perfusion

Heart failure is a condition that results from the inability of the heart to pump enough blood to meet metabolic demands by the body, which causes low tissue perfusion (Groenewegen et al., 2020). When the heart does not pump effectively, there is diminished cardiac output, the blood volume ejected from the heart per minute. With reduced cardiac output, blood reaching tissues and organs is less oxygenated, causing symptoms like dyspnea, fatigue, and fluid retention (Groenewegen et al., 2020)Heart Failure Assignment Discussion. The determinants of cardiac output are the heart rate and stroke volume, the blood ejected per heart rate. When either of these is altered, there is tissue perfusion disruption, and compensatory mechanism cascades like vasoconstriction, increased heart rate, and fluid retention occur, worsening this condition.

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Types of Heart Failure

The primary types of heart failure are Heart Failure with Preserved Ejection Fraction (HFpEF) and Heart Failure with Reduced Ejection Fraction (HFrEF). (HFpEF) or diastolic heart failure is common in women and older patients. Passive ventricular compliance and active ventricular relaxation abnormalities result in this condition (Hamo et al., 2024). This causes a reduction in stroke volume and, as a result, cardiac output reduction. This type of heart failure is suspected in individuals presenting with weakness, orthopnea, dyspnea, fatigue, edema, and paroxysmal nocturnal dyspnea signs as well as the distended jugular vein, displaced apical pulse and S3 heart sound signs of chronic heart failure (Hamo et al., 2024). The confirmatory diagnosis is echocardiography, which shows a normal ejection fraction but impaired diastolic function (Hamo et al., 2024)Heart Failure Assignment Discussion.

In (HFrEF), it results from the inability of the left ventricle to pump out sufficient blood. The left ventricle does not contract effectively in systole, pumping less blood than the body requires. The left ventricle’s normal ejection is 55%, equivalent to blood pumped out with each heartbeat (Butler et al., 2019). When the fraction of ejection is below 40%, one is diagnosed with this type of heart failure. It is caused by cardiomyopathy that weakens heart muscles, coronary artery disease, high blood pressure, diabetes, viral myocarditis, diabetes, aortic stenosis, and arrhythmias (Butler et al., 2019).

The Conditions Interaction

HFpEF and HFrEF can work together and result in combined heart failure or can work independently. A heart weakens in HFrEF, and this mechanism results in HFpEF. Therefore, with this combination, the ability of the heart to pump and fill the blood is altered and could degrade the functioning of the heart.

References

Butler, J., Anker, S. D., & Packer, M. (2019). Redefining heart failure with a reduced ejection fraction. Jama, 322(18), 1761-1762. doi:10.1001/jama.2019.15600

Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart failure. European journal of heart failure, 22(8), 1342-1356. https://doi.org/10.1002/ejhf.1858 https://doi.org/10.1002/ejhf.1858 Heart Failure Assignment Discussion

Hamo, C. E., DeJong, C., Hartshorne-Evans, N., Lund, L. H., Shah, S. J., Solomon, S., & Lam, C. S. (2024). Heart failure with preserved ejection fraction. Nature Reviews Disease Primers, 10(1), 55. https://doi.org/10.1038/s41572-024-00540-y Heart Failure Assignment Discussion