Pharmacology

Introduction

The term heart failure appears numerously in medical contexts and in the practice of healthcare. The real meaning of the term heart failure is often confused as many people consider it to be a complete failure of the heart when it is no longer functioning. Contrary to such understanding, the actual implication is that the heart is still functioning but abnormally. The role of the heart is paramount because it is in control of the body cells’ supplying with nutrients and oxygen-rich blood. This helps to maintain the functioning of the body processes. When a heart failure occurs, the supply of nutrients and oxygen to the body cells is affected. Consequently, the overall body performance is also affected. The cells receive insufficient amounts of nutrients and oxygen, and it leads to fatigue and shortness of breath (Tripathi, 2013). Additionally, the victim of heart failure faces difficulties performing daily activities such as walking, doing household chores, climbing stairs, or, for instance, cycling. Heart failure is a serious condition with no cure. However, many people who have fallen its victims may live a full, normal, and happy lives when the condition is well managed through appropriate medications and adopting healthy lifestyles.

Differences between Systolic and Diastolic Heart Failures

There are two types of heart failure, namely systolic and diastolic. Before differentiating these types of heart failure, we should look at the structure of the human heart. It has two main pumping chambers, namely right and left ventricles. The right ventricle forces blood from the heart to the lungs (Mandal, 2014). At the lungs, the blood is enriched with oxygen before flowing to the left ventricle. The left ventricle is more muscular than the right one, which is because it has a tasking role of pumping blood to the entire body system (American Heart Association, 2014). When the functionality of one or both ventricles declines so that they don’t squeeze as they are supposed to, different symptoms may arise with the common right ventricle systolic failure or left ventricle diastolic failure (Tripathi, 2013).

To start with, we discuss the diastolic heart failure. This is an abnormality in how the heart fills with blood during diastole. The dysfunction arises when left ventricle’s muscles of the heart are unable to relax in a normal manner because of its thickness and stiffness. This means that the rate at which the heart fills with blood is too slow and abnormal (Mandal, 2014). Basically, blood flows from the lungs to the left ventricle through the pulmonary vein in diastole. When the ventricle’s muscles of the heart fail to relax, the ventricle does not fill normally. This forces the blood to flow backward to the lungs leading to diastolic heart failure.

The systolic heart failure is opposite to the one described above. This occurs during the systole of the cardiac cycle whereby the right ventricle is unable to pump blood as required. This condition arises because the heart is enlarged and therefore weak. The right ventricle is unable to properly pump the blood out of the heart to the lungs (American Heart Association, 2014). This condition leads to low ejection volumes and subsequent accumulation of fluids in lungs.

The Action of ACEIs and ARBs and Their Effects on Mortality Rates in Heart Failure

Medications, surgery, and medical devices as well as lifestyle changes are among the recognized treatments for severe heart failures. Medications are the most effective treatment of heart failure with the common medicines being ACE inhibitors and ARBs. ACE inhibitor is an acronym for angiotensin-converting-enzyme inhibitor. Examples of ACE inhibitors include lisinopril, benazepril, and enalapril (Tripathi, 2013). Conversely, the notion of ARBs stands for angiotensin receptor blockers. Examples of ARBs are losartan, valsartan, and irbesartan.

Both ACEI and ARB have different functions and roles when used as medications. Firstly, the ACEIs stop conversion of angiotensin I to angiotensin II. The latter is a vasoconstrictor and therefore leads to increased blood pressure (The GoodRx Pharmacist, 2014). When the ACEIs cease to be effective, the blood vessels relax, blood pressure consequently decreases, and condition is corrected.

In contrast, the ARBs have different purposes. They also affect the angiotensin. The ARBs block angiotensin II from binding to the special area on blood vessels called the receptors. This medicine is effective as it causes blood vessels to relax, thus leading to a decline in blood pressure. ACEIs and ARBs are effective in lowering the morbidity rates by reducing hypertension, which is a common phenomenon with lethal end. The ACEIs and ARBs help to restore the size of blood vessels and therefore restoring the blood pressure (The GoodRx Pharmacist, 2014). This helps the patients to live long and normal lives as well as improves the quality of life even when heart failure condition persists.

Explain: Diuretics Must Be Used Very Carefully in Diastolic Ventricular Dysfunction

When heart failure occurs, it activates the renin-angiotensin-aldosterone system, which increases the amount of sodium and water retained by kidneys. Consequently, the volume of blood increases, and it leads to increased blood pressure in veins. The most likely results of these progressions are pulmonary and systemic oedema. When diuretics are used, they help to reduce the extent of clinical symptoms associated with heart failure. Futhermore, diuretics help to reduce the heart afterload and promotes systemic vasodilation when used for a long-term treatment. This improves ventricular ejection.

The treatment of heart failure victims is one of the most complicated activities for any healthcare provider because it calls for much caution, particularly in the use of diuretics. This ensures that there is no excessive blood ejection, which may lead to decreased cardiac output. This is based on the reason that systolic dysfunction is described by a flushed and depressed Frank-Starling curve. However, when the blood volume is severely reduced, then the stroke volume is likely to fall as heart will be functioning in an incremental manner according to the Frank-Starling law. In contrast, if heart failure is caused by diastolic dysfunction, care must be taken when using diuretics so as not to impair ventricular filling. In diastolic dysfunction, higher pressures are required to fill the ventricles because of the declined ventricular compliance.

Care Plans for Heart Failure Victims

Heart failure caused by gradual damage to the heart cannot be cured. However, it can be treated through various strategies that help to improve the symptoms. For a successful treatment, the patients must be willing to get involved in managing their condition. The patients together with the people they love should be actively involved in healthcare team. The care and treatment plans may take various forms. These include lifestyle changes, medications, surgery, and ongoing care among others.

Lifestyle Changes

This entails following all the recommendations given by healthcare providers about diet, physical exercises, and other habits that are likely to alleviate the symptoms of heart attack. When these recommendations are adhered to, the patient is likely to have an improved quality of life as well as slowed progression of the disease. Patients with mild heart failure consequences are likely to live a nearly complete, normal, and happy life. The recommended lifestyle changes include quitting smoking, avoiding excessive alcohol intake, proper weight managing, and tracking daily fluid intake. Others commendable lifestyle changes include getting adequate rest, proper stress managing, being on healthy diets, and also being physically active.

Medication

Heart failure patients need to have numerous medications in order to control their conditions. Each medication treats a different symptom and comes with different set of instructions and rules. The patient and the caregiver should work collaboratively so as to have a comprehensive understanding of how the medications work as well as how, when, and in what amounts the medications should be taken. All the direct and side effects of each medication should be well understood so as to ensure that the treatment does not bring about negative implications on a patient. Among the medications that might be used for heart failure conditions are diuretics, cholesterol lowering medications, and vasodilators. Others include ACEIs, calcium channel blockers, beta blockers, and antiplatelet agents.

Surgery

This may take two forms, namely regular surgical procedures and implantable medical devices. To start with, one should pay attention to surgical procedures. Although surgery is not a common treatment of heart failure, it can be used when a problem such as blocked coronary artery is detected. It can also be used in cases of severe heart failure, which cannot be treated through medications or lifestyle changes. Common surgical procedures include angioplasty, coronary artery bypass, and heart transplant. Additionally, the implantable medical devices may be used. This may entail valve replacement, defibrillator implantation, and left ventricle assist device.

Conclusion

Heart failure is a common and serious condition that affects many people. All potential victims should assess their risk factors, which are likely to alleviate the heart failure symptoms.  It can be controlled even with life-threatening condition. This can be achieved through various heart failure care plans such as lifestyle changes, surgery, and medications. While other treatments are also successful, the medications are most commonly used. The most prescribed drugs are angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin receptor blockers, (ARBs).

Related Free Medicine Essays