The Heart Of Heart Failure

The prevalence of congestive heart failure is on the increase both in the United States and all over the world, and it is the leading cause of hospitalization in the elderly population. Congestive heart failure is a progressive disease generally seen in the elderly, which if not properly managed, can lead to repeated hospital admissions or death. Heart failure means that the heart muscle is weakened. A weakened heart muscle may not be strong enough to pump an adequate amount of blood out of its chambers. To compensate for its diminished pumping capacity, the heart may enlarge. Commonly, the heart's pumping inefficiency causes a buildup of blood in the

Hernandez, A. F., Greiner, M. A., Fonarow, G. C., Hammill, B. G., Heidenreich, P. A., Yancy, C. W., Peterson E. D., Curtis, L. H. (2010). Relationship between early physician follow-up and 30-day readmission among medicare beneficiaries hospitalized for heart failure. Jama, 303(17), 1716-1722.

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Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

The heart is an organ that pumps oxygenated blood to the body and deoxygenated blood to the lungs. Heart failure is when the heart can’t pump blood very well. If the heart fails to work properly, a major system called the circulatory system won’t work properly and therefore the whole human body will fail to work properly because the cells won’t be able get oxygenated blood and use the oxygen to undergo cellular respiration and make energy.

When the heart begins to fail, mechanisms are activated to compensate for the impaired function and maintain the cardiac output. The primary compensatory mechanisms are Frank –Starling mechanism, neuroendocrine responses including activation of the sympathetic nervous system and the renin- angiotensin-aldosterone system, and ventricular hypertrophy. Decreased cardiac output initially stimulates aortic baroreceptors, which in turn stimulate the SNS. SNS stimulation produces both cardiac and vascular responses through the release of norepinephrine. Norepinephrine increases heart rate and contractility by stimulating cardiac beta- receptors. Cardiac output improves as both heart rate and stroke volume increase. Norepinephrine also causes arterial

Approximately 5.3 million Americans have heart failure and account for more hospital admissions than any other diagnosis in patients over 65

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

Heart failure is a major health problem worldwide, but especially in the United States. The CDC estimates that over 5.7 million Americans are living with heart failure, and that

A time that starts with contraction between the atria and ventricular relaxation is known as the cardiac cycle. The relaxation period also known as the diastole this occur when the chambers fills with blood. The blood will flow according to pressure. As the fluid from the vein into the left atrium the pressure gets higher and rises, initially move passively into the ventricles from the atria. As the left ventricle filled to its volume the mitral valves closes to prevent any backflow. The contraction from the left ventricle send the oxygenated blood by the aortic value to aorta as the semilunar valves closes to prevent backflow of blood into the left ventricles.

Coronary heart disease (CHD) and chronic heart failure (CHF) are a major public health concern in the world; each year both of them causes huge number of direct and indirect economic losses for many developed and developing countries, which is the ultimate outcome of disease progression in all patients with cardiovascular disease, is even greater for medical and public investments in patients with heart failure. In the United States every 1000 people over the age of 65 in 10 patients with chronic heart failure, Projections show that by 2030, the total cost of HF will increase almost 127% to $69.7 billion for every US adult. The costs associated with treating HF comorbidities and HF exacerbations in youths are significant, totaling nearly $1 billion in inpatient costs, and may be rising [8]. Even today's progress in medical technology and the development of medicine, the prognosis of patients with heart failure variability is more serious. Therefore, it is extremely important to classify the risk stratification accurately and to distinguish the high-risk population and start

Its prevalence is expected to continue to rise over the next several years due to decreased mortality from cardiovascular disease and the growth of the elderly population. The key actions for heart failure patient care are to provide a comprehensive and cost effective heart failure service for all, and to implement an agreed pathway for the care of those with chronic heart failure.

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)