A 64-year-old woman presents to the primary care office with shortness of breath, leg swelling, and fatigue. She has a history of type 2 diabetes and hypertension. She reports that recently she had been able to go for daily walks with her friends, but in the past month, the walks have become more difficult due to shortness of breath and fatigue. She also sometimes awakens in the middle of the night due to shortness of breath and has to prop herself up on three pillows. On physical examination, she is tachycardic (110 beats per minute) and has a blood pressure of 106/74 mm Hg. Fine crackles are noted on inspiration in bilateral bases. The cardiac exam reveals the presence of a third and fourth heart sound and jugular venous distension. 2+ pitting edema is noted in the knees bilaterally. An ECG shows sinus rhythm at 110 bpm with Q waves in the anterior leads. An echocardiogram shows decreased wall motion of the anterior wall of the heart and an estimated ejection fraction of 25%. She is diagnosed with systolic heart failure, secondary to a silent MI.

Discuss the pathophysiological mechanisms that can lead to heart failure.
Differentiate between systolic and diastolic heart dysfunction
Discuss the causes of the patient’s shortness of breath, awakening in the middle of the night and the need to prop herself up on three pillows. Include pathophysiological mechanisms that causes each of these signs and symptoms.
Include two points of teaching for this patient
Support your response with at least one current evidence based resource.
Students must post a minimum of three times in each graded discussion (see participation guidelines on the discussion rubric)

Solution:

Hypertension is mainly related to other related illnesses such as coronary arterial disease or cardiomyopathy among others. In most situations, the coronary arterial disease is the primary trigger of heart failure. Coronary artery disease narrows heart arteries, a situation that restrains both oxygen and blood supply to the heart (Tham, Bernardo, Ooi, Weeks, & McMullen, 2015). Due to poor blood and oxygen flow, an individual’s risk of developing hypertension heightens. Heart failure occurs when the heart muscle fails to pump blood at the rate sufficient to meet the required metabolic requirements.

The left ventricular chamber of the heart plays a crucial role in pumping and circulating blood in the heart. As such, the left ventricular chamber has to pump blood harder than its right counterpart does. This ability is made possible by the systolic and diastolic functionalities. However, these functionalities can fail, leading to systolic and diastolic heart dysfunction….Please click the Paypal icon below to purchase full solution for only $5