Wednesday, January 25, 2023

Congestive Heart Failure Blood Test

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How Would Mrs S Know If The Medications Are Effective

BNP Blood Test and its use diagnosing Congestive Heart Failure

Mrs. S may observe reduced swelling on her feet, ankles, hands, weight loss, and reduced pulmonary edema. Her breathing will become easier she may not require 2 or more pillows to sleep at night and she may be able to lie flat. She may observe increased urinary output and frequency and reduced wet cough after taking Lasix. Mrs. S may notice decreased symptoms of congestive heart failure, lowered blood pressure, less fatigued, and reduced heart rate within months of taking captopril.

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Congestive Heart Failure Drugs

There are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more.

ACE inhibitors

Angiotensin-converting enzyme inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cant tolerate ACE inhibitors.

You may be prescribed one of the following:

voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.

ACE inhibitors shouldnt be taken with the following medications without consulting a doctor, because they may cause an adverse reaction:

  • Potassium-sparing diuretics and potassium supplements. These diuretics can cause potassium buildup in the blood, which may lead to abnormal heart rhythms. Examples include: riamterene , eplerenone , and spironolactone .
  • Nonsteroidal anti-inflammatory drugs .NSAIDs such as ibuprofen, aspirin, and naproxen, can cause sodium and water retention. This may reduce the ACE inhibitors effect on your blood pressure.

Beta-blockers

This may be achieved with:

Diuretics

Your doctor may recommend:

O Restrict Salts From Diet Limit Fats And Cholesterol From Diet

  • Pathophysiology: Congestive heart failure, CHF, is a result of other conditions damaging the heart or if the heart muscles become stiff. I believe that my patients CHF is due to stiffening of the heart because while listening to her heart there was not the same lub-dub I am used to hearing, it sounded more like a vibration. When your heart becomes stiff, it is unable to fill your heart with blood in between beats, during the lub-dub sound. When it is unable to fill the chamber of the heart, it is not capable of properly pumping blood to the rest of your body which means the rest of your body is not getting the proper nutrition it needs. At some point, the heart cannot continue to work as hard as it is which leads to failure of function, aka heart failure.
  • References:

    Heart failure: When your heart doesn’t work efficiently. . Retrieved November 27, 2017, from mayoclinic/diseases-conditions/heart-failure/basics/definition/con- 20029801

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    Congestive Heart Failure Pathophysiology

  • Definition: According to Mayo Clinic Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn’t pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently. Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help you live longer. Lifestyle changes such as exercising, reducing salt in your diet, managing stress and losing weight can improve your quality of life. One way to prevent heart failure is to control conditions that cause heart failure, such as coronary artery disease, high blood pressure, diabetes or obesity.

  • Manifestations : Shortness of breath when you exert yourself or when you lie down Fatigue and weakness Swelling in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Increased need to urinate at night Swelling of your abdomen Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain if your heart failure is caused by a heart attack

  • Medical, Surgical, and/or Collaborative interventions: Surgical:
  • Bnp Blood Test Overview

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    If your doctor orders a BNP test, you are probably showing symptoms of heart failure. The test measures a hormone called brain natriuretic peptide.

    During heart failure, pressure builds up in the chambers of your heart and creates BNP. When the heart works harder and doesnt pump blood well, it releases this hormone in large amounts. BNP widens your blood vessels to help improve circulation. Thats why higher levels may be a sign of heart failure.

    Emergency departments can get your BNP test results in about 15 minutes.

    Here is information you can use to get a clearer understanding of heart failure and the value of this test. It will help you understand what the results mean and how you can use them to help improve your health.

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    Carrus Health Advanced Radiology Department

    At Carrus Health, we provide the imaging tests you need for a clinical diagnosis of congestive heart failure. We currently offer CT Scans, X-rays, and ultrasounds to diagnose your condition. Our radiology facility in Sherman, Texas is spacious, clean, and comfortable.

    To schedule an appointment, please call Carrus Health at 870-2600. Our friendly staff looks forward to assisting you.

    How Is Congestive Heart Failure Treated

    Advanced treatment approaches are extending and improving quality-of-life for patients with congestive heart failure. Congestive heart failure is treated and managed through a combination of lifestyle modifications and a wide range of therapies, including medication and interventions, which help the heart to work more effectively and alleviate heart failure symptoms. Pacemakers and ventricular assist devices can make it easier for heart the heart to pump blood and remain in rhythm. For some patients with advanced heart failure, a heart transplant may be an option.

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    Bnp: An Important Cardiac Test

    B-type natriuretic peptide belongs to a family of protein hormones called natriuretic peptides. These natriuretic peptides have an important role in regulating the circulation. They act on blood vessels, causing them to dilate, or widen. They also work on the kidneys, causing them to excrete more salt and water. In addition, the natriuretic peptides reduce the production of various hormones that narrow blood vessels, boost the heart rate, or affect fluid retention examples include adrenaline, angiotensin, and aldosterone.

    The net effect of natriuretic peptides is to promote urine excretion, relax blood vessels, lower blood pressure, and reduce the heart’s workload. They are part of the body’s natural defense mechanisms designed to protect the heart from stress. And they surge into action when they are needed most, when the heart itself is under siege.

    What Are The Most Common Symptoms Of Congestive Heart Failure

    Doctor explains Brain Natriuretic Peptide (BNP or NT-proBNP) blood test to detect Heart Failure

    Swelling is the most common symptom of congestive heart failure. Often, swelling is most apparent in the extremities, especially in the legs and ankles, but it can occur in other parts of the body as well. Fluid collection in and around the lungs can cause shortness of breath , especially during physical activity or when lying down. Other common symptoms of heart failure include fatigue, loss of appetite, and weight gain.

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    How Is Heart Failure Treated

    Your treatment will depend on the type of heart failure you have and, in part, what caused it. Medications and lifestyle behaviors are part of every treatment plan. Your healthcare provider will talk to you about the best treatment plan for you. Treatment is the same, regardless of gender.

    As heart failure gets worse, your heart muscle pumps less blood to your organs, and you move toward the next stage of heart failure. Since you cant move backward through the heart failure stages, the goal of treatment is to keep you from moving forward through the stages or to slow down the progression of your heart failure.

    Stage A treatment

    The usual treatment plan for people with Stage A heart failure includes:

    • Regular exercise, being active, walking every day.
    • Stopping the use of tobacco products.
    • Treatment for high blood pressure .
    • Treatment for high cholesterol.
    • Not drinking alcohol or using recreational drugs.
    • Angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions.
    • Beta-blocker if you have high blood pressure.

    Stage B treatment

    The usual treatment plan for people with Stage B heart failure includes:

    Stage C treatment

    The usual treatment plan for people with Stage C HF-rEF includes:

    If the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression to Stage D.

    Stage D treatment

    Quality Of Patient Care

    Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.

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    Congestive Heart Failure Lab Work Up

    Definition of the congestive heart failure

    • Heart failure is also called congestive heart failure.
    • Congestive heart failure is due to damage to the cardiac muscles.
    • In this condition, the heart cannot pump the blood at a rate needed by the body for the metabolism of the tissues.

    Pathophysiology of Congestive Heart Failure

  • The heart failure may be due to:
  • Coronary artery disease . If the coronary arteries become blocked or severely narrowed, the heart becomes starved of oxygen and nutrients.
  • The heart attack damages the heart muscle, resulting in a scarred area that does not function properly.
  • Cardiomyopathy. Damage to the heart muscle causes other than artery or blood flow problems, such as infections or alcohol or drug abuse.
  • High blood pressure leads to overwork of the heart.
  • Other diseases like valvular diseases, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure.
  • Heart failure can occur when several diseases or conditions are present at once.
  • In many pathologic conditions, the onset of heart failure is preceded by cardiac hypertrophy, which is the compensatory response of the heart.

    Congestive heart failure

  • Clinical presentation of heart failure

  • Congestive heart failure is the most common cause of transudative pleural effusion.
  • In treated cases, transudate may change into exudate.
  • Effusion due to congestive heart failure is more on the right side.
  • Classification of congestive heart failure:

    Stage A:

    What Is The Importance Of Ejection Fraction

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    Your ejection fraction is one way to measure the severity of your condition. If its below normal, it can mean that you have heart failure. Your ejection fraction tells your healthcare provider how good of a job your left or right ventricle is doing at pumping blood. Usually, your EF number is talking about how much blood your left ventricle is pumping out because its your heart’s main pumping chamber.

    Several non-invasive tests can measure your EF. With this information, your healthcare provider can decide how to treat you or find out if a treatment is working as it should.

    A normal left ventricular ejection fraction is 53% to 70%. An LVEF of 65%, for example, means that 65% of the total amount of blood in your left ventricle is pumped out with each heartbeat. Your EF can go up and down, based on your heart condition and how well your treatment works.

    Read Also: What Is The Difference Between Heart Attack And Cardiac Arrest

    Stage C Treatment Options

    Treatment at this stage focuses on managing your symptoms, optimizing your heart function, and preventing worsening of your condition.

    Medications to treat stage C heart failure include:

    • Diuretics to reduce fluid retention
    • Beta blockers to help make your heart work less hard
    • SGLT2 inhibitors to reduce the risk of cardiovascular death and hospitalization for heart failure
    • Angiotensin-converting enzyme inhibitors
    • Digoxin to help the heart beat stronger and more regularly
    • Possible cardiac resynchronization therapy
    • Possible implantable cardiac defibrillator therapy

    In addition to the lifestyle changes for stages A and B, you may need to make the following changes:

    • Reduce your sodium intake
    • Restrict fluid intake
    • Keep track of your weight daily

    Remember that even if the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression of your condition to stage D.

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    Diagnostic Tests And Procedures

    This animation discusses some of the tests used to diagnose heart failure. These tests may include an electrocardiogram to look at your hearts electrical activity, an echocardiogram to measure how well your heart is working and look at the structure, and a chest X-ray to see if your heart is enlarged or there is fluid in your lungs. Other tests may include blood tests and an exercise, or stress test. .

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    How Are Blood Tests Performed

    Blood tests may be performed in a lab or providers office.1-2 They are a typical part of a routine exam. Sometimes blood tests are done before you eat for the day, after an 8-12 hour fast. Samples of blood are drawn by a needle from a vein in the arm into test tubes which are then analyzed by a lab for the levels of specific components.2

    What Did This Study Do

    Testing for Congestive Heart Failure Using Ortho’s VITROS® NT-proBNP Assay

    The REFER study included 304 adults aged over 55 years who were recruited to the study when they presented with suspected heart failure at 28 UK GP practices. The final number of participants was lower than planned, but is still larger than previous, similar studies.

    Clinical assessment, blood tests, electrocardiograph and echocardiograms were carried out within seven days. Three heart specialists independently assessed each case. They were given patient data in three instalments: clinical assessment, ECG and echocardiogram results addition of clinical decision rule data and finally blood levels of NTproBNP .

    The accuracy of heart failure diagnosis using the decision rule, NTproBNP level , or combination of the two was compared against a reference standard. In this case, the standard was a diagnosis confirmed by consensus of three experts using agreed standard definitions.

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    What Are The Types Of Heart Failure

    There are many causes of heart failure, but the condition is generally broken down into these types:

    Left-sided heart failure

    Heart failure with reduced left ventricular function The lower left chamber of your heart gets bigger and cannot squeeze hard enough to pump the right amount of oxygen-rich blood to the rest of your body.

    Heart failure with preserved left ventricular function Your heart contracts and pumps normally, but the bottom chambers of your heart are thicker and stiffer than normal. Because of this, your ventricles can’t relax properly and fill up all the way. Because there’s less blood in your ventricles, your heart pumps out less blood to the rest of your body when it contracts.

    Right-sided heart failure

    Heart failure can also affect the right side of your heart. Left-sided heart failure is the most common cause of this. Other causes include certain lung problems and issues in other organs.

    Other Lifestyle Changes To Control Signs & Symptoms

    In addition to regular exercise, other lifestyle changes such weight management and dietary changes are essential to implement for control. Before Mrs. S is discharged, it is imperative that a dietician does an assessment of what her diet normally entails of. This will enable the dietician to make a detailed plan on what Mr. S can have. Social and financial influence should be accommodated into the detailed plan to ensure it is individualized and the patient feels involved. The diet should include fruits and vegetables as well as whole grains.

    Mrs. S needs to be taught about the importance of reducing her sodium intake. Water is attracted to sodium so with a high sodium intake, there will be an increase in water retention. Lewis et al states that 2-g/day sodium diet is recommended for mild HF while 1.5-g/day sodium is recommended for those with severe HF. It would benefit Mrs. S if she is taught about food labels, adding salt while preparing food and having food with lower salt content.

    Stress can exacerbate heart failure. Mrs. S should be taught techniques on reducing stress levels and stress causes an increase in heartrate. This is detrimental for the heart as it is already inefficient in meeting the bodys demands for blood supply.

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    How Long Can An 85 Year Old Live With Heart Failure

    In a recent study, it was reported that patients hospitalized with moderate systolic heart failure faced a median expected survival time of 2.4 years if they were aged 71 to 80 years and 1.4 years if they were aged 80 years or more. In patients with more advanced systolic dysfunction, life expectancy was even shorter.

    Expert Care For Patients With Chf

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    An estimated 8 million people in the U.S. have congestive heart failure , a condition where the heart is unable to pump an adequate amount of blood to the rest of the body. Symptoms include shortness of breath, swelling of the legs, chest tightness and difficulty doing day-to-day tasks.

    The Congestive Heart Failure Program at Montefiore Nyack Hospital, which brings you the same world-renowned care provided at Montefiore Einsteins main campus in New York City, specializes in diagnosing heart failure and offers a variety of effective treatments that can improve heart function and help you live longer. Every heart failure patient is differentand your condition can change over timeso routine follow-ups will be an important part of your care plan.

    In addition to CHF, the Program treats women with heart disease during pregnancy, as well as patients with heart valve disease, arrhythmias, heart muscle disease, pericardial disease and pulmonary hypertension.

    If CHF is suspected, your cardiologist will order a comprehensive study of your heart muscle. This will likely include an echocardiography or other imaging tests to measure your ejection fraction. Your ejection fraction is the percent of blood in the lower left chamber of your heart that is pumped out of your heart with each heartbeat. Ejection fraction measures how well your heart pumps. This helps diagnose the type of heart failure you have and guides your treatment.

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