E LECTROCARDIOGRAM AND THE D IAGNOSIS OF C ONGESTIVE H EART F AILURE By Angela Thomas

C ONGESTIVE H EART F AILURE CHF is an acute or chronic inability of the heart to pump enough blood throughout the body to meet the demands of homeostasis. CHF leads to a buildup of fluid in the lungs and surrounding body tissues. CHF may be due to failure of the right or left ventricle, or both.

PATIENT HISTORY / RISK FACTORS Family history of heart disease High blood pressure Diabetes Tobacco use Coronary artery disease Overweight High cholesterol Weakened heart muscle Pacemaker Poor diet Lack of exercise Chemotherapy

P ATIENT ’ S SYMPTOMS Shortness of breath Edema Fatigue Lack of appetite Nausea Rapid heartbeat Persistent cough Wheezing Increased urination

D IAGNOSIS OF HIS DISORDER History and physical examination. Electrocardiogram (EKG, ECG) Chest X-ray Blood tests Echocardiography The Ejection Fraction (EF) Cardiac catheterization Stress Test Nuclear stress test

A N EKG C AN HELP DIAGNOSIS Coronary heart disease Arrhythmia Heart failure Cardiomyopathy Heart valve disease Pericarditis

F OR MY GRANDFATHER, AN ECG HELPED THE DOCTOR TO DETERMINE THAT HE HAS CHF. My grandfather’s heart does not pump forcefully enough. His heart lacks blood flow to the heart muscle. Heart was beating normally, but not enough beats per minute. His pacemaker was functioning normally.

M EDICATION T REATMENTS Diuretic medications ACE inhibitors (angiotensin converting enzyme inhibitors) Beta blockers Digoxin Aldosterone blockers

T REATMENTS FOR C ONGESTIVE H EART F AILURE Exercise regularly Control diabetes Control high blood pressure Control cholesterol Monitor weight Diet Medication therapy Quit using tobacco Follow-up appointment Surgery if needed

H OW TO P REVENT C ONGESTIVE H EART F AILURE F ROM W ORSENING Keep blood pressure low Monitor symptoms Maintain fluid balance Limit sodium intake Monitor weight and lose weight if needed Take medications as prescribed Schedule regular doctor appointments

H OW C AN HE I MPROVE HIS Q UALITY OF L IFE WITH CHF ? Eating a healthy diet Exercising regularly Not overdoing it Preventing respiratory infections Control his diabetes, high blood pressure, and cholesterol Monitor his weight Take his medication Quit using tobacco

GRANDPA ’ S MEDICATIONS Amiodarone 200 mg Carvedilol 6.25 mg Simvastatin 20 mg Xarelto 20 mg ProAir® HFA 90 mg Aspirin 81 mg Oxygen

P ATIENT OUTCOME /P ROGNOSIS Congestive Heart failure is a major health problem that comes with the aging of the American citizen. More effective medications have been developed that improve the outlook of heart failure. Medications are the cornerstone of therapy for patients with congestive heart failure. Pacemakers and implantable defibrillators have improved and now offer the ability to control rare, but life-threatening, disturbances of heart rhythm in some people.

P ROGNOSIS AND LIFE EXPECTANCY FOR THE ELDERLY PATIENT The prognosis of congestive heart failure patients has improved over the past few decades, but the improvement has been less pronounced in the elderly population. The prognosis of elderly patients with heart failure is grave. The average life expectancy following diagnosis of CHF is under six years. However, the course of CHF is variable, and some patients live 10 or more years with good medication response and dietary and lifestyle management.

R EFERENCES heart-failure heart-failure