An Elderly With Congestive Heart Failure - 1429 Words

An elderly male with congestive heart failure was brought to a clinic because he was experiencing atrial fibrillation and had a ventricular response of 110 beats/min with palpitations and shortness of breath1. Medications that he was taking includes angiotensin-converting enzyme inhibitor, Lisinopril, Carvediol, Digoxin, and Furosemide1. His left ventricular ejection fraction has been reduced to 25%1. Further examinations showed that he had edema in his legs and crackles at the base of his lungs1. He was then told to increase the dosage of Furosemide by taking the drug twice daily instead of once, and doubling the dose per administration1. One week later, the electrocardiogram revealed that he had ventricular arrhythmias such as premature†¦show more content†¦Stroke volume is the volume of blood the ventricle ejects per heartbeat, and factors such as preload, afterload, and contractility of the heart all have implications in stroke volume2. Preload describes the extent to wh ich the myocardial fiber stretches at the end of diastole, and afterload is the resistance the heart must overcome for the ventricle to eject blood2. Heart failure describes a syndrome in which the patient has a dysfunctional heart incapable of sustaining an adequate cardiac output, and this syndrome is responsible for a large portion of cardiovascular-related deaths2. There are two types of left ventricular dysfunction, one is systolic dysfunction which has implications in defective ventricular ejection and contraction, and the other is diastolic dysfunction which has implications in dysfunctional ventricular relaxation and filling2. Heart failure patients with systolic dysfunction have an ejection fraction of less than 40%, and heart failure patients with diastolic dysfunction have an ejection fraction of greater than 40%. In the case study, the patient has a left ventricular ejection fraction of 25% which means that he is suffering from systolic dysfunction. Consequences of left ventricular systolic dysfunction include ischemic diseases, atrial fibrillation, increased ventricular response, and myocardial infarctions2. Some of these symptoms were seen in the patient from the case study. Factors leading to left