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Pathopharmacological Foundations for Advanced Nursing Practice
Heart Failure
Casey B Walkowiak
Western Governors University
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Pathopharmacological Foundations for Advanced Nursing Practice
Investigated Disease Process
Heart failure is a devastating, chronic illness that affects about 5.7 million adults in the
United States. Roughly half the patients who are diagnosed with heart failure die within 5 years
of the diagnosis and cost the nation an estimated $30.7 billion annually (CDC, n.d.). There is
expected to be an almost 50% increase in the prevalence of heart failure by the year 2030 (Albert
& Kozinn, 2018). As heart failure is a syndrome and not a disease, there is no cure, patients deal
with the debilitating effects of the symptoms through the rest of their lives. Heart failure patients
have significantly reduced the quality of life due to frequent admissions to the hospital, reduced
the ability to perform their normal daily tasks, missed workdays and stress on both the patient
and their family. Education for both the patient and their family regarding disease
pathophysiology, symptom management, and psychosocial effects is key to helping patients
maintain as much normalcy in their life as possible.
Pathophysiology
Heart failure is often times thought of as your heart no longer works but the term actually
refers to the failure of the heart to supply the volume of blood needed to meet the demands of the
body. According to Nicholson (2007), heart failure is a syndrome, a collection of signs and
symptoms indicative of certain anatomical and physiological changes in the heart. Heart failure
can be described in term of the structural changes in the heart, the functional changes in how the
heart performs and, either as acute or chronic depending on the symptoms at presentation
(Nicholson, 2007). The most noted manifestations of heart failure are dyspnea and fatigue,
exercise intolerance and fluid retention which could lead to pulmonary congestion and/or
peripheral edema (Aguanno & Samson, 2018). There are multiple risk factors that put patients at
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risk for developing heart failure including congenital heart disease, hypertension, ischemic heart
disease, age, valvular heart disease, diabetes, and obesity.
Heart failure occurs in patients when there is a change to the muscles of the heart then, in
turn, the heart is not able to meet the demands of the body. Some of the causes leading to these
changes can be caused by myocardial infarction, ischemic heart disease, arrhythmias or
hypertension. Heart failure can be characterized structurally by terms such as left-sided, right-
sided, biventricular and congestive heart failure (Nicholson, 2007).
