Running head: HEART FAILURE
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Pathopharmacological Foundations for Advanced Nursing Practice
Western Governors University
HEART FAILURE
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Pathopharmacological Foundations for Advanced Nursing Practice
Investigated Disease Process [A]
Heart failure is a form of heart disease that progressively gets worse over time. The
diagnosis of heart failure means the heart is unable to pump enough blood to effectively circulate
nutrient-rich, oxygenated blood to nourish the cells and meet the body’s needs (American Heart
Association [AHA], n.d-j). This is a chronic, progressive condition that gradually gets worse as
the heart’s ability to pump and/or fill with blood is reduced. Initially the heart attempts to
compensate for being unable to keep up with its workload by enlarging, developing more muscle
mass, and pumping faster. These compensation mechanisms mask the underlying problem of
heart failure, until the body can no longer keep up (AHA, n.d.-j). At this point, a person may
become symptomatic experiencing the most common symptoms of fatigue, edema, shortness of
breath, and/or persistent coughing (AHA, n.d.-i). According to McCance and Huether (2018), a
person with hypertension has the highest risk for developing heart failure. Other risk factors
include obesity, age, smoking, congenital heart disease, renal failure, excessive alcohol use, and
other cardiomyopathies. Heart failure is an incurable but treatable condition. Treatments include
lifestyle changes, medications, implanted devices, and surgical procedures (AHA, n.d.-g). With
many treatment options available, a person living with heart failure can continue living a full life.
Research sponsored by the National Heart, Lung, and Blood Institute (NHLBI), suggests
that after age 65, heart failure incidence approaches 21 per 1000 people (Benjamin et al., 2017).
The American Heart Association (AHA) reports that more than 6 million people in the United
States are currently living with heart failure (AHA, n.d.-h). Research by Savarese and Lund
(2017) indicates that the prevalence of heart failure is rising due to the aging population and
improvements in treatment. According to Benjamin et al. (2017), the prevalence projections of
HEART FAILURE
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people diagnosed with heart failure show an increase of 46% from 2012 to 2030, resulting in an
estimated 8 million people living with heart failure. In the next ten years, the estimated cost to
Americans is expected to increase by almost 40 billion dollars (AHA, n.d.-h).
Pathophysiology [A.1.]
Heart failure is the pathophysiologic condition in which the heart cannot generate
adequate supply of blood to the body, also known as cardiac output. Initially the heart uses
compensatory mechanisms to make up for lack of cardiac output, such as enlarging, developing
more muscle mass, or pumping faster (AHA, n.d-j). The body may compensate for low cardiac
output by narrowing or constricting the blood vessels to maintain a normal blood pressure. The
body may also divert blood from less important tissues and organs to allow vital organs, such as
the brain and heart, to receive more of the oxygenated blood. Although these compensatory
