Caring for the Patient with Heart Failure

About this course

More than 6 million Americans are living with heart failure, and the prevalence continues to rise, with over 1 million new cases diagnosed in adults aged 55 and older each year. Heart failure has an estimated mortality rate of 10%, with the primary causes being attributable to sudden cardiac death or organ dysfunction resulting from inadequate perfusion. This underscores the critical need for effective management strategies and interventions to mitigate the risks associated with heart failure and improve outcomes for affected individuals. This course serves as a comprehensive guide to understanding heart failure and its management. It covers a wide range of topics essential for understanding cardiovascular health, from the intricate mechanisms of normal heart function to the complexities of heart failure diagnosis and treatment.

Learning objectives

• Review normal cardiac physiology and function
• Describe the three types of heart failure and their stages, and classifications as described by the American College of Cardiology/American Heart Association classification and the New York Heart Association (NYHA) classification system.
• Understand potential risk factors of heart failure
• Analyze the differences between STEMI and NSTEMI
• Review treatment options for heart failure including common medications, laboratory and electrocardiograph findings, and procedural interventions.

Course outline

15 sections · finish in any order across devices

1. 1

   Introduction

   Heart failure is a progressive, lifelong condition currently afflicting approximately 37 million individuals globally. In the US alone, more than 6 million Americans are living with heart failure, and the prevalence continues to rise, with over 1 million new cases diagnosed in adults aged 55 and old

   4 min

2. 2

   Normal Heart Function

   The heart is an intricately structured muscular organ primarily composed of myocardial cells, also known as myocardium. Its anatomical configuration comprises four chambers: two atria positioned superiorly and two ventricles located inferiorly, such that each side, right and left, consists of one at

   4 min

3. 3

   Definition of Heart Failure

   Heart failure manifests when there is dysfunction or disruption in the heart's normal function. The abnormality can arise from various causes such as structural defects, problems in heart rhythms, diseases, infections, toxins, or a combination of these factors. While all these issues impair the hear

   4 min

4. 4

   Signs and Symptoms of Heart Failure

   Heart failure is a clinical syndrome characterized by a range of signs and symptoms. In the earliest stages of heart failure, individuals may experience subtle symptoms that gradually worsen over time. These include fatigue and weakness, decreased appetite and nausea, shortness of breath (dyspnea),

   4 min

5. 5

   Types of Heart Failure

   There are three types of heart failure:1

   4 min

6. 6

   Risk Factors for Heart Failure

   The main risk factors contributing to the development of heart failure include coronary heart disease, hypertension, diabetes mellitus, family history of heart disease, chronic pulmonary diseases, obesity, inflammation or chronic infection, and metabolic diseases. Conditions such as coronary heart d

   4 min

7. 7

   Stages and Classification Systems

   As heart failure progresses, healthcare professionals rely on classification systems to better understand and manage the condition, particularly in its advanced stages. Typically, patients' heart failure severity is assessed based on the classification of their symptoms. Among the widely utilized cl

   4 min

8. 8

   Treatment of Heart Failure

   Initial emergency treatment for acute heart failure aims to restore blood flow and oxygen levels while stabilizing the patient's condition. The approach involves several interventions tailored to the individual's symptoms and clinical presentation. For patients experiencing severe respiratory distre

   4 min

9. 9

   EKG Findings

   Electrocardiograms (EKGs) are fundamental tools for monitoring and documenting the heart's electrical activity, providing valuable insights into cardiac function. Interpreting an EKG involves reading its five fundamental waves:13,14

   4 min

10. 10

    Laboratory Values

    In emergency situations, healthcare professionals should prioritize laboratory tests that can rapidly diagnose or rule out heart failure. B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NTproBNP) are crucial biomarkers used for this purpose. Both these peptides are se

    4 min

11. 11

    Procedures for Treating Heart Failure

    Several procedures are available for treating heart failure, aiming to alleviate symptoms, improve heart function, and enhance the patient's quality of life. These include percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), heart valve repair or replacement, implantable

    4 min

12. 12

    Long-Term Management of Heart Failure

    In the long-term management of heart failure, the primary objective is to alleviate symptoms, minimize hospital admissions, and prolong patients' lifespans. Modern strategies for HF management have evolved, emphasizing individualized treatment approaches tailored to each patient's underlying pathoph

    4 min

13. 13

    STEMI and NSTEMI

    Understanding ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) involves differentiating between these two types of heart attacks that can cause heart failure, and understanding their respective treatment options and the critical importance of timely inte

    4 min

14. 14

    Nursing Considerations

    Nursing care plays a crucial role in the comprehensive management of patients with heart failure, addressing their diverse needs across various stages of the disease continuum, from preventive measures to end-of-life and palliative care. Patients with heart failure often require long-term engagement

    4 min

15. 15

    Conclusion

    Heart failure is a pervasive cardiovascular condition that leads to a cascade of symptoms and complications that can profoundly impact a patient’s life. Comprehensive knowledge of heart failure, including normal cardiac function, and signs and stages of heart failure is imperative for healthcare pro

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• G. Schwinger, R. H. (2021). Pathophysiology of heart failure. Cardiovascular Diagnosis and Therapy, 11(1), 263-276. https://doi.org/10.21037/cdt-20-302
• American Heart Association. (2023). Causes and Risks for Heart Failure. Www.heart.org. https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure
• Voorhees, A. P., & Han, C. (2015). Biomechanics of Cardiac Function. Comprehensive Physiology, 5(4), 1623. https://doi.org/10.1002/cphy.c140070
• Circulation: Heart Failure | AHA/ASA Journals. (2010). Ahajournals.org. https://www.ahajournals.org/journal/circheartfailure
• American Heart Association. (2023). Warning Signs of Heart Failure. Www.heart.org. https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure
• American Heart Association. (2023, March 23). Types of heart failure. American Heart Association. https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/types-of-heart-failure
• Ghani, U., Farooq, O., Aziz, S., Alam, S., Khan, M. J., & Rahim, O. (2023). The Spectrum of Heart Failure Management. Cureus, 15(6). https://doi.org/10.7759/cureus.40587
• Thandavarayan, R. A., Chitturi, K. R., & Guha, A. (2020). Pathophysiology of Acute and Chronic Right Heart Failure. Cardiology Clinics, 38(2), 149-160. https://doi.org/10.1016/j.ccl.2020.01.009
• American Heart Association. (2023). Causes and Risks for Heart Failure. Www.heart.org. https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure
• Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., & Milano, C. A. (2022). 2022 AHA/ACC/HFSA guideline for the management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18). https://doi.org/10.1161/cir.0000000000001063
• New York Heart Association (NYHA) Classification. (2018). Jointcommission.org. https://manual.jointcommission.org/releases/TJC2018A/DataElem0439.html
• Twiner, M. J., Hennessy, J., Wein, R., & Levy, P. D. (2022). Nitroglycerin Use in the Emergency Department: Current Perspectives. Open Access Emergency Medicine, Volume 14(14), 327–333. https://doi.org/10.2147/oaem.s340513
• Anbalagan, T., Nath, M. K., Vijayalakshmi, D., & Anbalagan, A. (2023). Analysis of various techniques for ECG signal in healthcare, past, present, and future. Biomedical Engineering Advances, 6, 100089. https://doi.org/10.1016/j.bea.2023.100089
• Rafie, N., Kashou, A. H., & Noseworthy, P. A. (2021). ECG Interpretation: Clinical Relevance, Challenges, and Advances. Hearts, 2(4), 505-513. https://doi.org/10.3390/hearts2040039
• Wayne, S. L., & Zimmet, A. D. (2021). Surgical Management of Heart Failure. Current Cardiology Reviews, 17(5). https://doi.org/10.2174/1573403X17666210414094452
• Devices and Surgical Procedures to Treat Heart Failure. (2017). Www.heart.org. https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/devices-and-surgical-procedures-to-treat-heart-failure
• Defibrillators - What are Defibrillators? | NHLBI, NIH. (2022, March 24). Www.nhlbi.nih.gov. https://www.nhlbi.nih.gov/health/defibrillators
• National Heart, Lung, and Blood Institute. (2022, March 24). Pacemakers - What Are Pacemakers? | NHLBI, NIH. Www.nhlbi.nih.gov.
• Östman, M., Bäck-Pettersson, S., Sundler, A. J., & Sandvik, H. (2020). Nurses’ experiences of continuity of care for patients with heart failure: A thematic analysis. Journal of Clinical Nursing, 30(1-2), 276-286. https://doi.org/10.1111/jocn.15547
• Jaarsma, T., Hill, L., La Rocca, P. B., Castiello, T., Čelutkienė, J., Plymen, C. M., Piper, S. E., Riegel, B., Rutten, F. H., Gal, T. B., Bauersachs, J., Coats, J. S., Chioncel, O., Lopatin, Y., Lund, L. H., Lainscak, M., Moura, B., Mullens, W., Piepoli, M. F., . . . Strömberg, A. (2020). Self‐care of heart failure patients: Practical management recommendations from the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure, 23(1), 157-174. https://doi.org/10.1002/ejhf.2008
• Vogel, B., Claessen, B. E., Arnold, S. V., Chan, D., Cohen, D. J., Giannitsis, E., Gibson, C. M., Goto, S., Katus, H. A., Kerneis, M., Kimura, T., Kunadian, V., Pinto, D. S., Shiomi, H., Spertus, J. A., Steg, P. G., & Mehran, R. (2019). ST-segment elevation myocardial infarction. Nature Reviews Disease Primers, 5(1). https://doi.org/10.1038/s41572-019-0090-3
• Pollack, C. V., Amin, A., Wang, T., Deitelzweig, S., Cohen, M., Slattery, D., Fanikos, J., DiLascia, C., Tuder, R., & Kaatz, S. (2020). Contemporary NSTEMI management: the role of the hospitalist. Hospital Practice (1995), 48(1), 1–11. https://doi.org/10.1080/21548331.2020.1701329

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