alterations in the cardiovascular and respiratory systems

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1 ADVANCED PATHOPHYSIOLOGY

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2 ADVANCED PATHOPHYSIOLOGY

Case Scenario

76-year-old female patient complains of weight gain, shortness of breath, peripheral

edema, and abdominal swelling. She has a history of congestive heart failure and admits

to not taking her diuretic, as it makes her “have to get up every couple hours to go to the

bathroom.” She now must sleep on two pillows in order to get enough air.

Introduction

Congestive heart failure is a chronic and progressive disease that influences the

ability of heart muscles to pump blood within the heart. Blood pumping becomes

ineffective after the buildup of fluid in the heart. This paper explores a congestive heart

failure patient, presenting both cardiovascular as well as cardiopulmonary

pathophysiologic processes leading to the patient's symptoms, the influence of ethnicity

and racial variables, and the interaction of processes affecting the patient on the above

scenario.

Cardiovascular and cardiopulmonary pathophysiologic processes

The patient in the above scenario presents with symptoms such as abdominal

swelling, weight gain, and peripheral edema history. Since the patient has a history of

cognitive heart failure, the above symptoms might be occurring due to cognitive heart

failure. It is important to understand that abdominal swelling and peripheral are caused

by heart failure (McCance, &Huether, 2019). Cognitive heart failure is the major

cardiovascular process that results in the patient presenting the above symptoms.

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3 ADVANCED PATHOPHYSIOLOGY

Cognitive heart failure makes the heart weak, thus failing to pump blood within the body.

This causes blooding clotting in front of the heart.

The patient admitted that she does not take diuretics since they made her get up

every few hours to go to the bathroom. "Diuretics are the mainstay pharmacological

therapy which reduces preload in patient with cognitive heart failure and their

medications inhibit water reabsorption from the tubules which consequently increases the

volume and loss of water in the urine" (Josep Comín-Colet et al., 2020). Due to the heart

damage, the patient presented symptoms of muscular heart efficiency. In systole

dysfunction, the stroke volume is reduced, thus making the heart muscle enhance end-

systolic volume. When there is a reduction in fibers myosin during the process of heart

relaxation as well as contractions, the heart's contractility is lost (Carter et al., 2019).

Racial/ethnic variables

African Americans have higher chances of being affected by heart failure

conditions compared to white Americans. Also, compared to ethnic groups, they register

more deaths due to cognitive heart failure (Tillman et al., 2019). It is estimated that

around fifty percent of African Americans are affected by cognitive heart failure, where

hypertension is considered is the major contributing factor (Josep Comín-Colet et al.,

2020). Sodium sensitivities, rennin activities (relatively low), as well as low nitric oxide

production are mostly found in the pathophysiology of hypertension in African

Americans. Some other conditions include limited care access, genetics, kidney diseases,

and reduced compliance to medications.

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4 ADVANCED PATHOPHYSIOLOGY

Processes interaction

When both functional and structural changes occur on the hearts of clients

diagnosed with cardiovascular heart failure, they interact, resulting in the rise of disease

conditions. The stroke volume occurs in a patient with cardiovascular heart failure due to

a compensatory increase in blood volume, which improves the ventricular preload.

"Aorta baroreceptors and stretch receptors are also stimulated by decreases in blood

pressure which the results in stimulation of the sympathetic nervous system" (Inamdar &

Inamdar, 2016). Cardiovascular and cardiopulmonary pathophysiologic processes cause

renal perfusions, which reduce, thus affecting output and retention of urine inpatient.

Reduction of blood flow in the kidney causes the release of renin as well as angiotensin.

Also, it leads to fluid and sodium retention, especially when the condition continues, thus

increasing blood volume circulation.

Conclusion

Cardiovascular heart failure influences the ability of blood pumping by heart

muscles, and it results in specific symptoms like in the above case. Diuretics play an

essential role in treating heart failure and high blood pressure conditions. However, a lack

of close observance can cause damages to the heart. In conclusion, African Americans are

most affected by heart failure, with high blood pressure being the leading cause. Due to

changes in the normal functioning of the heart, the conditions of disease increase.

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5 ADVANCED PATHOPHYSIOLOGY

References

Carter, P., Lagan, J., Fortune, C., Bhatt, D. L., Vestbo, J., Niven, R., Chaudhuri, N.,

Schelbert, E. B., Potluri, R., & Miller, C. A. (2019). Association of

Cardiovascular Disease With Respiratory. Disease. Journal of the American

College of Cardiology (JACC), 73(17), 2166–2177. https://doi-

org/10.1016/j.jacc.2018.11.063

Inamdar, A. A., & Inamdar, A. C. (2016). Heart failure: diagnosis, management and

utilization. Journal of clinical medicine, 5(7),

62 ; https://doi.org/10.3390/jcm5070062

Josep Comín-Colet, Teresa Martín Lorenzo, Almudena González-Domínguez, Juan

Oliva, & Silvia Jiménez Merino. (2020). Impact of non-cardiovascular comorbidities on

the quality of life of patients with chronic heart failure: a scoping review.

Health and Quality of Life Outcomes, 18(1), 1–13. https://doi-

org/10.1186/s12955-020-01566-y

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease

in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Tillman, F., Kim, J., Makhlouf, T., & Osae, L. (2019). A comprehensive review of

chronic heart failure pharmacotherapy treatment approaches in African

Americans. Therapeutic advances in cardiovascular disease, 13,

1753944719840192. https://doi.org/10.1177/1753944719840192

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