Posted: September 17th, 2023
76-year-old female patient complains of weight gain
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 has to sleep on two pillows in order to get enough air.
In your Case Study Analysis related to the scenario provided, explain the following 3 questions in 1-2-page max:
The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
Cardiovascular and Cardiopulmonary Analysis
This case study analysis will explain how the patient’s symptoms relate to underlying cardiovascular and cardiopulmonary processes based on the provided health information. Congestive heart failure and pulmonary edema will be discussed in relation to the shortness of breath, abdominal swelling, and leg edema reported. Recent statistics on congestive heart failure prevalence and racial disparities in outcomes will provide additional context. Treatment options beyond medication will also be reviewed.
The patient’s symptoms of abdominal swelling and leg edema indicate peripheral edema, which can result from congestive heart failure when the weakened heart is unable to properly circulate blood (Verhoeff & Mitchell, 2017). Congestive heart failure affects over 6 million American adults, with approximately 900,000 new cases annually (American Heart Association, 2022). African Americans specifically have higher rates of risk factors like hypertension and are less likely to receive guideline-directed therapies, contributing to poorer outcomes (Vaduganathan et al., 2021).
Congestive heart failure can also cause pulmonary edema by overfilling the lungs with fluid when the left side of the heart fails to pump blood back efficiently from the lungs (Jearath et al., 2016). This accumulation of fluid in the lung tissues and blood vessels leads to the shortness of breath experienced by the patient.
Interaction of Processes
When congestive heart failure and pulmonary edema interact, the condition becomes life-threatening. The fluid buildup in the lungs reduces oxygen movement, exacerbating shortness of breath. Renal sodium retention may also occur from activation of renin-angiotensin systems and further deplete intravascular volume (Dhondup & Qian, 2017).
Beyond medications, lifestyle changes such as sodium restriction, regular exercise, and weight management through diet have been shown to reduce hospitalization and death risks for heart failure patients (Zheng et al., 2018). Comprehensive lifestyle interventions lower the risk of associated health outcomes.
In summary, this case study demonstrates how the patient’s symptoms relate to underlying cardiovascular and cardiopulmonary pathophysiological processes. Understanding these system interactions is crucial for proper diagnosis and treatment by medical professionals.
American Heart Association. (2022). Heart disease and stroke statistics—2022 update. Circulation, 145(9). https://www.ahajournals.org/doi/10.1161/CIR.0000000000000104
Dhondup, T., & Qian, Q. (2017). Electrolyte and acid-base disorders in chronic kidney disease and end-stage kidney failure. Blood purification, 43(1-3), 179-188.
Jearath, V., Vashisht, R., Rustagi, V., Raina, S., & Sharma, R. (2016). Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction. Journal of pharmacology & pharmacotherapeutics, 7(1), 41.
Vaduganathan, M., Fonarow, G. C., Gheorghiade, M., Butler, J., Lam, C. S., & Bonow, R. O. (2021). Disparities in care and outcomes of patients with heart failure from 2020 to 2021. JAMA, 326(18), 1837-1839. https://doi.org/10.1001/jama.2021.18584
Verhoeff, K., & Mitchell, J. R. (2017). Cardiopulmonary physiology: why the heart and lungs are inextricably linked. Advances in physiology education, 41(3), 348-353. homework help assignment writing service.
Zheng, S. L., Orsi, J. M., Chow, S. K., Wang, H., & Moore, J. X. (2018). Lifestyle factors and hospitalization for heart failure: a systematic review and meta-analysis. Journal of the American Heart Association, 7(9), e008833. https://doi.org/10.1161/JAHA.118.008833