Systolic and diastolic heart failure.

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Differentiate between systolic and diastolic heart failure.
State whether the patient is in systolic or diastolic heart failure.
Explains the pathophysiology associated for each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
Explains the significance of the presence of a 3rd heart sound and an ejection fraction of 25%.

Sample Solution

Heart failure is common in the United States, with over 6 million people living with this condition. Additionally, nearly 1 million new cases are diagnosed each year. Fortunately, medical advances have made it possible to manage heart failure. Both sides of the heart are prone to dysfunction, but heart failure on the left side is more common. Systolic heart failure occurs when the left side of the heart becomes too weak to squeeze normal amounts of blood out of the heart when it pumps. Diastolic heart failure occurs when the left side of the heart is too stiff to relax and fill normally with blood.

 

Systolic Heart Failure

Systolic heart failure occurs when the left ventricle (LV) of the heart is unable to pump blood effectively. This is due to a decrease in the LV’s ability to contract, which is measured by the ejection fraction (EF). A normal EF is 50% or greater. In systolic heart failure, the EF is typically less than 40%.

Symptoms of systolic heart failure include shortness of breath, fatigue, and swelling in the legs. Treatment for systolic heart failure typically includes medications, such as ACE inhibitors, beta-blockers, and diuretics. In some cases, surgery may be necessary.

Diastolic Heart Failure

Diastolic heart failure occurs when the LV is unable to relax properly between beats. This is due to a thickening of the LV walls, which makes it difficult for the heart to fill with blood.

Symptoms of diastolic heart failure are similar to those of systolic heart failure, but they are often less severe. Treatment for diastolic heart failure typically includes lifestyle changes, such as weight loss and exercise, as well as medications, such as beta-blockers and calcium channel blockers.

Differentiating Between Systolic and Diastolic Heart Failure

The main difference between systolic and diastolic heart failure is the cause of the heart’s inability to pump blood effectively. In systolic heart failure, the cause is a decrease in the LV’s ability to contract. In diastolic heart failure, the cause is a thickening of the LV walls.

There are other differences between systolic and diastolic heart failure, including the following:

  • Symptoms: Symptoms of systolic heart failure are typically more severe than those of diastolic heart failure.
  • Treatment: Treatment for systolic heart failure typically includes medications that help the heart to contract more effectively. Treatment for diastolic heart failure typically includes lifestyle changes and medications that help the heart to relax more effectively.
  • Prognosis: The prognosis for systolic heart failure is typically worse than the prognosis for diastolic heart failure.

Statement of Whether the Patient is in Systolic or Diastolic Heart Failure

The patient is in systolic heart failure. This is because the patient’s EF is less than 40%, which is the diagnostic criteria for systolic heart failure. The patient’s symptoms, such as shortness of breath and fatigue, are also consistent with systolic heart failure.

Conclusion

Systolic and diastolic heart failure are two different types of heart failure that have different causes, symptoms, and treatments. It is important to be able to differentiate between the two types of heart failure in order to provide the best possible care for patients.

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