Acute decompensated heart failure (ADHF) is a common and potentially fatal cause of acute respiratory distress. The clinical syndrome is characterized by the development of dyspnea, generally associated with rapid accumulation of fluid within the lung’s interstitial and alveolar spaces, which is the result of acutely elevated cardiac filling pressures (cardiogenic pulmonary edema) [1].
ADHF can also present as elevated left ventricular filling pressures and dyspnea without pulmonary edema. Patients presenting with acute dyspnea from acute decompensated heart failure (ADHF) should be rapidly assessed and stabilized using the ABC criteria.
●Airway assessment and continuous pulse oximetry to assure adequate oxygenation and ventilation
●Supplemental oxygen and ventilatory support (noninvasive ventilation [NIV] or intubation) as indicated
●Vital signs assessment with attention to hypotension or hypertension
●Continuous cardiac monitoring
●Intravenous access
●Seated posture
●Diuretic therapy
●Early vasodilator therapy (for severe hypertension, acute mitral regurgitation, or acute aortic regurgitation); later vasodilator use for refractory cases is discussed below.
●Urine output monitoring (perhaps with urethral catheter placement)
Intra venous furosemide (Lasix) is given to help get rid of the extra fluid by increasing urination. To help the body rid itself of the extra fluid.
Enalapril (Vasotec) is a Blood vessel relaxing medication, it is given to make it easier for the heart to pump. Blocks the enzyme responsible to produce angiotensin II, resulting in a
decrease in blood pressure.
Metoprolol (Lopressor) Inhibits the strength of the heart’s contractions, as well as heart rate. This
results in a decrease in cardiac oxygen consumption.
IV morphine sulfate (Morphine) used for treatment of moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.
Four cardiovascular conditions that can lead to heart failure are, Coronary heart disease is a condition in which a waxy substance called plaque builds up inside the coronary arteries.
Diabetes is a disease in which the body’s blood glucose (sugar) level is too high. Over time, high blood sugar levels can damage and weaken the heart muscle and the blood vessels around the heart, leading to heart failure.
High Blood Pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over time, it can weaken your heart and lead to plaque buildup. And Hyperlipidemia or high cholesterol causes atheresclerosis. In these four conditions, Lifestyle changes, such as appropriate diet, exercise and seeking prompt medical attention will help to prevent the development of heart failure.
Interventions that can help prevent drug interaction in elderly includes. Medication reconciliation, this will prevent taking different forms of one medication, like generic and brand name. Providing medication card list. This lists every medication patient is taking and this can be shared with multiple providers. Taking brown bag of all patient’s medications to appointments. Finally educating patient and caregivers especially in the language they understand, utilizing pill box is also an effective way to keep track of older adults’ medication.
