Heart failure treatment - Late stages | Circulatory System and Disease | NCLEX-RN | Khan Academy
Aug 26, 2023
Heart failure treatment - Late stages | Circulatory System and Disease | NCLEX-RN | Khan Academy
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3.534 -> - So in the early stages of heart failure,
5.391 -> remember that treatments
were more targeted
7.156 -> at the risk factors for heart failure
9.235 -> and this is usually before the symptoms
11.22 -> of heart failure even come about
12.821 -> to try and slow or stop these
symptoms from ever appearing.
15.933 -> But in the later stages,
when the symptoms associated
19.021 -> with heart failure have
already started to crop up,
21.599 -> there's going to be a
different set of medications
23.885 -> that we might try and use
25.499 -> that are aimed at treating
and controlling these symptoms
28.238 -> that have already started to affect
29.737 -> the patient's quality of life.
31.339 -> And two of the main symptoms
we're going to target
33.742 -> are congestion, or fluid
build up, and fatigue.
38.401 -> So the first type that
we look at are diuretics
41.068 -> and these medications help treat
the symptoms of congestion.
44.504 -> But how do they do that?
45.909 -> Well, they help the body
get rid of excess fluid
50.344 -> and this can have several effects,
51.274 -> one of which is to reduce the symptoms
53.317 -> that result from fluid buildup, right,
55.036 -> that makes sense.
56.034 -> Like shortness of breath
from fluid in the lungs.
60.84 -> And the second is that with less fluid,
62.059 -> your blood volume also decreases, right?
63.882 -> And so there's less blood
in your blood vessels.
66.204 -> When there's more blood
in the blood vessels,
68.363 -> they actually have to stretch more
70.14 -> and this causes this higher pressure
73.13 -> and so when you reduce this amount,
74.632 -> one of the effects is actually
a reduction in blood pressure
77.825 -> and this can potentially
help keep heart failure
80.309 -> from getting worse in the future.
83.706 -> And so one of the primary
types of diuretics used
85.982 -> are aldosterone inhibitors.
89.12 -> And from this name, we can see that these
90.405 -> are probably going to inhibit
92.192 -> aldosterone in some form, right?
94.483 -> But what's aldosterone?
95.966 -> Well in short, it's this
super important hormone
98.531 -> that causes our body to retain sodium
101.213 -> and when we retain sodium,
we also retain fluid.
105.068 -> So if aldosterone causes us
to retain sodium and fluid,
109.014 -> we'd expect aldosterone inhibitors
110.965 -> to have the opposite effect
112.59 -> and that's exactly what it does.
114.134 -> It helps remove excess fluid.
117.513 -> So aldosterone inhibitors
act as a diuretic
119.51 -> that help reduce fluid
buildup and therefore,
122.04 -> reduce the symptoms
associated with fluid buildup.
126.66 -> And the second type of medication
127.717 -> that might be prescribed are
calcium channel blockers.
130.713 -> These, however are reserved
132.442 -> for treating diastolic heart failture
135.042 -> where your heart has trouble
filling with enough blood.
138.614 -> Again, the name is going to be
139.338 -> pretty self-explanatory, right?
140.882 -> These must block the channels for calcium.
143.483 -> And the entry of calcium
through these channels
145.584 -> plays an important role as a messenger
147.964 -> that tells certain muscle cells
149.324 -> that it's time to contract.
151.157 -> And one of these types of muscles
153.003 -> is the smooth muscle around your arteries
155.198 -> and so if this channel is blocked
156.822 -> and this muscle isn't getting
the signals to contract,
159.517 -> that means they aren't as constricted
161.454 -> so one of the effects is
to dilate your arteries
165.043 -> and this lowers the
arterial blood pressure
167.528 -> and makes it easier for your
heart to pump blood out.
171.589 -> And a second type of
muscle that it affects
173.156 -> is your heart muscle
and when these contract,
175.966 -> you get a heartbeat, right?
177.544 -> So blocking these channels tend
179.227 -> to make the heart contract less
181.388 -> therefore lowering your heart rate
184.736 -> and lowering your heart
rate gives it more time
186.008 -> to fill with blood and allows
more blood to be pumped out,
188.969 -> which is a big part of
diastolic heart failure.
191.51 -> And so if you're pumping more blood out,
193.508 -> that means your body's
receiving more blood
195.447 -> so you might not feel as
fatigued as you did before.
199.811 -> Finally, the last type of medication
201.182 -> that's not as often used anymore
202.958 -> but sometimes for select patients
204.758 -> is digoxin and it has two main effects.
208.519 -> So the first effect is that
it can increase the strength
210.911 -> of your muscle contractions in your heart
213.174 -> so it makes the heart pump harder
215.253 -> and then it tends to
slow down the heart rate
217.19 -> so sometimes, it's used for patients
218.735 -> that have uncontrollably fast heart rates
221.114 -> and it just kind of brings it
down to a reasonable level.
225.746 -> And so in addition to these just listed,
227.639 -> the ACE inhibitors and the Beta Blockers
229.892 -> described in the early stages
video may also still be used
233.222 -> to control blood pressure
in the later stages.
Source: https://www.youtube.com/watch?v=JDo9LNMOLtE
