Heart failure treatment - Early stages | Circulatory System and Disease | NCLEX-RN | Khan Academy
Aug 26, 2023
Heart failure treatment - Early stages | Circulatory System and Disease | NCLEX-RN | Khan Academy
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3.314 -> - In the early stages of Heart Failure
4.555 -> the patient might not even have symptoms.
6.817 -> And they might only have risk
factors for Heart Failure.
9.814 -> This means that they
probably have some kind of
11.172 -> pre-existing condition that might,
13.301 -> if you leave it unchecked,
14.862 -> will lead to Heart Failure in the future.
16.976 -> Or lead to worsening Heart
Failure if it's already present.
20.295 -> But these conditions haven't
led to full blown Heart Failure
22.514 -> with, with symptoms.
24.463 -> So patients are likely
25.403 -> still able to go about their daily lives.
27.75 -> Some example of Risk Factors might include
29.839 -> something like hypertension,
or high blood pressure,
32.787 -> or coronary artery disease, or diabetes.
36.201 -> The doctor might
recognize these conditions
37.524 -> as red flags for Heart Failure.
39.449 -> And even though they're just seeing it
41.216 -> as these preliminary
signs and risk factors,
43.92 -> they'll emphasize the importance
44.942 -> of improving these conditions
46.382 -> before Heart Failure gets worse.
48.789 -> Because most of the time
49.948 -> especially with structural
changes to your heart,
51.862 -> where it starts to look different,
53.843 -> these tend to be unidirectional.
55.763 -> Meaning that those changes
56.716 -> only tend to get worse not better.
60.155 -> So with that said, a very important
61.661 -> early stage treatment that's
recommended is exercise.
65.201 -> With exercise your
cardiovascular fitness increases.
68.903 -> This increases your heart's efficiency
71.351 -> so your heart gets
better at pumping blood.
73.676 -> And we know that a
reduced pumping efficiency
75.522 -> is a main theme in Heart Failure.
79.086 -> And in addition to exercise
another lifestyle change
81.442 -> that might be recommended
is a change in diet.
85.262 -> And reducing salt intake is a
common and important change.
89.133 -> And doing this tends to
reduce your blood pressure,
91.565 -> making it easier to pump blood out.
94.121 -> And this lowers the chances
of the heart to start
95.365 -> to compensate and start
making structural changes
98.683 -> to the heart's ventricles
which, like we said,
101.306 -> is a one way street.
104.498 -> The doctor might also decide
to prescribe medications.
108.342 -> And these will often be targeted
at reducing blood pressure
111.14 -> which, like we said, makes it easier
112.707 -> for the heart to pump blood out.
114.378 -> And reduces the chance of compensation
116.086 -> and structural changes to the heart.
118.562 -> So the first class of
medications are ACE inhibitors
121.902 -> or A-C-E inhibitors.
123.899 -> This stands for
angiotensin-converting-enzyme
127.382 -> and these are vasodilators.
129.517 -> And from this word we've
got vaso which means vessels
132.443 -> so your blood vessels.
133.72 -> And then you've got
dilator which is to widen
136.145 -> so these cause your blood
vessels to dilate or get bigger.
139.687 -> And when they dilate
140.605 -> they aren't squeezing the
blood inside them as much
143.763 -> and so the pressure in your
blood vessels goes down.
146.466 -> And if the pressure in your
blood vessels goes down
148.639 -> your heart's going to have an
easier time pumping blood out
151.737 -> to this lower pressure system.
153.979 -> Just remember that analogy
about trying to blow air
155.964 -> through a really small straw
and then a really big tube.
159.342 -> Which one's more difficult?
161.01 -> It's the straw, right?
162.396 -> Well, in the same way
your heart's going to have
163.779 -> an easier time pumping blood
165.205 -> through these dilated blood vessels.
168.786 -> And another set of medications
that might be prescribed
171.392 -> are Hydralazine and Nitrates.
173.97 -> And these also tend to
reduce your blood pressure.
177.093 -> Hydralazine specifically
acts as a vasodilator
179.589 -> for arteries and arterials.
181.725 -> Which are the blood vessels
182.579 -> going away from the heart, right?
184.43 -> And like we just mentioned
185.406 -> this makes it easier for
your heart to pump blood out.
188.447 -> Nitrates, on the other hand,
189.771 -> although they can act
on your arteries as well
192.452 -> mostly act on your veins.
194.369 -> So they act to reduce your
venous blood pressure.
197.329 -> And this reduces the
pressure in getting blood
199.187 -> back to the heart.
200.591 -> Which also reduces your Preload.
202.971 -> Remember, that the Preload
is one of those mechanisms
204.991 -> of compensation.
206.674 -> So if we reduce the Preload
207.811 -> we can limit the structural changes
209.565 -> that might start to happen as a result.
214.627 -> Finally, the last class of medications
216.053 -> are called Beta Blockers.
218.11 -> And these help inhibit the activation
219.645 -> of the sympathetic nervous system.
222.142 -> Remember how the sympathetic response
223.671 -> in the heart is activated,
225.331 -> with these receptors on the heart.
227.467 -> Well these receptors are
generally known as Beta Receptors.
230.59 -> So Beta Blockers tend
to block these receptors
233.411 -> from being activated.
235.269 -> That makes sense.
236.534 -> So if they were activated,
238.175 -> the heart rate and pumping
force increases, right?
241.19 -> But if they're blocked
242.071 -> this tends to slow down the heart rate
243.628 -> and limits that sympathetic response.
246.332 -> And limiting this is important
247.354 -> because just like increased Preload,
249.523 -> we remember that over activation
251.312 -> of the sympathetic nervous system
252.869 -> is a method of compensation
254.617 -> which can lead to structural
changes to the heart.
257.303 -> And so we want to try
to reduce the chances
258.906 -> of any structural changes.
Source: https://www.youtube.com/watch?v=PJgRZA5mE0s
