Heart failure treatment – Late stages | Circulatory System and Disease | NCLEX-RN | Khan Academy

Heart failure treatment – Late stages | Circulatory System and Disease | NCLEX-RN | Khan Academy


– So in the early stages of heart failure, remember that treatments
were more targeted at the risk factors for heart failure and this is usually before the symptoms of heart failure even come about to try and slow or stop these
symptoms from ever appearing. But in the later stages,
when the symptoms associated with heart failure have
already started to crop up, there’s going to be a
different set of medications that we might try and use that are aimed at treating
and controlling these symptoms that have already started to affect the patient’s quality of life. And two of the main symptoms
we’re going to target are congestion, or fluid
build up, and fatigue. So the first type that
we look at are diuretics and these medications help treat
the symptoms of congestion. But how do they do that? Well, they help the body
get rid of excess fluid and this can have several effects, one of which is to reduce the symptoms that result from fluid buildup, right, that makes sense. Like shortness of breath
from fluid in the lungs. And the second is that with less fluid, your blood volume also decreases, right? And so there’s less blood
in your blood vessels. When there’s more blood
in the blood vessels, they actually have to stretch more and this causes this higher pressure and so when you reduce this amount, one of the effects is actually
a reduction in blood pressure and this can potentially
help keep heart failure from getting worse in the future. And so one of the primary
types of diuretics used are aldosterone inhibitors. And from this name, we can see that these are probably going to inhibit aldosterone in some form, right? But what’s aldosterone? Well in short, it’s this
super important hormone that causes our body to retain sodium and when we retain sodium,
we also retain fluid. So if aldosterone causes us
to retain sodium and fluid, we’d expect aldosterone inhibitors to have the opposite effect and that’s exactly what it does. It helps remove excess fluid. So aldosterone inhibitors
act as a diuretic that help reduce fluid
buildup and therefore, reduce the symptoms
associated with fluid buildup. And the second type of medication that might be prescribed are
calcium channel blockers. These, however are reserved for treating diastolic heart failture where your heart has trouble
filling with enough blood. Again, the name is going to be pretty self-explanatory, right? These must block the channels for calcium. And the entry of calcium
through these channels plays an important role as a messenger that tells certain muscle cells that it’s time to contract. And one of these types of muscles is the smooth muscle around your arteries and so if this channel is blocked and this muscle isn’t getting
the signals to contract, that means they aren’t as constricted so one of the effects is
to dilate your arteries and this lowers the
arterial blood pressure and makes it easier for your
heart to pump blood out. And a second type of
muscle that it affects is your heart muscle
and when these contract, you get a heartbeat, right? So blocking these channels tend to make the heart contract less therefore lowering your heart rate and lowering your heart
rate gives it more time to fill with blood and allows
more blood to be pumped out, which is a big part of
diastolic heart failure. And so if you’re pumping more blood out, that means your body’s
receiving more blood so you might not feel as
fatigued as you did before. Finally, the last type of medication that’s not as often used anymore but sometimes for select patients is digoxin and it has two main effects. So the first effect is that
it can increase the strength of your muscle contractions in your heart so it makes the heart pump harder and then it tends to
slow down the heart rate so sometimes, it’s used for patients that have uncontrollably fast heart rates and it just kind of brings it
down to a reasonable level. And so in addition to these just listed, the ACE inhibitors and the Beta Blockers described in the early stages
video may also still be used to control blood pressure
in the later stages.

10 thoughts on “Heart failure treatment – Late stages | Circulatory System and Disease | NCLEX-RN | Khan Academy

  1. Thanks for the Video! Sorry for the intrusion, I would appreciate your thoughts. Have you ever tried – Trentvorty Irreplaceable Doctor Theorem (Have a quick look on google cant remember the place now)? It is a good exclusive product for curing heart disease minus the hard work. Ive heard some pretty good things about it and my friend Sam at last got great results with it.

  2. Great video (like always).
    I just have one question though about the diuretics: aren't we suppose to use loop diuretics instead of aldosterone inhibitors ?

  3. thanks, understood the treatments better. only if the doctor had the patience to explain the reasons for the medications and treatment!

  4. Its so painful most people suffering from CHF still runt to the hospital hoping to get help, I've been a victim of CHF and the hospital had no help to give to me even after I had a CABG surgery not until I found about Chief Wole who made everything go away now I can do what everyone can do, no more palpitation, swelling of legs or all the heart aches and tiredness, if anyone reading this is suffering from CHF i advice you contact Chief Wole [email protected], he will make it go away

  5. How about monitoring the effectiveness of diuretic treatment? I just started in the internal medicine ward and to do that, we monitor the pacient's fluid intake and how much they are peeing and in the texts and videos this was never really discussed… Could you please shed some light on this?

  6. Hi! I’m a woman in her 40s. I have low blood pressure, excessive Pleural liquid (found by accident on MRI), I have pain in my neck veins, I have cold extremities, I cough extensively, I cannot get enough air – that’s how it feels.I drink a lot of water, but it doesn’t seem to come out of me as urea, I sweat like crazy though ! Could that be a way for my body to remove the excessive fluids ? I have also been made to drink lots of liquids that should bulk my intestines since there is no movement in my gut, the doctors want to fill my gut with these medications to try to get my guts moving again. Thinking of my heart it would not be very beneficial to drink so many liters of medication that absorbs fluids. I was wondering how a patient like me would be treated since the medications you have listed in this video are lowering the blood pressure even more, how would that fit me? Also the funny thing is that you mention calcium blockers, I had spinal fusion done two years ago and it does not heal, I have eaten excessive amounts of calcium but my body does not produce any bone on the contrary it actually removes my skeletal bones around the area where I had my surgery done. How can this be related? It must be related somehow!!

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