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


– In the early stages of Heart Failure the patient might not even have symptoms. And they might only have risk
factors for Heart Failure. This means that they
probably have some kind of pre-existing condition that might, if you leave it unchecked, will lead to Heart Failure in the future. Or lead to worsening Heart
Failure if it’s already present. But these conditions haven’t
led to full blown Heart Failure with, with symptoms. So patients are likely still able to go about their daily lives. Some example of Risk Factors might include something like hypertension,
or high blood pressure, or coronary artery disease, or diabetes. The doctor might
recognize these conditions as red flags for Heart Failure. And even though they’re just seeing it as these preliminary
signs and risk factors, they’ll emphasize the importance of improving these conditions before Heart Failure gets worse. Because most of the time especially with structural
changes to your heart, where it starts to look different, these tend to be unidirectional. Meaning that those changes only tend to get worse not better. So with that said, a very important early stage treatment that’s
recommended is exercise. With exercise your
cardiovascular fitness increases. This increases your heart’s efficiency so your heart gets
better at pumping blood. And we know that a
reduced pumping efficiency is a main theme in Heart Failure. And in addition to exercise
another lifestyle change that might be recommended
is a change in diet. And reducing salt intake is a
common and important change. And doing this tends to
reduce your blood pressure, making it easier to pump blood out. And this lowers the chances
of the heart to start to compensate and start
making structural changes to the heart’s ventricles
which, like we said, is a one way street. The doctor might also decide
to prescribe medications. And these will often be targeted
at reducing blood pressure which, like we said, makes it easier for the heart to pump blood out. And reduces the chance of compensation and structural changes to the heart. So the first class of
medications are ACE inhibitors or A-C-E inhibitors. This stands for
angiotensin-converting-enzyme and these are vasodilators. And from this word we’ve
got vaso which means vessels so your blood vessels. And then you’ve got
dilator which is to widen so these cause your blood
vessels to dilate or get bigger. And when they dilate they aren’t squeezing the
blood inside them as much and so the pressure in your
blood vessels goes down. And if the pressure in your
blood vessels goes down your heart’s going to have an
easier time pumping blood out to this lower pressure system. Just remember that analogy
about trying to blow air through a really small straw
and then a really big tube. Which one’s more difficult? It’s the straw, right? Well, in the same way
your heart’s going to have an easier time pumping blood through these dilated blood vessels. And another set of medications
that might be prescribed are Hydralazine and Nitrates. And these also tend to
reduce your blood pressure. Hydralazine specifically
acts as a vasodilator for arteries and arterials. Which are the blood vessels going away from the heart, right? And like we just mentioned this makes it easier for
your heart to pump blood out. Nitrates, on the other hand, although they can act
on your arteries as well mostly act on your veins. So they act to reduce your
venous blood pressure. And this reduces the
pressure in getting blood back to the heart. Which also reduces your Preload. Remember, that the Preload
is one of those mechanisms of compensation. So if we reduce the Preload we can limit the structural changes that might start to happen as a result. Finally, the last class of medications are called Beta Blockers. And these help inhibit the activation of the sympathetic nervous system. Remember how the sympathetic response in the heart is activated, with these receptors on the heart. Well these receptors are
generally known as Beta Receptors. So Beta Blockers tend
to block these receptors from being activated. That makes sense. So if they were activated, the heart rate and pumping
force increases, right? But if they’re blocked this tends to slow down the heart rate and limits that sympathetic response. And limiting this is important because just like increased Preload, we remember that over activation of the sympathetic nervous system is a method of compensation which can lead to structural
changes to the heart. And so we want to try
to reduce the chances of any structural changes.