Heart Failure Preliminary Care Coordination Plan

Preliminary Care Coordination Plan

The primary purpose of this care coordination plan is to ensure integration of health care services that meet the needs of individuals at risk of heart failure. There exist many causes of heart failure, which if identified early enough can inform a preventative care plan. Some of these conditions include high blood pressure, thyroid disease, valve disease, diabetes, kidney disease, or heart defects at birth (Groenewegen, 2020). Heart failure affects over 6 million Americans. Approximately 670,000 individuals are diagnosed with heart failure annually.

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Thus, heart failure is should be a priority for the health care system. Notably, heart failure does not necessarily mean that the heart has stopped working. It means that that the heart has stopped working efficiently causing blood to move through the heart and body at a slower rate. This causes pressure in the heart to increase. Consequently, the heart is unable to pump enough oxygen and nutrients to meet body’s needs (Tomasoni et al., 2019). Thus, heart failure is a major concern for the health care system necessitating an effective preliminary care coordination plan to combat it.

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Causes of Heart Failure

Before delving into the preliminary care coordination plan for heart failure, it is imperative to identify the causes of heart of heart failure. According to Groenewegen et al. (2020), many conditions that damage the heart muscles can cause heart failure. Common causes include heart attack, coronary artery disease, cardiomyopathy, and other conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue, weakness, and rapid or irregular heartbeats (Tomasoni et al., 2019). There are two types of heart failure namely systolic and diastolic dysfunctions. Systolic dysfunction occurs when the heart muscles do not contract with enough force. This causes less oxygen-rich blood to be pumped throughout the body. On the other hand, diastolic dysfunction occurs when the heart contracts normally, but the ventricles do not relax properly. This causes less blood to enter the heart during normal filling (Groenewegen et al., 2020).

Diagnosing Heart Failure

            During diagnosis, a doctor asks the patient many questions regarding their medical history and symptoms. Some of these questions include conditions that can cause heart failure such as high blood pressure, angina, diabetes, coronary artery disease, and heart valve disease. The doctor also asks if the patient smokes, takes any drugs, or drink alcohol. The doctor also does a calculation during an echocardiogram to measure how well the heart pumps with each beat. The calculation is known as ejection fraction (EF). This helps determine the presence of either systolic or diastolic dysfunction. Additionally, the patient must complete a physician exam. The doctor listens to the patient’s heart beat looking for signs of heart failure. The doctor also tests for other illnesses that causes heart muscle to weaken or stiffen. The doctor may also order other tests including chest x-ray, echocardiogram, B-type natriuretic peptide blood test, blood tests, electrocardiogram, cardiac catheterization, and stress test (McDonald et al., 2021).

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Treatment

There are several treatments for heart failure. They involve discipline over medication and lifestyle, coupled with strict monitoring. These treatment option is prescribed during the initial stages of heart failure. However, if the condition has progressed, there are more advanced treatments options. Notably, the primary goal of heart failure treatment is to keep the condition from getting worse, ease symptoms, and improve quality of life. Common types of medication include aldosterone antagonists, ACE inhibitors (angiotensin-converting enzyme inhibitors), beta-blockers, digoxin, ARBs (angiotensin II receptor blockers), blood vessel dilators, and ARNIs (angiotensin receptor-neprilysin inhibitors).

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Others include soluble guanylate cyclase (sGC) stimulator, calcium channel blockers, selective sinus node inhibitors, diuretics, potassium or magnesium, and heart pump medications. A doctor may also recommend cardiac rehabilitation, which is a rehabilitation program that helps a patient exercise safely and keep up a healthy lifestyle. The program involves regular workouts, education entailing tips to lower chances of heart trouble, diet change, and quitting smoking and drinking (McDonald et al., 2021). The table below illustrates stages of heart failure and usual treatments.

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StageStage DefinitionUsual Treatments
Stage AThis stage entails individuals at high risk of developing heart failure. It includes people with: DiabetesHigh blood pressureMetabolic syndromeCoronary artery diseaseHistory of alcohol abuseHistory of cardiotoxic drug therapyFamily history of cardiomyopathyHistory of rheumatic feverTreatment entails: Quitting smoking Treat lipid disordersAn angiotensin converting enzyme inhibitor (ACE inhibitor)Discontinuing alcohol or illegal drug useBeta blockers
Stage BThis stage includes individuals diagnosed with systolic left ventricular dysfunction but have never had symptoms of heart failure. This includes people with: Valve diseasePrior heart attackCardiomyopathyThe treatment approaches for Stage A apply to this stage too.Beta-blockers for patients after a heart attackPatients must take an angiotensin II receptor blocker (ARB) or angiotensin converting enzyme inhibitor (ACE inhibitors)Surgery options are also available for coronary artery repair or valve repair and replacement.
Stage CEntails patients with known systolic heart failure. Common symptoms include: FatigueShortness of breathReduced ability to exerciseTreatment approaches for Stage A apply. Additionally:Patients must take beta-blockers  and an angiotensin converting enzyme inhibitor (ACE inhibitors)Digoxin and Diuretics (water pills) may be prescribed if symptoms persist.Weight monitoringRestricting dietary sodium saltRestricting fluidsDiscontinuing drugs that might worsen the conditionDoctor may recommend an implantable cardiac defibrillator (ICD) Doctor may recommend cardiac resynchronization therapy (biventricular pacemaker) if appropriate
Stage DEntails patients with systolic heart failure coupled with presence of advanced symptoms after receiving optimum medical careThe treatment methods for Stages A, B, and C apply. The doctor must also evaluate the patient to determine if the following treatment options  are suitable: surgery options, heart transplant, ventricular assist devices, continuous infusion of intravenous inotropic drugs research therapies, and end-of-life (palliative or hospice) care  

(McDonald et al., 2021).            

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To sum up, recommended practices to keep heart failure from getting worse include keeping blood pressure low, maintaining fluid balance, monitoring own symptoms, limiting dietary salt (sodium) intake, and monitoring weight. Others include visiting the doctor for regular checkups to monitor symptoms, and taking mediation as prescribed. Regular exercise and quitting smoking, alcohol, and drugs are also necessary (McDonald et al., 2021).

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