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Related Concept Videos

Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

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The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
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Disease management interventions for heart failure.

Andrea Takeda1, Nicole Martin, Rod S Taylor

  • 1Institute of Health Informatics Research, University College London, London, UK.

The Cochrane Database of Systematic Reviews
|January 9, 2019
PubMed
Summary
This summary is machine-generated.

Disease management interventions for heart failure likely reduce all-cause mortality and hospital readmissions, particularly case management and multidisciplinary approaches. Evidence for effects on quality of life and cost-effectiveness remains uncertain due to data limitations.

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Area of Science:

  • Cardiology and Public Health
  • Evidence-based healthcare interventions

Background:

  • Heart failure (HF) is a significant global health burden, exacerbated by aging populations, leading to high morbidity, mortality, and healthcare costs.
  • Frequent hospital readmissions for HF contribute substantially to healthcare expenditures.
  • Disease management interventions offer a proactive, preventative strategy beyond pharmacotherapy for HF patients.

Purpose of the Study:

  • To evaluate the comparative effectiveness of various disease management interventions for heart failure against usual care.
  • To assess impacts on mortality, hospital readmissions, quality of life, and cost-related outcomes.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) with at least six months' follow-up.
  • Included interventions: case management, clinic-based, and multidisciplinary approaches for hospitalized HF patients.
  • Outcomes: mortality (HF and all-cause), readmissions (HF and all-cause), adverse effects, quality of life, costs, and cost-effectiveness.

Main Results:

  • Multidisciplinary interventions probably reduce all-cause mortality (moderate-quality evidence). Case management may reduce all-cause mortality (low-quality evidence).
  • Case management interventions probably reduce heart failure readmissions (moderate-quality evidence) and all-cause readmissions (moderate-quality evidence).
  • Evidence regarding quality of life and cost-effectiveness is generally low-quality and uncertain, with some indications of potential cost reductions.

Conclusions:

  • Disease management, particularly case management and multidisciplinary models, shows potential for reducing mortality and readmissions in heart failure patients.
  • Significant uncertainty remains regarding the impact on quality of life due to poor reporting and data heterogeneity.
  • Further high-quality research with standardized reporting is needed to clarify the benefits of these interventions, especially concerning patient-reported outcomes and cost-effectiveness.