The conditions known as systolic and diastolic heart failure are quite the opposite in nature. The former means the inability of one’s heart to contract properly during heartbeats. In other words, it emerges due to the loss of contractile strength and leads to a low ejection fraction (< 45%), disrupting the work of this organ (Liu, 2021). This disease is more common than the second type because of the prevalence of particular symptoms among the patients, such as increased afterload, increased preload, or cardiac arrhythmias (“Congestive heart failure,” 2020). On the contrary, diastolic heart failure is an issue characterized by the heart’s inability to relax between the beats. As a result, it cannot function due to this impairment in filling, whereas a patient’s ejection fraction can be normal (Liu, 2021). This problem is also revealed by increased afterload and preload, but these symptoms are complemented by decreased ventricular compliance indicating the heart’s failure to expand when pressing (Liu, 2021). Therefore, even though these two diseases might have similar manifestations, they vary depending on the mechanism of their action and, in fact, correspond to different issues.
The Patient’s Condition
The patient under consideration is in diastolic heart failure due to several reasons stemming from the results of the diagnostics. First, the presence of the third heart sound normally appears when one’s heart has a problem in the ventricular filling, which corresponds to this condition (“Congestive heart failure,” 2020). Second, the high sinus rhythm (at 110 bpm) indicates the man’s irregular heartbeat, which is the result of the emergence of the specified event, and it is referred to as cardiac arrhythmias (“Congestive heart failure,” 2020). Third, the decreased wall motion of the heart’s interior wall and an ejection fraction of 25% positively correlate with his heart’s inability to relax (Liu, 2021). Alongside other symptoms typical for both systolic and diastolic heart failure, it can be concluded on the presence of the second issue regarding the mentioned symptoms.
Pathophysiology: Dyspnea on Exertion
The pathophysiology of such a symptom of heart failure as dyspnea on exertion is the feeling of shortness of breath described by the patient. It emerges when exercising and disappears when one’s body is relaxed, as happened to the man experiencing this issue only while walking (Liu, 2021). This problem stems from one’s inability to breathe fast or deeply when not sitting (“Congestive heart failure,” 2020). It is triggered by the impaired interactions of receptors in the central nervous system, the respiratory tract, and the chest wall (“Congestive heart failure,” 2020). The sensory information regarding the volume of the lung space is distorted, and a person’s brain receives a signal to increase the rate of breathing, its frequency, and other patterns.
Pathophysiology: Pitting Edema
Pitting edema is another sign of heart failure, which was also present in the patient, and it means swelling of soft tissues. It emerges as a result of the increased movement of fluid and the decreased movement of water in the body (“Congestive heart failure,” 2020). The venous pressure stemming from this process triggers this symptom connected to other conditions (Liu, 2021). In this case, primarily feet and calves are affected, leading to reduced cardiac stroke volume in cardiac failure (Liu, 2021). This fact allows considering pitting edema as one of the problems connected to heart issues. Moreover, it can be easily diagnosed by residual indentation left after applying pressure to the location of the swelling (Liu, 2021). For a patient with heart failure of any type, this kind of edema means fluid retention complicating the condition.
Pathophysiology: Jugular Vein Distention
Jugular vein distention presents a bulge on a person’s neck appearing due to the pressure in their veins, more specifically, vena cava, as it is the largest vein in the upper body. The process of its development is accompanied by the increase in one’s volume of blood, which also means heart failure, mostly right-sided (“Congestive heart failure,” 2020). It is explained by the fact that the right ventricle pumps blood to the lungs, and its failure to function properly leads to its accumulation (“Congestive heart failure,” 2020). In turn, veins start to bulge, and this outcome is the enhanced work of one’s heart after the first event of the disease.
Pathophysiology: Orthopnea
The pathophysiology of orthopnea as another type of problem corresponding to heart failure implies a complex mechanism of action. This issue is described as the shortness of breath of a patient when lying down in contrast to dyspnea on exertion typical for active movement (Liu, 2021). It is caused by the increased pressure in blood vessels in one’s lungs deriving from the problems with blood distribution (“Congestive heart failure,” 2020). It happens when the heart does not have enough strength to pump the blood out of the heart (Liu, 2021). As a result, the fluids leak into the lungs and trigger breathing difficulties (“Congestive heart failure,” 2020). Considering the above, this disruption positively correlates with congestive heart failure since it is a disease characterized by complications in pumping blood (“Congestive heart failure,” 2020). In this case, this organ’s weakness results from the lack of control over the process, and the symptoms such as orthopnea allow to diagnose of the patients efficiently.
References
Congestive heart failure. (2020). Amboss.
Liu, L. (2021). Heart failure. MedBullets.