Question

Why did Mr. Stone develop heart failure?

The patient is a 60-year-old male who has hypertension and heart failure. He had Hydrochlorothiazide prescribed by MD for his hypertension a couple of years ago. However, the patient has not taken the medications as directed. He complains that he is experiencing increasing fatigue, shortness of breath, paroxysmal nocturnal dyspnea and weight gain. An ECG and a chest x-ray were performed and also had blood drawn. The patient is alert and oriented. His bp was 168/96 mmHg, the temperature was 98.4, pulse 98/min and RR was 22/min. Oxygen saturation 90% on room air and increased to 94% with oxygen at 2 liters/min, per nasal cannula. The nurse administered Enalapril 5 mg PO.

Answer 1

Long term hypertension can lead to heart failure:

Mechanism behind it is, left ventricular hypertrophy.As due to increasing blood pressure there occurs increasingly resistance to blood pumping by the left ventricle into the aorta.This increased resistance leads to building of muscle fibers in the left ventricle wall leading to its hypertrophy

This leads to narrowing of the left ventricle chamber.So the amount of blood present in the chamber decreases leading to reduced stroke volume which in turn leads to heart failure

Answer 2

High blood pressure can lead to heart failure due to he hypertrophy of the left ventricle. Back flow of blood to the left ventricle causes a reduction in stroke volume