Question

Carl Edwards is a 75-year-old man with congestive heart failure. Having sustained three myocardial infarctions in the last 10 years, he has decreased left ventricular function. Mr. Edwards takes Digoxin, Capoten, Coreg, and Lasix for management of this disease. Today he presents to the emergency department with fatigue, generalized weakness, and feelings of “skipping” heartbeats. Upon arrival, he is placed on the cardiac monitor, his vital signs are assessed, and an IV is inserted. He currently denies chest pain, but is experiencing some shortness of breath, and is placed on 2 L of oxygen via nasal cannula. Mr. Edwards has noticed over the last 8 to 9 months that mild exercise causes fatigue, dizziness, palpitations, or shortness of breath and is having difficulty living independently and performing his usual ADLs.

a.     Which of his medications might be contributing to his symptoms of generalized weakness and heart irregularities?

b.     For what clinical manifestations should you assess to correlate to his left-sided heart failure?

c.     How do his medications treat his congestive heart failure?

d.     How does the hypokalemia affect the effects of Digitalis?

Answer 1

a, Digoxin medication help strengthen the heart muscle, contraction and slows the heart rate. This medication causes generalized weakness and irregular heartbeat and slow heart rate.
b, Left-sided heart failure correlated with shortness of breath when the blood backs up into the lungs due to improper functioning of the left-sided heart.
c, Digoxin (digitalis) it helps to pump the weaned heart efficiently and strengthen the cardiac muscle contractions, heart rhythm and improve blood circulation, it treats cardiac failure.
Captopril or capoten is a vasodilator for treating heart failure and hypertension. It is a combination of digitalis and diuretics. In heart failure, it does not need the digitalis.
Coreg treats high blood pressure and heart failure. It forces the contraction and reduce the heart rate and stabilize the work of the heart.
Lasix is a diuretic to treat hypertension. It removes excess water and salt from the body through urine. It makes the heart to pump easier and controls the blood pressure.
d, Patient with heart failure used to take digoxin as a diuretics. This drug removes excess fluid from the body, it causes potassium loss. due to less potassium in the body, it increases the risk of digitalis toxicity.