PubMed · 2325741
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B Phibbs. 1990-05-10. Syncope and electrophysiologic testing.. https://doi.org/10.1056/nejm199005103221916
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Congestive heart failure (CHF) is a common clinical problem and in its advanced stage has a poor prognosis. Approximately 400,000 individuals develop heart failure each year (Parmley 1989). CHF can be caused by coronary artery disease such as myocardial infarction, ischemia and hypertension. Should heart failure occur as a result of acute myocardial infarction, a classification tool developed by Killip can be used to assess the degree of CHF. Killip's classification is organised into the following four categories: Class I: no heart failure Class II: mild to moderate failure Class III: acute pulmonary oedema Class IV: cardiogenic shock (Killip, as cited by Benz 1989). This system helps in organising clinical signs and symptoms of heart failure. Due to the fact that CHF is now the most common hospital discharge diagnosis for those over the age of 65, critical care nurses need to be able to recognise complications and intervene rapidly (Parmley 1989) in collaboration with medical staff. The purpose of this paper is first to discuss cardinal signs and symptoms and clinical data associated with CHF. Second, critical care nurses' management of CHF is organised around common nursing diagnoses.
The pharmacotherapy of ischemic heart disease has evolved at a rapid pace during the past several decades. Drug therapy is prescribed for ischemic heart disease to either increase myocardial oxygen supply, decrease myocardial oxygen demand, or both. Although the types and number of drugs to treat ischemic heart disease are increasing and will continue to do so, there are still several major categories of pharmacologic agents that are essential in managing ischemic heart disease. The major drug categories covered are antiplatelet agents, anticoagulants, nitrates, beta-adrenergic receptor antagonists (beta-blockers), calcium channel antagonists, angiotensin-converting enzyme inhibitors, and thrombolytic agents. Current information and recommendations are presented for safe and effective use of these agents.