Critical care nurse
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Critical care nurse · Apr 2014
Pathophysiological relationships between heart failure and depression and anxiety.
Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. ⋯ Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals.
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Critical care nurse · Apr 2014
Case ReportsDestination to nowhere: a new look at aggressive treatment for heart failure--a case study.
Approximately 5.7 million people in the United States experience heart failure, and about 670 000 new cases are diagnosed annually. Patients who are ineligible for heart transplant may benefit from a left ventricular assist device. These devices have provided patients with an increased life span, but eventually patients die of the underlying heart disease. This case study illustrates the appropriate use of palliative care teams to address preparedness planning and help decrease moral distress among nursing staff. (Critical Care Nurse. 2014; 34[2]:47-56).