Progress in cardiovascular nursing最新文献

An atrial septal defect (ASD) is a hole in the atrium of the heart. There are 3 types of ASDs; sinus venosus (high in the atrial septum), secundum ASD (middle of septum), and ostium primum (low in the septum). The most common ASD is a secundum ASD. Secundum ASDs are caused by a failure of the atrial septum to close completely during the development of the heart. The most common reported symptoms are fatigue and shortness of breath. Most patients are found to have an ASD after evaluation for a murmur. All ASDs used to be repaired by open heart surgery. However, with advances in the cardiac catheterization lab and development of new devices, some secundum ASDs are able to be closed in the catheterization lab by an interventional cardiologist. There are various types of devices that may be used for closure of an ASD in the cardiac catheterization laboratory. This paper will address 2 of the devices most commonly used. Anticoagulation therapy will need to be followed for approximately 6 months and echocardiograms will need to be obtained at follow-up visits. Nurses have an important role in preparing and teaching the patient and family about the ASD closure procedure and follow-up care.

More than 6 million people in the United States are affected by chronic angina. On January 27, 2006, the US Food and Drug Administration (FDA) approved a new medication for the treatment of chronic stable angina called ranolazine (Ranexa). This is the first angina drug approved by the FDA in over a decade. The unique thing about this drug is that it falls into a new class of therapies in that it works at the level of cellular metabolism in decreasing demand on the cardiac tissue. There are many factors to consider when prescribing this medication including past studies, dosing, and education. There is also evidence that this drug may also benefit diabetic patients with glycemic control.

Although heart failure (HF) is equally prevalent in men and women, women with HF are more likely to report decreased quality of life and are more likely to die of the disease compared with men. Moreover, HF has been studied less extensively in women and no study has specifically addressed women with New York Heart Association (NYHA) class III HF using a qualitative method. This pilot study sought to gain insight into the lived experience of women with NYHA class III HF. Using a phenomenological approach, interviews obtained from 4 middle-aged women with NYHA class III HF were analyzed using the Giorgi method of data analysis. Five themes emerged: (1) developing a new conception of self, (2) conceding physical limitations, (3) enduring emotional heartache, (4) accepting support, and (5) rejuvenating through rest. This study provides a beginning to our understanding of the lived experience of women with NYHA class III HF. However, further exploration is needed to increase our knowledge of HF in women, particularly among diverse populations.

This paper presents the main causes of heart failure (HF) and an update on the genetics studies on each cause. The review includes a delineation of the etiology and fundamental pathophysiology of HF and provides rational for treatment for the patient and family. Various cardiomyopathies are discussed, including primary cardiomyopathies, mixed cardiomyopathies, cardiomyopathies that involve altered cardiac muscle along with generalized multiorgan disorders, and various cardiovascular conditions, such as coronary artery disease (ischemic cardiomyopathy) and hypertension (hypertensive cardiomyopathy). A brief review of pharmacogenetics and HF is presented. The application of the genetic components of cardiomyopathy and pharmacogenetics is included to enhance cardiovascular nursing care.

Acute coronary syndrome (ACS) is a leading cause of morbidity worldwide. Although cardiac rehabilitation (CR) programs can decrease recurrence of coronary events by as much as 25%, few patients engage in CR after a cardiac event. Current therapeutic procedures for ACS are provided quickly after the onset of symptoms, resulting in briefer hospital stays. Therefore, within this shorter time frame, the education of patients about ACS risk factors and their reduction presents a new nursing challenge. The purpose of this paper is to describe the systematic pathway in the development of a nursing intervention which addresses these new challenges in ACS risk factor reduction. The intervention aims to increase enrollment in CR, and enhance illness perceptions and medication adherence, while decreasing anxiety, risk factors, and emergency revisits.