Coronary Heart Disease

Coronary heart disease is the major cause of death in older individuals; half of all heart attack victims are over the age of 65. Stable angina, unstable angina, myocardial infarction, and sudden coronary death are all examples of coronary heart disease.

Risk Factors

• High blood pressure
• Smoking
• Diabetes
• Lack of exercise
• Obesity
• High blood cholesterol
• Poor diet
• Excessive alcohol

Coronary heart disease can present as reversible bouts of myocardial ischemia, which cause chest pain and shortness of breath, or as a more serious type, a heart attack, which causes heart muscle death and scar formation due to insufficient blood flow.

An ECG or echocardiography may reveal evidence of cardiac damage.

Lidocaine, an antiarrhythmic medication intended to prevent ventricular rhythm abnormalities, is administered prophylactically. Thrombolytic therapy is a medicine used to break blood clots that are blocking blood flow to the heart.

Heart Valve Disorder

Aortic valve disease is the most frequent valvular issue in old age. The aortic valve transports blood from the left ventricle to the rest of the body. The process of thickening and stiffness of the valve is referred to as aortic sclerosis. The aortic valve narrows and becomes blocked by hard, calcified deposits in aortic stenosis. Fainting, heart failure, and chest pain can all result from severe aortic valve stenosis. Physical examination is typically used to diagnose aortic stenosis, but echocardiography is the primary technique used to assess the severity of this and other valve abnormalities.

Mitral annular calcification, or calcification of the ring-like support structure encircling the mitral valve, is another valvular issue observed almost exclusively in the elderly. The resultant dysfunction usually results in either a valve blockage or blood leaking back into the atrium from the ventricle. The problem is rarely severe and usually does not necessitate surgical treatment. Prompt infection treatment and the use of prophylactic antibiotics prior to dental treatments and other procedures with an infection risk are especially critical for persons with valvular heart disease.

Heart Failure or Congestive Heart Disease

The American College of Cardiology/American Heart Association guidelines for a chronic clinical syndrome caused by any anatomical or functional cardiac problem impairing the ventricle's ability to fill or eject blood.

The primary symptoms of heart failure are dyspnea and fatigue, with or without leg edema. Orthopnea and paroxysmal nocturnal dyspnea are two signs of heart failure in older people.

All elderly patients with systolic heart failure should be given an ACE inhibitor or an angiotensin receptor blocker. All elderly individuals with systolic heart failure should be treated with an authorized beta-blocker, such as carvedilol, metoprolol extended release, or bisoprolol. In advanced heart failure patients, an aldosterone antagonist such as spironolactone may be given. Digoxin should be used in low doses for patients who are symptomatic despite receiving appropriate ACE inhibitor and beta blocker therapy.

Hypertension

Hypertension is a chronic medical condition characterized by high blood pressure in the arteries. If an elderly person is prescribed hypertension medication, he or she will most likely need to return to the doctor for regular examinations to monitor the results. A trial of diet change, moderate activity, smoking cessation, and weight loss may be adequate for persons with no underlying cardiac disease to lower blood pressure and reduce other concurrent hazards. Weight control, daily physical activity, diabetes medication, less salt and saturated fat intake, and encouraging greater fruit and vegetable consumption are all preventive approaches.

Hypotension

Hypotension Is termed when the blood pressure drops less than 90/60 mm of hg. Chronic low blood pressure without symptom is almost never serious. But the problems can occur when blood pressure drops suddenly and the brain is deprived of an adequate blood supply, this leads to dizziness or light-headedness.

Risk factors

• Dehydration, a lack of nourishment, exhaustion, genetic age, nutritional and psychological variables, acute infection, and allergies are all possible.
• Medication such as antihypertensive medications

Treatment

• Increase your salt intake.
• Drink plenty of nonalcoholic beverages.
• Limit your alcohol consumption.
• Drink more water during hot weather and when suffering from viral disease, cold, or flu.
• Assist with over-the-counter medication and follow-up visits to the doctor.
• Exercise on a regular basis.
• Avoid hefty liftings by elevating the head of the bed at night.
• Avoid squeezing the toilet seat.
• When dizzy, avoid prolonged exposure to hot water, such as hot showers, and sit down.
• Consume smaller, more frequent meals to avoid postprandial hypotension.

Cerebrovascular Accident/Stroke

When the heart tissue lacks nourishment due to a lack of blood supply, blood flow to the brain tissue is disrupted, and brain cells die. A cerebrovascular accident occurs when brain tissue circulation is impaired. A stroke or CVA occurs when a portion of the brain is completely deprived of blood.

Early Signs of Stroke

• Numbness in the face and limbs most commonly on one side of the body
• Sudden vision problems in one or both eyes.
• Severe headaches
• Difficulty with communication
• Lack of coordination

Types of Stroke

Ischemic stroke: The process of ischemia involves harmful blood clotting that plugs arteries and prevents blood flow to essential organs. These strokes may be caused by fatty buildup and cholesterol buildup in the blood vessels.

Hemorrhagic stroke: It is caused by the rapid and violent rupture of a blood artery in the brain, known as hemorrhage. Some of the known causes of this type of stroke include high blood pressure and aneurysms.

Treatment and Management

• Early notice to appropriate staff from the emergency ward.
• Unless contraindicated, patients with atrial fibrillation are treated with dose-adjusted warfarin. Platelet inhibitors such as aspirin, clopidogrel, and ticlopidine are utilized.
• Thrombolytic medicines are used to treat ischemic stroke by dissolving the blood clot that is obstructing blood flow to the brain.
• Maintaining cerebral hemorrhage: It is possible to achieve this by taking the following steps:
• Elevation of the bed's head to facilitate venous drainage and lower elevated ICP.
• Hemicraniectomy as a treatment option for elevated ICP
• An endotracheal tube is used to establish a patient airway.
• Hemodynamic monitoring in real time

Prevention of Cardiovascular Disease

• Cessation of smoking and tobacco
• Exercise for 30 minutes on most days of the weeks.
• Heart healthy diet
• Maintain a healthy weight
• Enough quality of sleep
• Get regular health screenings

Nursing Care of Client with Cardiovascular Disease

• Electrolyte, blood urea nitrogen (BUN), creatinine, lipid profile, and urine protein levels should all be monitored.
• Encourage weight loss if indicated.
• Teach the patient how to check his or her own blood pressure.
• Encourage relaxation techniques and encourage emotional expression.
• Reinforce the need to minimize physical exertion and cold exposure, as well as the importance of regular exercise.
• Increase your intake of high fiber foods, soluble fiber, and low-fat dairy products.
• Inform the client about the drug.
• After a vein ligation, provide specific care for the client. Elevate the foot of the bed for the first 24 hours, monitor for signs of hemorrhage, keep compression dressings in place, and assist with ambulation.
• Use appropriate infection control techniques and, if necessary, initiate neutopenic precautions.