Case Study: Differential Diagnosis of congestive heart failure

Case Study: Differential Diagnosis of congestive heart failure. Diagnosis of congestive heart failure. This condition occurs as a result of the inability of the heart to maintain the required cardiac output needed to meet the body metabolic demand. The dysfunction of ventricles causes the majority of the causes associated with cognitive heart failure. The problem originates from systolic dysfunction or myocardial infarction (Schuetz et al., 2014).

Cognitive heart failure is linked to many abnormalities that include the disease of primary muscle, high output failure, muscle loss, volume and pressure overload among others. Many factors determine the cognitive heart disease. They include the decrease in the contraction of the muscle and the increase in the filling pressure of left atrial and this could lead to dyspnea and pulmonary congestion.

I would diagnose Esse for cognitive heart failure. This is as a result of the age of the patients and the signs and symptoms he is describing. The symptoms of heart failure are associated with the cardiac output reduction such as weakness and fatigue and high rates of fluids retention. Another fact concerning cognitive failure is that around 25% of the patients who are less than 70 years old develops lower –extremity edema. In this case, Esse is 57 years old.

Another condition I would diagnose the patient for is myocardial infarction or heart attack. It is caused by the blockage of one or more coronary arteries. Accumulations of substances such as cholesterol can lead to the narrowing of the coronary artery leading to the disease of coronary heart leading to heart attack(Meurs et al., 2015). The elements can break and falls into the blood stream and may end up blocking the coronary arteries. The condition can also be caused by the spasms associated with coronary artery thus blocking blood from supplying the muscles of the hearts with the needed metabolites(Böttche, Kuwert, &Knaevelsrud, 2011). The origins of spasm include from tobacco users. The signs and symptoms associated with a heart attack include sudden dizziness fatigue, shortness of breath, nausea, pressure and pain that may spread to the arm or back. Esse often experienced fatigue, difficulty in breathing and epigenetic pain, which could mean that he was suffering from heart attack.

The patient may also be suffering from pulmonary thrombosis. This is a clot from the legs that is distributed via general circulation to the lungs(Shindo et al., 2014). The signs and symptoms associated with pulmonary embolism include shortness of breath and increased heart rate. Deep vein thrombosis is ruled out because Esse is not experiencing Sharp Pain which becomes worse when the pain coughs. Also, Esse legs’ aren’t swollen (Yun & Kim, 2015).

The tests conducted

An electrocardiogram (ECG)can be carried out to determine the rhythm of the heart and electrical activity of the heart. The tests involve attaching the sensors on the skin with the aim of detecting electric signals thatare produced by the heart upon beating. The rhythm and signals are recorded, and health care professionals can check for any abnormality.

Another test that can be carried out is 2D echo tests. It is employed in testing the movement and the shape of the heart. Can be used to detect the swelling of the heart as a result of the clot in the coronary artery causing the heart attack.


The immediate treatment includes provision of diuretic in cases of a heart attack. Additionally, heparin can be provided in the event of embolism (Yun & Kim, 2015). The need to control the heart rate of the patient is also essential. It is also important to provide the patient with drugs such as beta blockers or calcium channel blockers to control high blood pressure at home(Meurs et al., 2015). Assuming the diagnosis was definitive and the patients come to the hospital with ankles swollen, the explanation is that the patients could be suffering from pulmonary thrombosis at the first time . The pulmonary vein thrombosis could develop into deep pain thrombosis after three months


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Meurs, M., Burger, H., Van Riezen, J., Slaets, J. P., Rosmalen, J. G., Van Melle, J. P., … De Jonge, P. (2015). The association between cardiac rehabilitation and mortality risk for myocardial infarction patients with and without depressive symptoms. Journal of Affective Disorders188, 278-283. doi:10.1016/j.jad.2015.08.057

Schuetz, P., Kutz, A., Grolimund, E., Haubitz, S., Demann, D., Vögeli, A., … Mueller, B. (2014). Excluding infection through procalcitonin testing improves outcomes of congestive heart failure patients presenting with acute respiratory symptoms: Results from the randomized ProHOSP trial. International Journal of Cardiology175(3), 464-472. doi:10.1016/j.ijcard.2014.06.022

Shindo, A., Wada, H., Ishikawa, H., Ito, A., Asahi, M., Ii, Y., …Tomimoto, H. (2014). Clinical features and underlying causes of cerebral venous thrombosis in Japanese patients. International Journal of Hematology99(4), 437-440. doi:10.1007/s12185-014-1550-x

Yun, J. K., & Kim, J. B. (2015). Pulmonary thromboembolism caused by huge uterine myoma. Asian Cardiovascular and Thoracic Annals23(8), 1003-1003. doi:10.1177/0218492314532109