Heart failure is defined as a condition in which the heart can no longer pump enough blood into the body's tissues. This situation can arise with or without heart disease. Impaired heart function can be a disorder of diastolic or systolic function, heart rhythm disturbances, or incompatibility of preload and afterload (Santoso et all, 2007).
Heart failure is difficult to recognize clinically, because of the variety of clinical conditions and not specific and only a few clinical signs in the early stages of the disease. Recent developments make it possible to recognize early heart failure and the development of treatments that improve clinical symptoms, quality of life, decrease in treatment rates, slow progression of disease and improve survival. (Davis et all, 2000)
Clinically, patients with heart failure can find symptoms and signs such as shortness of breath during activity, pulmonary edema, increased JVP, hepatomegaly, leg edema(Nieminen, 2005), (Davis et all, 2000).
Diagnostic examinations that can be done include chest radiographs, 12 lead ECGs, echocardiography, blood tests, radionuclide examination, angiography and pulmonary function tests. (Watson et all,2000)
The main symptom in patients with heart failure is chest pain. Chest pain arises suddenly. The cause is a decrease in the oxygen supply to the myocardium which results in cardiac cell death. Clinical symptoms of chest pain in cases of heart failure, appear suddenly and continuously. If this pain is left, the severity of the pain will increase so that the pain is unbearable again. The pain can spread to the neck, and continue towards the arm. This pain is accompanied by shortness of breath and pale (Aspiani, 2014).
Acute pain identifies that damage or injury has occurred. This pain is generally less than six months and is usually less than one month. For purposes of definition, acute pain can be explained as pain that lasts from a few seconds to six months (Brunner & Suddarth, 2016).
The assessment that needs to be done in patients with heart failure is to review the main complaints, review the current disease history by asking questions about pain on a PQRST basis.
Nursing problems in patients with heart failure due to an imbalance between the need and availability of oxygen to the heart causing chest pain (Ranitya, 2009). Acute pain is related to biological injury agents: imbalance of oxygen supply to the heart (Wilkinson & Ahem, 2011). Chest pain is usually described as a feeling of heaviness, such as being pressed, crushed, or like burning (Rilantono, 2013).
Interventions carried out include assessing the scale of pain, intensity, location, duration of spread, in addition to nursing actions that provide progressive relaxation techniques that are individual and expected to be effective and able to achieve comfort, teach deep breathing relaxation techniques, teach guide imagery techniques. (Wilkinson & Ahern, 2011)
Some of the nursing management of non-pharmacological therapies include regulating physiological positions and immobilizing extremities that experience pain, resting clients, managing the environment, compressing, deep breathing relaxation techniques, distraction techniques, and touch management (Muttaqin, 2011). Giving deep breath relaxation techniques will increase the supply of oxygen to the tissue, thereby reducing the level of pain experienced by individuals (Agung, Andriyani, & Sari, 2013). In addition to deep breathing relaxation techniques, giving warm compresses also has an effect on reducing chest pain. Warm compresses are non-pharmacological actions performed to promote blood circulation and also relieve pain (Wurangian, Bidjuni, & Kallo, 2015). Giving warm compresses should be done for 10 minutes (Millard, Towle, Rankin, & Roush, 2013).
