Background Animal-assisted therapy improves physiological and psychosocial variables in healthy and hypertensive patients. Objectives To determine whether a 12-minute hospital visit with a therapy dog improves hemodynamic measures, lowers neurohormone levels, and decreases state anxiety in patients with advanced heart failure. Methods A 3-group randomized repeated-measures experimental design was used in 76 adults. Longitudinal analysis was used to model differences among the 3 groups at 3 times. One group received a 12-minute visit from a volunteer with a therapy dog; another group, a 12-minute visit from a volunteer; and the control group, usual care. Data were collected at baseline, at 8 minutes, and at 16 minutes. Results Compared with controls, the volunteer-dog group had significantly greater decreases in systolic pulmonary artery pressure during (−4.32 mm Hg, P = .03) and after (−5.78 mm Hg, P = .001) and in pulmonary capillary wedge pressure during (−2.74 mm Hg, P = .01) and after (−4.31 mm Hg, P = .001) the intervention. Compared with the volunteer-only group, the volunteer-dog group had significantly greater decreases in epinephrine levels during (−15.86 pg/mL, P = .04) and after (−17.54 pg/mL, P = .04) and in norepinephrine levels during (−232.36 pg/mL, P = .02) and after (−240.14 pg/mL, P = .02) the intervention. After the intervention, the volunteer-dog group had the greatest decrease from baseline in state anxiety sum score compared with the volunteer-only (−6.65 units, P =.002) and the control groups (−9.13 units, P < .001). Conclusions Animal-assisted therapy improves cardiopulmonary pressures, neurohormone levels, and anxiety in patients hospitalized with heart failure.

Advanced practice nurses are met with the ongoing challenge of using interventions and practices that are evidence based in the care of their patients. Such practices include traditional as well as complementary and alternative therapies. Animal-assisted therapy is an alternative therapeutic modality that can be used to promote quality of life and positive health benefits. This article reviews the theoretical and scientific basis for the use of animal-assisted therapy in patient care. A pilot study in which the effect of fish aquarium animal-assisted therapy on patients' stress levels was examined is summarized.

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Coronary artery fistula is a congenital abnormality that can present with a variety of cardiovascular complications. This article presents a patient with a coronary artery fistula outlining the pathophysiology and course of hospitalization, with particular emphasis on nursing management of a patient with coronary artery fistula.