series of progressive events

culminates to impaired cardiac output

can lead to hf, dysrythmia, sudden death

primary: unknwon cause

secondary: suspected cause, (ex cardiac disease diagnosis)

most common type

increased atrial chamber size

increased vent chamber size in right and left venticles

decreased muscle size

decrease in hearts ability to pump effectively

blood accululates in the venticles and inc ventricular/atrial/pulmonary pressures

causes by alcohol, chemo, pregnancy (3rd trimester), myocarditis

abnormally thickened intraventricular septum

thickening is usually asym with patches of myocardial fibrosis

left vent hypertrophy

dec vent chamber size

genetically transmitted-like when athletes randomly drop dead

ultrasound shows disruption of heart shape, size, and distensibility-muscle stiffness impairs filling of ventricles, blood ejects too quickly and theres an abnormal pressure gradient

left vent hypertrophy

rare in US

heart muscle becomes infiltrated with various substances-severe fibrosis

heart muscle becomes stiff and non distensible, impairing the ability of ventricle to fill with blood,

caused by amyloidosis-connective tissue disease, hematochromotosis (excess Fe)

chest xray shows cardiomegaly

ECG may show dysrythmia

24 hour holter monitor

ECHO-detects valve structures and wall motion

radionucliede imaging-assess vent functioning

cardiac catherization-evaluate for ischemia

extreme dyspnea

chest pain

signs of heart failure

pulmonary edema

dysrythmia

pericardial effusion

cardiac murmur

syncope

mural thrombosis (stasis of blood in ventricles)

severe heart failure

sudden cardiac arrest

PE

imparied gas exhange

dec cardiac output

activity intolerance

excess fluid volume

ineffective tissue perfussion (cerebral)

risk for ineffective renal tissue performance

manage heart failure symptoms

oral anticoaglants to prevent thrombus and pulmonary emboli

heart transplanatation in terminal disease phase

alert px to signs and sx of dig toxicity

-anoerexia, N, V, inc fatigue, muscle weakness

beta blockers dimisih obstructive pressure

CCB decrease heart rate and vasodilate, and dec contractility

anti dysrhytmic

device implantation

surgical resection and ablation

manage chest pain with rest and elevation

NO NITRO-may dec venous return

therapy is paliative

control heart failure

dig for a fib and oral anticoag

position in high fowlers

apply oxygen

monitor HR and rhyt, RR, temp

eval CVP, PAWP (pulmonary artery wedge pressure)

admin meds/monitor effects

maintain diet restrictions fluid/sodium

monitor coag studies and observe for bleeding

observe for decrease in CO: change in mental status, dec bp, dec urinary output

explain procedures and treatments

ther comm

assist w/ adls-energy conservation

provide rest periods

teach diversion and relaxation therapy

teach about meds

teach cpr

teach s and s of heart failure

teach about diet