Term
| What is Congestive heart failure? |
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Definition
A CV condition in which the heart is unable to pump an adequate amount of blood.
It is not a disease, but a shydrome |
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Term
| What are the common causes of CHF? |
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Definition
CAD
HTN
Cadiomyopathy
Heart valve disease |
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Term
| What are the risk factors for CHF? |
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Definition
CAD
Advancing age
HTN
Diabetes
Smoking
Obesity
Hyperlipedima |
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Term
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Definition
| Interference with the mechanisms that control CO |
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Term
| What are the mechanisms that control CO? |
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Definition
Preload
Afterload
Contractility
HR |
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Term
| What are the classifications of HF? |
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Definition
Systolic
Diastolic
Left
Right |
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Term
| What is the most common classification of HF? |
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Definition
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Term
| What causes inadequate delivery of the arterial system during systolic HF? |
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Definition
V ability of the myocardial muscle to contract (MI
Increased afterload (HTN)
Mechanical abnormalities (valve problem) |
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Term
| What does systolic HF cause? |
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Definition
| Decreased ejection fraction |
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Term
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Definition
| Stroke volume + HR= 4-8 L/min |
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Term
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Definition
| Disorder of relaxation and filling due to stiff ventricular walls (can’t relax) |
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Term
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Definition
| Disturbance of the contractile function of the LC |
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Term
| What does left sided HF result from? |
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Definition
LV MI
Mitral/aortic valve disease
HTN |
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Term
| What happens when blood goes backwards into the lungs? |
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Definition
Engorment in the pulmonary vascular system
The blood gets in the capillaries pushing the alveoli |
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Term
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Definition
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Term
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Definition
| Disturbance of the contractile function of the RV |
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Term
| What causes right sided HF? |
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Definition
Pulmonary Embolism
Right ventricular MI
L sided failure: most common |
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Term
| What is seen in right sided HF? |
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Definition
JVD
Peripheral edema
Engorged liver |
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Term
| What are the compensatory mechanisms for HF? |
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Definition
Sympathetic nervous system activation
Hormonal response
Ventricular dilation
Ventricular hypertrophy |
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Term
| What is the first compensatory mechanism to act in response to HF? |
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Definition
| Sympathetic nervous system |
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Term
| How does the sympathetic nervous system compensate for HF? |
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Definition
Respond to a low CO
It releases Epinephrine and Norepinephriene to ^HR, ^ contractility of heart, cause systemic vascular constriction |
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Term
| What is the hormonal response to HF? |
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Definition
| Decreased glomerular blood flow to the kidneys make the kidneys think there is a decreased volume which causes a release of rennin which converests angiotensinogen to angiotension |
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Term
| What to angiotension cause? What is the overall hormonal response to HF? |
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Definition
Sodium and water retention
Systematic vasoconstriction |
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Term
| How does ventricular dilation compensate of HF? |
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Definition
Caused from high pressure build up to increase contraction
Will eventually give out |
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Term
| How does ventricular hypertrophy compensate of HF? |
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Definition
More common with HTN
Ventricles become thick in an effort to increase output against HTN |
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Term
| What is the counterregulatory mechanism for HF? |
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Definition
| B-type natriuetirc peptide (BNP) is released by a stretched myocardium to help start getting rid of fluid |
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Term
| What is cardiac compensation? |
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Definition
| What occurs when compensatory and counterregulatory mechanisms maintain CO for adequate tissue perfusion |
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Term
| What is cardiac decompensation? |
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Definition
| What occurs when compensatory and counterregulatory mechanisms can no longer maintain CO and tissue perfusion is compromised |
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Term
| What is Acute decompensated heart failure (ADHF) |
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Definition
| A result of an acute event and there is no time for compensatory mechanism to be initiated |
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Term
| What are the clinical manifestations of chronic HF? |
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Definition
Fatigue
Dyspnea
Tachycardia
Edema
Nocturia
Skin changes
Behavioral changes
Chest pain
Weight gain |
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Term
| What are the complications of chronic HF? |
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Definition
Pleural effusion
Dysrhythmias (can also be a cause)
L. ventricular thrombus
Hepatomegaly
Renal failure |
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Term
| What is the limitation of class I HF? |
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Definition
| No limitation of physical activity. Ordinary physical activity does not cause fatigue, dyspnea, palpitation, or angina pain |
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Term
| What is the limitation of class II HF? |
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Definition
| Slight limitation of physical activity. No symptoms at rest. Ordinary physical activity results in fatigue, dyspnea, palpations, or angina pain |
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Term
| What is the limitation of class III HF? |
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Definition
| Marked limitation of physical activity. Usually comfortable at rest. Ordinary physical activity causes fatigue, dyspnea, palpitation, or angina pain |
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Term
| What is the limitation of class IV HF? |
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Definition
| Inabiltiy to carry on physical activity without discomfort. Symptoms of cardiac insufficiency or of angina may be present even at rest. IF any physical activity is undertaken, discomfort is increased |
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Term
| What are the basic goals of management of chronic HF? |
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Definition
Primary goal is to correct underlying problems if possible
Maximize CO
Treat symptoms
Preserve organ function |
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Term
| How can hypoxemia be reduced? |
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Definition
Reduction of activity to decrease cardiac work
Supplemental O2 administration |
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Term
| What is Cardiac resynchronization therapy (CRT) used for? |
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Definition
Coordinates left and right contractility through biventricular pacing
This improves CO and therefore quality of life |
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Term
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Definition
| A couple of years while waiting on a heart transplant |
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Term
| What are diagnostic studies used for chronic HF? |
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Definition
Echocardiogram and/or nuclear imaging studies
BNP |
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Term
| What are the levels of BNP? |
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Definition
<100 normal
100-500 probable
>500 Highly probable |
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Term
| What are the goals for drug therapy for HF? |
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Definition
Correct volume overload
Reduce cardiac workload
Improve contractility |
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Term
| What are diuretics used for in HF? |
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Definition
| To decrease edema in the interstitial and pulmonary tissues and to decrease preload |
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Term
| How do ACE-Inhibitors work? |
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Definition
| Block the vonversion of angiotensin I and II to prevent vasoconstriction |
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Term
| How is tissue perfusion enhanced with ACE inhibitors? |
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Definition
| CO and dieresis in enhanced due to a suppression of aldosterone |
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Term
| What are the side effects ACE inhibitors? |
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Definition
Hypotension
Cough
Hyperkalemia
Renal insufficiency
Angioedema |
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Term
| How do Nitrates work for HF? |
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Definition
| Cause vasodilation by actind directly on the smooth muscle of the vascular system resulting in decreased preload and afterload |
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Term
| How to beta blockers work for HF? |
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Definition
| Block the negative effects of the SNS (^HR) |
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Term
| What is Dobutamine used for in HF? |
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Definition
| Short term, life-threatening situations |
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Term
| How does Digitalis work for HF? |
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Definition
| ^ contractility and V speed of conduction |
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Term
| What are signs of a dig toxicity? |
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Definition
Visual disturbance
N&V
Anorexia |
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Term
| How does potassium affect digoxition? |
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Definition
Hypokalemia is a common cause of toxicity
Hyperkalemia v effects |
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Term
| When are angiotensin II receptor blockers used? |
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Definition
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Term
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Definition
| HF in AA; combination of nitrate and vasodilator |
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Term
| What teaching is necessary for HF? |
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Definition
How to take care of themselves
S/S to watch for
Correct doses/medications
Low sodium diet
Weighing themselves |
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