Term
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Definition
| heart cannot adequately provide circulatory support to meet the metabolic demands of the body |
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Term
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Definition
| volume of blood ejected from the ventricle during systole (single contraction) |
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Term
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Definition
| volume of blood in the ventricle just prior to contraction |
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Term
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Definition
| tension/ resistance the left ventricle must overcome in order to empty and eject its SV |
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Term
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Definition
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Term
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Definition
| % of blood pumped out of the LV with each contraction, normal range (50%-70%) |
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Term
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Definition
| volume of blood ejected from the LV per min, normal range 4-7 L/min |
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Term
| decreased amount of blood/sodium sensed by stretch receptors in the blood vessels and barroreceptors |
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Definition
| leads to decreased nerve firing causes relese of NE from CNS |
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Term
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Definition
| causes increased HR (chronotropy) and release of renin from juxtaglomerular cells in kidney |
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Term
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Definition
| stimulates secretion aldosterone, vasopressin, endothelin |
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Term
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Definition
| down regulation of B1 receptors, shortened filling time, arrhythmias |
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Term
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Definition
| loss of flow mediated vasodilation |
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Term
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Definition
| smooth muscle cells in vasclature hypertrophy, fibrotic changes |
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Term
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Definition
| apoptosis of endothelial cells, mechanical stress on heart from increased preload and afterload |
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Term
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Definition
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Term
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Definition
| ischemic, non-ischemic (HTN, obesity, DM, dilated cardiomyopathy), valvular heart disease |
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Term
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Definition
| more long-term disease process that causes HF |
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Term
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Definition
| dyspnea, fatigue, orthopnea, edema, paroxysmal nocturnal dyspnea (PND), pulmonar congestion |
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Term
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Definition
| right sided; issue is with filling the heart, walls dont relax as much to allow blood to fill ventricle (peripheral edema) |
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Term
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Definition
| left sided; contractility issue, heart cannot pump blood out of ventricle (pulmonary edema) |
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Term
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Definition
| systolic (right sided) HF; LVEF <40% |
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Term
| increased resistance to filling |
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Definition
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Term
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Definition
| backflow of blood, blood swishing around in the heart |
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Term
|
Definition
| jugular venous distension |
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Term
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Definition
| brain natriuretic peptide |
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Term
| brain natriuretic peptide |
|
Definition
| protein released when there is left ventricular stretching |
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Term
|
Definition
| masked by heart failure, check thyroid levels |
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Term
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Definition
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Term
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Definition
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Term
|
Definition
| at risk of HF, A is no structural change, B is structural heart dx |
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Term
|
Definition
| structural heart dx, stage D is refractory despite max treatment |
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Term
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Definition
| no limitation of physical activity |
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Term
|
Definition
| slight limitation of physical activity |
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Term
|
Definition
| marked limitation of physical activity |
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Term
|
Definition
| unable to carry on physical activity without symptoms of HF of symptoms at rest |
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Term
|
Definition
| ACE inhibs/ARBs, isosorbid dinitrate/hydralazine, BB, diuretics, aldosterone antagonists, inotropes, vasodilators |
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Term
|
Definition
| decreases preload and afterload *all pt's and specifically those with LVEF |
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Term
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Definition
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Term
|
Definition
| 2.5-5 mg initially titrate to 20 mg daily |
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Term
|
Definition
| use when ACE inhib are not tolerated |
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Term
| combo of ARB and ACE inhib |
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Definition
| not recommended due to hyperkalemia |
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Term
| Isosorbide dinitrate and hydralazine |
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Definition
| African Americans with NYHA class II-IV HF, already receiving an ACEI, BB, and diuretic therapy; can be substitute if ACEI/ARB are not indicated |
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Term
|
Definition
| contraindicated with PDE-5, TID dosing, stimulates nitric acid |
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Term
|
Definition
| vasodilator, enhances nitrates, TID dosing, drug induced lupus |
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Term
|
Definition
| indicated for ALL HF patients, may increase dig levels, take with food |
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Term
| must start slowly under supervision of cardiologist, can cause ADHF |
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Definition
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|
Term
| risk of causing bronchospasm with BB's |
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Definition
| benefits outweigh risks for HF patients |
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Term
|
Definition
| carvedilol, metoprolol succinate, and bisoprolol |
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Term
|
Definition
| 25 mg BID; 50 mg BID if >85 kg |
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Term
|
Definition
| ototoxicity with rapid IV administration |
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Term
|
Definition
| needs potassium supplementations |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
|
Definition
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Term
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Definition
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Term
| thiazides used in combo with loops |
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Definition
| in cases of ‘diuretic resistance’ |
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Term
|
Definition
| metolazone (PO) or chlorothiazide (IV/PO) |
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Term
|
Definition
| keep a diary of daily weights, fluid intake and diuretic dose |
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Term
|
Definition
| when daily weight gain is over 2-3 days of 3-5lbs, or WT loss >2 lbs/day |
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Term
|
Definition
| "dry weight," in which diuretic doses are adjusted |
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Term
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Definition
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|
Term
| split daily dose of diuretic |
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Definition
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Term
|
Definition
| antagonizes effects of aldosterone secondary to AT2 buildup; cause gynecomastia and sexual dysfunction |
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Term
|
Definition
| less side effects than other aldosterone antag like spironolactone |
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Term
|
Definition
| considered for PTs with LV systolic dysfunction (LVEF <40), who have S/Sx of HF while receiving first line care (ACEI, BBs, Diuretics) |
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Term
|
Definition
| Inhibits the Na-K ATPase pump; increase intracellular calcium |
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Term
|
Definition
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Term
|
Definition
| HF patients: 0.5-0.9 ng/mL |
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Term
|
Definition
| unless a patient is experiencing significant conduction abnormalities; level alone is not an indicator |
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Term
|
Definition
| p-glycoprotein inhibition (antiarrhythmic agents, azole antifungals, macrolides), and agents that cause hypokalemia (diuretics) |
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Term
|
Definition
| renal dose adjusted starting at > 60 mL/min |
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Term
|
Definition
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|
Term
| treatment of diastolic dysfunction |
|
Definition
| control tachycardia, HTN, reduce preload |
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|
Term
| dietary sodium restriction |
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Definition
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|
Term
|
Definition
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Term
|
Definition
| NSAIDs, antiarrhythmics (amiodarone, dofetilide--safe), CCB (verap and dilt-neg inotropic effects), thiazolididinediones (rosiglit and pioglit) and corticosteroids |
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