Term
| Blood pressure regulated by: |
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Definition
- ANS: SNS
- Kidneys: renin-angiotensin-aldosterone mechanism
- Endocrine: release hormones to stimulate SNS
- Arterial baroreceptors
- Fluid volume
- Vascular autoregulation |
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Term
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Definition
Amount of pressure generated by the left ventricle to distribute blood into the aorta with each contraction
- Measure of heart's pumping ability and vascular tone
- Isolated systolin HTN: health threat for older adults, indicator of MI, stroke, PVD |
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Term
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Definition
| Amount of pressure against arterial wall during relaxation phase of the heart |
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Term
| High blood pressure values |
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Definition
SBP: >140
DBP: >90
Diabetics: >130/80 |
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Term
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Definition
- Difference between the SBP and DBP
- Indirect measure of CO |
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Term
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Definition
4-6 L/min
Decreases with age |
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Term
| Types/classifications of HF |
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Definition
- Systolic vs diastolic (based on pathophysiology)
- R sided vs L sided (based on symptoms)
- High output: adequate volume but underlying issues |
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Term
| Causes of chronic heart failure |
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Definition
CAD
HTN
Rheumatic heart disease
Congenital heart disease
Cor pulmonale
Cardiomyopathy
Anemia
Bacterial endocarditis
Valvular disorders |
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Term
| Causes of acute heart failure |
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Definition
Acute MI
Dysrhythmias
Thyrotoxicosis
Hypertensive crisis
Rupture of papillary muscle
Myocarditis |
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Term
|
Definition
Heart can't contract sufficiently enough to eject blood
Normal EJ is 60%, HF is less than 40%, severe HF is less than 30% |
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Term
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Definition
Left ventricle is impaired and can't relax and fill enough
EF may still be normal |
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Term
|
Definition
Ischemic heart disease (CAD, MI)
HTN
Valvular heart disease
Cardiomyopathy |
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Term
|
Definition
HTN
Aortic stenosis
Hypertrophic cardiomyopathy
Ischemic heart disease |
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Term
|
Definition
- Suggested by history of MI
- Younger patient age
- Displaced point of maximal impulse
- S3 gallop on the physical examination
- Presence of Q waves on the ECG
- Cardiomegaly on the chest radiograph |
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Term
|
Definition
- History of hypertension
- Older patient age,
- Sustained point of maximal impulse
- S4 gallop on the physical examination
- Left ventricular hypertrophy on the ECG
- Normal-sized heart on the chest radiograph |
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Term
|
Definition
- Decrease preload and afterload:
ACE inhibitors
Diuretics
Beta blockers
- Increase contractility
Digoxin
- Decrease RAAS and SNS response
ACE inhibitors
Beta blockers |
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Term
| Treatment of diastolic HF |
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Definition
Treatment depends on underlying cause
Beta blockers and calcium channel blockers frequently used when dysfunction is secondary to ischemia or hypertension
- Reduce strength of contraction (don't give inotropes)
- Decrease preload and afterload
- Maintain adequate cardiac perfusion |
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Term
| Body's initial compensation for decrease CO |
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Definition
- Frank Starling mechanism: increase preload to sustain cardiac performance
- Myocardial hypertrophy
- Activation of neuroendocrine systems (epinephrine, anti-diuretic hormone, renin-angiotensin-aldosterone, decline of endogenous vasodilators) |
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Term
| Body's initial compensation for decrease CO leads to |
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Definition
| Compensatory mechanisms aggravate Hf by increasing ventricular afterload and preload |
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Term
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Definition
Causes backward flow into pulmonary vasculature
Due to increased volume and pressures, fluid is pushed from pulmonary capillaries into intersitital space and alveoli
Causes decrease CO and systemic perfusion
- Causes
HTN
CAD
Valvular disease involving the mitral or aortic valve |
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Term
| Left sided heart failure symptoms |
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Definition
- Dyspnea, orthopnea, tachypnea, coughing but no mucus
- Tachycardia, weak pulses, cool extremities
- Fatigue, weakness, confusion
- Rales, low O2 sat
- Oliguria (low urine output) |
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Term
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Definition
Can result from left sided heart failure
- Lungs fill with fluid
Symptoms
- Severe SOB, acute onset
- Expiratory wheezes
- Frothy pink-tinged sputum
- Rales throughout
- Low O2 sat |
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Term
| Pulmonary edema treatment |
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Definition
IV diuretics stat
100% non-rebreather mask--may need to be intubated
CPAP (continuous positive airway pressure) |
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Term
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Definition
RV unable to pump effectively causing backward failure into systemic vasculature
Causes
- Left-sided HF
- Chronic lung disease (Cor pulmonale)
- Primary pulmonary HTN
- Pulmonic valvular disease |
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Term
| Right sided heart failure symptoms |
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Definition
Peripheral edema
Hepatomegaly, ascites
JVD
Rapid weight gain (from fluid) |
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Term
|
Definition
BNP levels
Chest X-ray
Echocardiogram
Cardiac catheterization |
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Term
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Definition
- Biventricular pacing
- ICD: high risk of arrhythmia
- Ventricular assist device
- Cardiac transplantation |
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