26- Heart Failure Flashcards
cardiac origin, periphery affected
primary heart failure
peripheral cause, cardiac affected
secondary heart failure
ex: sepsis
can’t empty
systolic HF
can’t fill
diastolic HF
low EF
systolic HF sign
how does the kidney compensate for HF?
tries to increase volume by retaining sodium and water
most common cause of RV failure
LV failure
symptoms of LV failure
- dsypnea
- diminished exercise capacity
- nocturia
- CNS impairment
symptoms of RV failure
- peripheral edema
- edema of bowel wall which can impair med absorption
NYHA classification
class I - IV
class I
no limitations
class II
slight limitation of
activity
25% mortality 1 yr
class III
marked limitation
50% mortality 1 yr
class IV
symptoms at rest
50% mortality 1 yr
PE: pallor, cool extremities, anxiety, dyspnea at rest, pulses normal t rapid, weak, varying BP. Pulmonary rales, pleural effusion
left HF
PE: hepatojugular reflux, kussmaul’s sign, congestive hepatomegaly, symmetrical edema
Right HF
what is kussmauls’s sign?
paradoxical jugular movement in which the JVD rises when the patient take a deep breath (normally would decrease because of increasing pulmonary pressure)
x ray findings for HF
cardiomegaly
pulmonary congestion
pleural effusion
kerley lines
risk factors for worse HF prognosis
male CAD S3 narrow pulse pressure High NYHA class reduced exercise capacity
AHA stage A
presence of HF risk factors but no disease and no symptoms
AHA stage B
heart disease present but no symptoms
AHA stage C
structural heart disease present AND symptoms have occurred
AHA stage D
presence of advanced heart disease with continued HF symptoms requiring treatment
stage A therapy
ACE inhibitors
stage B therapy
ACE inhbitors
maybe also B blocker, diuretics, digoxin
stage C therapy
ACEinhibtors and spironolactone, diretics beta blockers
stage D therapy
palliative
improve symptoms
what do ACE inhbitors prevent?
myocyte hypertrophy myocyte apoptosis presynaptic facilitationof NE release direct myocyte toxicity proliferation of fibroblasts
example of ACEi
enalapril
only beta blocker FDA approved for chronic HF
carvedilol
