410 Flashcards
Major changes with CHF(Heart failure)
- Systolic dysfunction
- Pulmonary blood flow/pulmonary blood pressure
- Altered hormone levels (vasopressin, aldosterone
- Skeletal muscle metabolism
- Renal failure- leads to sodium and water retention
Ventilatory issues
• Pulmonary bl pressure
• Physiological dead space
• Worsened breathing patterns
Signs and Symptoms of CHF
- Quick fatigue, reduced tolerance to exercise, dyspnea
-Edema to the legs and ankles and swollen neck veins
-tachycardia/arrythmias/palpations - heart murmur
cardiac enlargement
Treatments for CHF
- Diuretics
- Digoxin
- ACE inhibitors
- beta blockers
- vasodilators
- angiotensin 2 receptor blockers
- physical activity
what is CHF
When the heart is failing to pump adequate blood from ventricles
What are the types of MI’s?(heart attacks)
Transmural- entire heart wall in the area is affected (Endocardium, myocardium, epicardium)
-Subendocardial- only a portion of the thickness (endocardium and myocardium) is damaged
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Medical name for stroke
Cerebral Infarction
caused by atherosclerosis, embolism or hemorrhage
What are the signs and symptoms of stroke or TIA (Transient ischemic Attack)
- Paralysis
- Changes in behavior
- Memory Deficits
- changes depend on side of brain affected
- loss of sensation, speech coordination
PAD (Peripheral Artery Disease)
- decreased bl flow
- increase leg pain usually below the knees
- lowered physical capacity
- stenose and or occlusions of the lower extremity
Signs and Symptoms of PAD
- Leg pain with exercise (disappears with rest)
- coldness or numbness and tingling in lower legs and feet
Determining the severity of PAD
-Time and or distance of onset of pain
ankle/brachial systolic pressure index
Exercise Testing Procedures
- Measure and calculate ABI after 15m supine test
- exercise test with gradual increase in grade (2mph, 0% grade, then increase in grade every 2-3 min
- use pain scale, record times to onset of each level of pain, record HR and BP
- 15 min recovery (supine), record pain score
Severity of PAD
Stage 1: asymptomatic
Stage 2A: Intermittent claudication (walking >200m)
Stage 2B: Intermittent Claudication (walking <200m) (no ischemic pain at rest for either 2a or 2b)
Stage 3: ischemic pain at rest
Stage 4: Ulceration or gangrene; or both
Ventilatory issues that result from Heart Failure
Pulmonary congestion
hypertension
2 direct causes of angiotensin 2
- sodium retention
- increased vasopressin
NYHA HF Classifications
- No symptoms w/ activity or rest
- symptoms w/ grater than ordinary activities but comfy @ rest w/ mild exertion
- symptoms w/ ordinary activities, comfy only @ rest
- symptoms w/ any activity, symptoms may occur @ rest
what is a healthy relative vo2?
Around 35, 40 and 60’s in trained people
traditional cardiac rehab categories
- Inpatient- phase 1
- Early outpatient- Phase 2
- Maintenance and follow-up- Phase 3 (also outpatient)
Fontaine Classifications
Stage 1: Asymptomatic
Stage 2a: Intermittent claudication (walking >200m)
Stage 2b: Intermittent claudication (<200m) no ischemic pain @ rest for either 2a or 2b
Stage 3: Ischemic pain @ rest
Stage 4: ulceration or gangrene or both ( minor or major tissue loss)
CHF causes
- systolic dysfunction
- Pulmonary Bl flow/ Pulmonary BP
- Altered Hormone levels
~ vasopressin
~ Aldosterone
what does ace inhibitors do?
Lower BP
Changes w/ CHF
- Skeletal muscle metabolism
- decreased aerobic metabolic capacity= increased reliance on glycolysis= increased co2/lactate prod.
- Renal Failure
