A: HEART FAILURE Flashcards
A complex clinical syndrome that can result from any cardiac disorder that impairs the ability of the ventricle to deliver adequate blood
Heart Failure
Edematous state resulting to SOB, fatigue, limitation to exercise tolerance and fluid retention
Heart Failure
Edematous state results in
SOB, fatigue, limitation to exercise tolerance and fluid retention
Occurs when the heart’s delivery of blood is inadequate for the needs of the tissue
Heart Failure
Occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the needs of the body
Heart Failure
A complex condition associated with several symptoms arising from defects in left ventricular filling and/or emptying
Heart Failure
Etiology of Heart Failure
CAD (Coronary artery disease) and hypertension
Causes of Heart Failure
- Among elderly, consequence of underlying disease
- Independent diagnosis
- Coronary artery disease
Heart Failure is classically accompanied by
fluid retention
It is the progressive inability of the heart to supply adequate blood flow to vital organs
Heart Failure
It is a leading cause of mortality and morbidity
Heart Failure
Class of Limit normal individuals
Class 1
Class of Ordinary exertion
Class 2
Class of Less than ordinary exertion
Class 3
If metabolic demands are within normal limits but the heart is unable to meet the requirement
Low Output
If metabolic demands increase and the
heart is unable to meet them
High Output
Back-ups in the area that collects “used” blood
Right sided heart failure
The heart’s pumping action moves “used” blood that returns to the heart through the veins through the right atrium into the right ventricle
Right sided heart failure
This occurs as a result of left-sided failure
Right sided heart failure
Failure to properly pump out blood to the body
Left sided heart failure
The heart’s pumping action moves oxygen-rich blood as it travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body.
Left sided heart failure
supplies most of the heart’s pumping power, so it’s larger than the other chambers and essential for normal function
Left Ventricle
Compensation:
1.) Sympathetic responses
2.) Hormonal stimulation
3.) Concentric cardiac hypertrophy
4.) Frank- starling mechanism
Decompensation
1.) Afterload
2.) preload
What are the Loop Diuretics
Bumatenide
Furosemide
Torsemide
What are the Thiazide Diuretics
Chlorthiazide
Hydrochlorothiazide
Chlortalidone
Indapamide
Metolazone
What are the Potassium Sparing Diuretics
Amiloride
Spironolactone
Triamterene
What are the ACE Inhibitors
Benzepril
Captopril
Enalapril
Fosinopril
Lisinopril
Moexipril
Perindopril
Quinapril
Ramipril
Trandopril
What are the ARBs
Candesartan
Losartan
Valsartan
What are the Aldosterone Antagonist
Spironolactone
Eplerenone
What are the Beta Blocker
Bisoprolol
Carvedilol
Metoprolol succinate
What are the Vasodilators
Nitroprusside / Nitrates
Nesiritide
Hydralazine
Provide potent vasodilation of both arteries and veins
Nitroprusside / Nitrates
Reduce left ventricular filling pressures
Nesiritide
A naturally occurring hormone secreted by ventricles
Nesiritide
Binds to natriuretic peptide receptors in blood vessels, resulting to production of CGMP which mediates vasodilation
Nesiritide
Decreases afterload and increases cardiac output
Hydralazine
Produces positive inotropic effect
Digitalis
Produces negative chronotropic effects
Digitalis
Precaution and Monitoring in Digitalis
- Decreased potassium levels
- Calcium works synergistically with digoxin
- Decrease in magnesium level
Signs of Toxicity in Digitalis
Anorexia, fatigue, N/A\V, mental confusion
and disorientation, alteration in visual
perception
Antidote for Digitalis
- Cholestyramine (acute digoxin overdose)
- Digibind / DigiFab
What are the Inotropic Agents
Dopamine
Dobutamine
Inamrinone
Milrinone
Stimulate specific receptors within the kidney to increase renal blood flow and increase urine output
Dopamine
Increases urine output by increasing cardiac output
Dobutamine
Shows positive inotropic effect and vasodilation effect
Inamrinone
Milrinone