Acute HF (Newman) Flashcards

1
Q

3 neurohumoral systems activated in HF

A

renin
Naturetic peptides
symp system

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2
Q

Major determinants of afterload

A

systolic BP

size of ventricle

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3
Q

3 contraindications to heart transplant

A

> 65 yo
systemic disease
drug addicts/compliance

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4
Q

circumstance in which O2 delivery to the tissues is in adequate relative to their O2 requirements

A

heart failure

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5
Q

causes of acute heart failure

A

** DECREASED CONTRACTILITY**
–> dec CO and O2 delivery
acute MI
exacerbation of chronic HF
post operative

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6
Q

signs and symptoms of acute HF

A
dyspnea and fatigue
pulmonary congestion 
dec BP
cold extremities
dec urine output
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7
Q

removing functional myocytes will decrease ____

A

contractility

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8
Q

Ejection fraction in acute HF

A

less than 50%

* on test?

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9
Q

how to measure O2 utilization

A

O2 in arterial blood - O2 in venous blood of a specific tissue
= arterial venous difference

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10
Q

normal tissues extract ___% of the O2 delivered to them

A

25%

**blood leaves heart 100% and returns to the pulmonary artery/RT heart at 70%

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11
Q

if the tissues extract way more than 25% O2 we know…

A

person is in HF

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12
Q

As CO decreases the amt of extraction of O2 (increases or decreases)

A

increases (From 3%0 to 60%)

**measure wil mixed venous something rather

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13
Q

In AHF, how is perfusion to the brain maintained?

A

vasoconstriction at kidneys, skin = limit blood flow to kidney and ~give to brian

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14
Q

A normal person and a HF pt have the same MAP. How is this possible?

A

the person in HF has very high TPR

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15
Q

When will the BP drop in HR causing shock?

A

when the TPR can no longer maintain BP

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16
Q

CArdiac Index?

A

?

17
Q

Hemodynamics of acute HF

A
  1. dec Cardiac Index
  2. reduced SvO2 (<55%; more extracted = more ischemia)
  3. elevated LV filling pressure
  4. Elevated TPR

Hypotension and HF (dec CO due to dec TPR)
Extreme: Acidosis and hypotension

18
Q

How do we raise CO?

A

ionotropic (dobutamine and milrinone)

19
Q

How do we try to reduce TPR?

A

nitroprusside

**not always indicated

20
Q

When are vasodilators not used?

A

when MAP is low

21
Q

WHat does the pulmonary artery catheter measure

A

preload*** on test

22
Q

How do we reduce LVFP?

A

diuretics