B3W3 Heart Failure Flashcards
Hypertension Diagnoses
3 Separate readings above 140/90 mmHg
Primary Hypertension
No known cause
Essential hypertension
Secondary Hypertension
Due to an underlying medical condition
Heart Failure
Heart that can not maintain cardiac output due to either systolic or diastolic dysfunction
Systolic Disfunction
Impaired ability to pump blood
causes decreased stroke volume and cardiac output
decreases ejection fraction
Diastolic Dysfunction
impaired filling of the blood
Ventricle unable to relax
decreases stroke volume and cardiac output
ejection fraction remains the same
Most Common cause of Right Sided Heart Failure
Left Sided heart failure
Cause of Systolic Dysfunction
Myocardial Infarction, ischemia, or chronic regurgitation
increases afterload
ESPVR
The point of the end of systole on a PV loop will be shifted down and to the right
Cause of Diastolic Dysfunction
Impaired relaxation
Left ventricular hypertrophy, restrictive cardiomyopathy, or myocardial ischemia
Impaired lv filling
Mitral Stenosis
Pericardial Constriction or tamponade
Chronic Neurohormonal Release
Increase in plasma NE, Renin, ADH,ANP, and ET-1
Nonpharmalogical Treatment of HF
Lifestyle changes
Stop smoking, decrease alcohol, maintain ideal body weight, and exercise
Diuretics
Increase sodium and water secretion to decrease blood pressure
All drugs work well with diuretics
Thiazide Diuretics
Most effective treatment for hypertension
Loop Diuretics
Most effective at volume decrease
Beta 1 Receptors
Increase Sympathetics of the heart
Muscarinic Receptors
Only in Heart
Parasympathetics lower sympathetic response
Alpha 1 Receptors
Sympathetics Cause Vasoconstriction
Beta 2
Sympathetics cause relaxation
Beta Blockers
Can Block Beta 1 or Beta 2
Both decrease contractility and heart rate
Prevents overuse of the heart
Can be used with ACE inhibitors or diuretics
ACE inhibitors
Prevents Angiotensin converting into Angiotensin II
RAAS
Renin Angiotensin Aldosterone System
In response to low water and sodium volume
Activates SNS
AT-1
Angiotensin Receptor
When stimulated causes vasoconstriction
ARB
Angiotensin II type 1 inhibitor
causes Vasorelaxation
Calcium Channel Blockers
Inhibits voltage gated calcium channels causes vasodilation
Decreases heart rate and contractility
Treats Diastolic Heart Failure and Hypertension
Direct Effect of Cardiac Glycosides
Inhibits Na/K pump
Increases Intracellular Calcium which increases contraction, stroke volume, and cardiac output
Indirect Effect of Cardioglycocides
Increases parasympathetics and decreases sympathetics to the AV node which decreases vascular rate
Increases ventricle filling and increases cardiac output
