CAD (Congestive / Chronic Heart Failure) Flashcards
What is Congestive/Chronic Heart Failure?
inability of the heart to pump adequate blood through the entire system
CHF results from any structure or functional cardiac disorder that impairs the ventricles ability to ____ or _____ blood.
Fill or eject
“Big-Hearted Friends”
Ventricle walls become too thick (impairs filling)
“Old Underwear”
Thin/stretched out ventricle walls (impairs ejection)
Half of the people who develop heart failure die within how many years?
5
Causes of CHF
-Coronary artery disease
-HTN
-pulmonary HTN (cor pulmonale)
What is Left Sided Heart Failure?
Inability of the left ventricle to pump or eject blood enough blood
What are the 2 types of Left Sided Heart Failure?
Systolic Dysfunction
Diastolic Dysfunction
What is Systolic Dysfunction in Left Sided Heat Failure?
Inability to contract or shorten against a load (weakened heart muscle)
What is Diastolic Dysfunction in Left Sided Heart Failure?
Stiff heart muscle during filling of the ventricle/can’t relax normally
What does the delayed relaxation in diastolic dysfunction L sided HF lead to?
-reduction in ejection fraction
-pulmonary congestion
-pulmonary hypertension
What is the %EF that classifies someone as high risk for HF?
≤40%
What is the primary cause of Left Sided Heart Failure?
Previous MI
Long-standing HTN
Signs/symptoms of Left Sided Heart Failure
Fatigue
Dyspnea
Wet cough
Pulmonary crackles
Edema
What causes Right-sided Heart Failure
Left-sided failure
What is Right-sided Heart Failure?
Enlargement of the right ventricle due to high BP in the arteries and lungs
Signs/Symptoms of Right-sided heart failure
Fatigue
Pitting edema
S3 heart sound
What does an S3 sound indicate?
Heart failure or enlarged heart
What are crackles?
Discontinuous, intermittent, brief popping sounds
What are crackles caused by?
Fluid in small airways
How do we diagnose CHF?
Chest radiograph
Echocardiography
EKG
Exercise stress test
Blood test (renal or liver function)
What increases as your VO2 peak decreases?
Risk of death
What VO2 peak classifies end stage heart failure?
16 mlkgmin
What is the functional classification for Class IV Heart Failure?
Experiences heart failure symptoms while at rest
What is the functional classification for Class III Heart Failure?
Comfortable only at rest
What is the functional classification for Class II Heart Failure?
Mild symptoms and slight limitation during ordinary activity. Comfortable at rest
What is the functional classification for Class I Heart Failure?
No symptoms and no limitations
Treatment for CHF
Surgery
Medications
Exercise
Behavior modification
Exercise effects of Heart Failure medications
Decreased BP
Decreased HR
Peak VO2, Type I fiber characteristics, Cardiac Output and Quality of life all ______ with exercise.
Increase
Pulmonary ventilation needs and blood lactate _________ with exercise.
Decrease
CHF FIIT guidelines for aerobic exercise
F: 3-5x per week
I: 60%-80% HRR or
RPE 11-14
T: 5-15 minute sessions, increase to 30min/day then 60min/day
T: Non-weightbearing until BP is WNL; long warm-up
CHF FIIT guidelines for strength training
F: 1-2 non-consecutive days/week
I: 50% of 1RM lower body
40% of 1RM upper body
T: Higher repetition and
lower resistance
Fixed machines (no
free weights
SEATED
T: 1-2 sets for each muscle
group, 10-15 reps
CHF FIIT guidelines for flexibility
F: 2-3 days/wk
I: to point of feeling
tightness
T: 10-30 sec static hold
2-4 reps each
T: static, dynamic, PNF
When should exercise be stopped with CHF patients?
-Rapid or irregular heart beat
-heart palpitations
If a patients pulse is ________ after resting for 15 minutes, they should call their doctor.
120-150 BPM
At a respiratory rate of _______, exercise should be terminated
> 40 breaths/min
Exercise should be modified or terminated with development of _______ and ________.
S3 heart sound and pulmonary crackles
Exercise should be modified or terminated when HR and BP decrease by _____bpm
10
CHF FIIT guidelines for strength training
F: 1-2 non-consecutive days/week
I: 50% of 1RM lower body
40% of 1RM upper body
T: Higher repetition and lower resistance
T: Fixed machines (no free weights
