Cardiac Failure

Question 1

The right side of the heart receives

———-blood from the body and pumps it to the lungs.

Answer 1

deoxygenated

Question 2

The left side of the heart receives——-

blood from the lungs and pumps it to the body.

Answer 2

oxygenated

Question 3

Both sides of the heart work.

Answer 3

simultaneously

Question 4

HEART RATE (HR)

Healthy adult:

Children and infants:

Answer 4

60 to 80 beats per minute

faster pulses

Question 5

Children and infants have faster pulses because of

Answer 5

their smaller size and higher metabolic rate.

Question 6

A person in excellent physical condition has a——

resting pulse because?

Answer 6

slow /

the heart is a more efficient
pump and pumps more blood per beat.

Question 7

Cardiac output (CO) is

Answer 7

the amount of blood pumped by

a ventricle in 1 minute.

Question 8

Stroke volume (SV) is

Answer 8

is the amount of blood pumped by

a ventricle in one beat; average is 60 to 80 mL.

Question 9

Stroke volume (SV) Determined by

Answer 9

1) preload
2) afterload and
3) myocardial contractility

Question 10

Cardiac output =

Answer 10

stroke volume x pulse (heart rate)

Question 11

average resting

cardiac output is approximately— liters

Answer 11

5

Question 12

Starling’s law of the heart:

Answer 12

the more cardiac muscle
fibers are stretched, the more forcefully they
contract.

Question 13

During exercise, stroke volume increases as ?

Answer 13

venous
return increases and
stretches the myocardium of
the ventricles (Starling’s law).

Question 14

During exercise, the increase in stroke volume and

the increase in pulse result in

Answer 14

increase in

cardiac output: two to four times the resting level.

Question 15

Cardiac reserve is

Answer 15

the difference between
resting cardiac output and the maximum
cardiac output

Question 16

Cardiac reserve may be - liters or more.

Answer 16

15

Question 17

ejection fraction (EF) is

Answer 17

the percent of
total blood that a ventricle pumps per beat;
average is 60% to 70%.

Question 18

The force of contraction of cardiac muscle depends on

Answer 18

its preloading and its afterloading.

Question 19

Preload the degree to which the myocardium is

Answer 19

stretched before it contracts

Question 20

Preload
– Volume of blood in ventricles at—-
– Depends on?

Answer 20

• end diastole
  1) venous return
  2) compliance

Question 21

Afterload the

Answer 21

resistance against which blood is

expelled.

Question 22

Afterload
– Force needed to eject blood into circulation
– Arterial B/P, pulmonary artery pressure
– Valvular disease increases afterload

Answer 22

T

Question 23

Heart Failure (HF)

Definition

Answer 23

When the heart is unable to pump blood at a rate sufficient to meet the metabolic demands of the tissues or can do so only at an elevated filling pressure.

Question 24

Heart Failure (HF)

Often called

Answer 24

congestive heart failure (CHF).

Question 25

forward failure

Answer 25

CO = SV x HR-becomes insufficient to meet

metabolic needs of body

Question 26

backward failure

Answer 26

Accumulation of blood in the venous system

Question 27

CHF Common end point of many

Answer 27

cardiac conditions.

Question 28

Congestive Heart Failure Has—- prognosis.

Answer 28

poor

Question 29

Classifications of HF

Answer 29

1) Systolic versus diastolic
2) Left-sided versus right –sided
3) High output:

Question 30

Systolic versus diastolic

– Systolic:
– Diastolic:
– Mixed

Answer 30

• loss of contractility  decreased CO

- decreased filling or preload

Question 31

Left-sided versus right –sided

Answer 31

– Left- lungs

– Right-peripheral

Question 32

High output:

Answer 32

hyper-metabolic state e.g thyrotoxicosis.

Question 33

CHFcan develop over different time periods:

Answer 33

Chronic CHF

Acute CHF

Question 34

Chronic CHF

Answer 34

Chronic work overload (valve disease, HTN or post

MI)

Question 35

Acute CHF

Answer 35

Acute hemodynamic stress (fluid overload, acute

valvular dysfunction or acute MI)

Question 36

CHF- Etiology

Answer 36

1. Impaired cardiac function
2. Increased cardiac workload
3. Acute non-cardiac conditions

Question 37

Impaired cardiac function

Answer 37

• Coronary heart disease
• Cardiomyopathies
• Rheumatic fever
• Endocarditis
• Arrythmias

Question 38

Increased cardiac workload

Answer 38

• Hypertension
• Valvular disorders
• Anemias
• Congenital heart defects

Question 39

Acute non-cardiac conditions

Answer 39

• Volume overload

* Hyperthyroid, Fever, infection

Question 40

Heart Failure-Risk Factors

Answer 40

Primary risk factors

Contributing risk factors

Question 41

Primary risk factors:

Answer 41

– Coronary artery disease

– Advancing age

Question 42

Contributing risk factors:

Answer 42

– Hypertension
– Diabetes
– Tobacco use
– Obesity
– High serum cholesterol
– African descent
– Valvular heart disease
– Hypervolemia

Question 43

Systolic dysfunction (—)

Answer 43

pump failure

Question 44

Systolic dysfunction (pump failure) , result of
progressive

Answer 44

myocardial contractile dysfunction.

Question 45

systolic dysfunction

Hallmark

Answer 45

decreased left ventricular ejection

fraction (EF)

Question 46

decreased left ventricular ejection
fraction (EF)
– Left side

Answer 46

congested pulmonary vasculature and

edema.

Question 47

decreased left ventricular ejection
fraction (EF)
– Right side

Answer 47

systemic venous hypertension and

edema.

Question 48

Causes of systolic dysfunction

Answer 48

• Ischemic injury
• Volume overload 
• Pressure overload 
• Dilated cardiomyopathy
• Drugs
arrhythmia