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Cardiopulmonary > Cardiac Muscle Dysfunction > Flashcards

Cardiac Muscle Dysfunction Flashcards

1
Q

T/F Cardiac Muscle Dysfunction is the most common cause of congestive heart failure

A

True

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2
Q

Name 3 common causes of cardiac muscle dysfunction

A
  1. HTN
  2. CAD
  3. Dys-Arrhythmia
  4. Cariomyopathy
  5. Renal Insufficiency
  6. Heart valve dysfunction
  7. Pericardial effusion
  8. PE
  9. Pulmonary HTN
  10. SCI
  11. Age
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3
Q

HTN leads to which sided ventricular hypertrophy?

A

Left

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4
Q

Renal insufficiency leads to what heart dysfunction?

A

CHF due to fluid overload

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5
Q

Pulmonary hypertension leads to which sided ventricular failure?

A

Right, increases afterload

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6
Q

Pulmonary embolism leads to which sided ventricular failure?

A

Right, leads to hypoxemia

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7
Q

What is the 2nd most common cause of CMD?

A

CAD

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8
Q

CAD leads to left, right or both sided ventricular dysfunction

A

either side or both

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9
Q

___ is defined as impaired cardiac muscle contraction and relaxation

A

cardiomyopathy

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10
Q

Choose hypertrophic/dilated/restrictive: diastolic dysfunction

A

hypertrophic

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11
Q

Choose hypertrophic/dilated/restrictive: enlargement of all cardiac chambers?

A

dilated

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12
Q

Choose hypertrophic/dilated/restrictive: rigid ventricular walls

A

Restrictive

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13
Q

Choose hypertrophic/dilated/restrictive: diastolic dysfunction

A

both hypertrophic and restrictive

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14
Q

Choose hypertrophic/dilated/restrictive: systolic dysfunction

A

dilated

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15
Q

Choose hypertrophic/dilated/restrictive: thickened left ventricular walls

A

hypertrophic

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16
Q

Choose hypertrophic/dilated/restrictive: most common

A

dilated

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17
Q

Choose hypertrophic/dilated/restrictive: risk of sudden death sudden death in young athletes

A

hypertrophic

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18
Q

Choose hypertrophic/dilated/restrictive: causes are long term alcohol abuse, systemic HTN, smoking, pregnancy

A

dilated

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19
Q

Choose hypertrophic/dilated/restrictive: causes are genetic

A

hypertrophic

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20
Q

Choose hypertrophic/dilated/restrictive: causes are myocardial fibrosis, ventricular hypertrophy, infiltrate

A

restrictive

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21
Q

Choose hypertrophic/dilated/restrictive: marked by scarring of the ventricles resulting in impaired diastolic filling

A

restrictive

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22
Q

Choose hypertrophic/dilated/restrictive: excessive left ventricular hypertrophy

A

hypertrophy

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23
Q

Pericardial effusion will result in a decrease in which volume?

A

Stroke volume

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24
Q

T/F Pericardits can lead to pericardial effusion

A

True

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25
Q

Pulmonary embolism increase work for right or left ventricle?

A

Right

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26
Q

An abnormal pulmonary arterial pressure is above what number?

A

> 25mmHg

>20mmHg in patients with COPD

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27
Q

Name three physiological changes that occur in the elderly’s cardiovascular system

A
  1. Decreased CO
  2. Decreased vascular elasticity
  3. Increased HTN
  4. Diastolic Dysfunction
  5. Impaired ventricular filling
  6. decreased twitch force of cardiac muscle
  7. Increased systolic arterial pressure
  8. Decreased aortic distensibility
    9.
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28
Q

Which valve does congenital heart disease most often effect?

A

Mitral/bicuspid valve

29
Q

The most common clinical manifestation of heart failure is:

a. pulmonary hypertension
b. pulmonary edema
c. systolic hypertension
d. diastolic dysfunction

A

B

30
Q

The most common cause of an increase in pulmonary capillary pressure is:

a. right ventricular failure
b. left ventricular failure
c. pulmonary edema
d. pulmonary hypertension

A

B

31
Q

High end ventricular diastolic volume means good or bad cardiac output?

A

Bad. Higher end diastolic volume means CHF which means CO or SV will be decreased

32
Q

During exercises, you would expect a patient with heart failure to have a high or low stroke volume?

A

Low, and increased ventricular end diastolic volume will induce dyspnea and pulmonary edema.

33
Q

Inotrophy is defined as:

A

contractility

34
Q

Frank starling law of the heart is a relationship between ___ and ____

A

length and tension

35
Q

Decreased stroke volume leads to hypertrophy which leads to increased ventricular mass which leads to increased atrial pressure

A

Just know this

36
Q

Decreased stroke volume leads to increased ventricular end diastolic volume which leads to an increase in atrial pressure

A

Just know this

37
Q

Increased levels of BNP and ANP(Natriuretics) are indicative of:

a. heart failure
b. acute coronrary syndrome
c. heart disease
d. all of the above

A

D. ANP and BNP are released by cardiac muscle during times of high filling pressure(detected by stretch receptors of atrium) and are used to diagnose and manage disease states(BNP is the most important)

38
Q

True or false: Renal dysfunction can lead to CHF

A

True

39
Q

Hepatomegaly occurs in this organ? It occurs when ____

A

Liver, increased fluid leads to hepatic venous congestion and decreased O2 perfusion

40
Q

Name the 3 major “pneas” of CHF:

A

Dsypnea
paroxymal nocturnal dsypnea
orthopnea

41
Q

Name 3 S/S of CHF:

A 
Rapid respiratory rate
rales/crackles with inspration
S3 heart sounds
peripheral edema
jugular venous distention
weight gain
sinus tachycardia
decreased exercises tolerance
42
Q

In what population would a S3 heart sound be normal

A

Children

43
Q

S1 is the ___ and S2 is the ___

A

lub, dub

44
Q

Treating CHF: The mneumonic is UNLOAD FAST! List each letter of the pneumonic

A 
Upright position
Nitrates
Lasix
Oxygen
ACE Inhibitors
Digoxin
Fluids(Decreases)
Afterload(Decrease)
Sodium Restriction
Test(Digitalis glycoside Level, ABGS, Potassium)
45
Q

ICD implantation for CHF is recommended if ejection fraction is below:

a. 45%
b. 25%
c. 35%

A

c. 35% with mild to moderate s/s

46
Q

With CHF would you expect tachycardia or bradycardia?

A

Tachycardia(91-110bpm)

47
Q

What type of exercise would you provide a patient with CHF on the first visit?

a. low level, low impact
b. moderate level, low impact
c. low level, moderate impact(walking)

A

a. 5-10 minutes of walking, gradually increasing duration to 30 minutes. 1-2x/day for 5-7days/week

48
Q

T/F CPAPs may function to reduce preload and afterload in the heart

A

True

49
Q

T/F It is important to give a CHF individual both inspiratory and expiratory exercises?

A

True

50
Q 
What two things would you monitor during exercises for a person with CHF?
A. dyspne and RPE
B. orthopnea and RPE
C. dyspnea and HR
D. dyspnea and BP
A

A.

51
Q

You are deciding if a CHF patient is ready to perform your exercises program. Which of the following would indicate she is ready to begin? Choose all that apply

a. ability to speak without signs of dyspnea
b. crackles present in < 1/2 of the lungs
c. Mild-moderate fatigue
d. RR of 35
e. resting HR of 110

A

All of the above except RR of 35. Should be <30. HR should be <120bpm.

52
Q

A patient with CHF is exercising and you think you may have to stop the treatment because of all of the below except:

a. Dyspnea or fatigue of 3/10 or higher
b. RR >40bpm
c. development of S3 heart sound
d. decrease in both diastolic and systolic of more than 10mmHg
e. decrease in HR of 5bpm

A

e. HR decrease >10bpm indicates you should terminate exercise

53
Q

T/F Day 1 with CHF patient you should work on independent ambulation for 15 minutes

A

False: that is for day 4, Day 1 work on commode/chair activity and bedrest

54
Q

T/F Day 3 with CHF patient you should work on commod/chair activity and advocate bedrest

A

False: that is for day 1, day 3 focus on hallway ambulation, cycle ergometry(10 minutes), MET level 2-3

55
Q

What should the MET level for a CHF patient be?

A

2-3

56
Q

What should the MET level for a Day 4 CHF patient be?

A

3-4

57
Q

T/F A day 4 CHF patient should be independent in hallway ambulation?

A

True

58
Q

T/F A Day 2 CHF patient should be able to perform room ambulation and gentle active strengthening exercises?

A

True

59
Q

T/F Day 4 a CHF patient should be able to ascend and descend 2 flights of stairs

A

True

60
Q

T/F A day 4 CHF patient should be able to shower independently

A

True

61
Q

Should the patient perform exercises training before, during, or after CPAP and BiPAP ventilation sessions?

A

During, research shows CPAPs have improved exercise tolerance

62
Q

T/F Energy conservation is a major concern in CHF patients?

A

True

63
Q

What heart dysfunction occurs when blood is backed up from the left ventricle causing pulmonary congestion?

A

Congestive Heart Failure, Chronic Heart Failure

64
Q 
Systolic heart failure is when the heart is \_\_\_\_, the ejection fraction is \_\_\_, BNP levels are \_\_\_, and myocardial \_\_\_ is impaired
options in order:
1.hypertrophied or dilated
2. reduced or normal
3. elevated or decreased
4. contractility or relaxation/filling
A 
Dilated heart
reduced EF
Elevated BNP
Contractility impaired
Prior MI
65
Q 
Diastolic heart failure is when the heart is \_\_\_\_, the ejection fraction is \_\_\_, BNP levels are \_\_\_, and myocardial \_\_\_ is impaired
options in order:
1.hypertrophied or dilated
2. reduced or normal
3. elevated or decreased
4. contractility or relaxation/filling
A 
Hypertrophied heart
Normal EF
Less elevated BNP
Relaxation and filling impaired
Found in elderly, women, obese, HTN, atrial fib patients
66
Q

Significant ventricular dilation often causes ___ regurgitation

a. mitral
b. tricuspid
c. either of them
d. both at the same time
e. all of the above

A

E

Occurs with Systolic Heart Failure

67
Q

True/False: Diastolic Heart Failure will have normal ejections fraction

A

True

68
Q

Impaired relaxation and increased passive stiffness with normal systolic function and EF is associated with diastolic of systolic heart failure?

A

Diastolic

69
Q

List 3 S/S of left ventricular failure

A 
Dyspnea, dry cough
Orthopnea
Paroxysmal nocturnal dyspnea (PND)
Pulmonary rales, wheezing
S and S of acute pulmonary edema (dyspnea, pallor or cyanosis, diaphoresis, tachycardia, anxiety, agitation)
Hypotension
Tachycardia
Lightheadness, dizziness
Fatigue, weakness
S and S of peripheral hypoperfusion (weak, thread pulse, vasoconstriction)
Poor exercise tolerance
S3 and sometimes S4 (3rd heart sound or ventricular gallop, 4th heart sound or atrial gallop)

Cardiopulmonary (8 decks)

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