Cardiac Muscle Dysfunction and Congestive Heart Failure Flashcards
What is…
- Congestive Heart Failure (CHF) = ?
- Differences between right and left-sided heart failure = ?
- CHF: A condition where the heart is unable to pump enough blood to meet the body’s needs.
- Right Side: Fluid backs up into the system (legs, liver).
- Left Side: Fluid backs up into the lungs.
What are the symptoms right and left sided CHF?
- Right:
- Peripheral Edema
- Jugular Venous Distention
- Pulsus Alternans - Arterial pulse alternating between strong and weak
- Extremity Changes
- Weight Gain
- Sinus Tachycardia
- Reduced exercise tolerance
- Left:
- Increased Respiratory Rate
- Crackles
- Heart Sounds – S3
- Reduced Exercise Tolerance
- Dyspnea (DOE)
- Orthopnea
- ParadoxicalNocturnalDyspnea
- Frothy Pink Sputum
What is…
- Cardiac Muscle Dysfunction (CMD) = ?
- Causes = ?
- Cardiac Muscle Dysfunction (CMD): A condition where damage to the cardiac muscle leads to heart failure.
- Causes:
- Hypertension
- CAD (MI)
- Cardiomyopathy
- Renal insufficiency
CMD and heart valve abnormalities
(flip to read)
Heart Valve Abnormalities:
- Blocked or incompetent valves cause the heart to contract more forcefully, leading to myocardial hypertrophy.
What are the types of cardiomyopathy?
- 1) Dilated =
- 2) Hypertrophic =
- 3) Restrictive =
What is dilated cardiomyopathy?
dilated cardiomyopathy:
Ventricular dilation leads to impaired systolic function and a decrease in ejection fraction.
What are symptoms of dilated cardiomyopathy?
- dyspnea
- fatigue
- pulmonary congestion
- palpitations
What is hypertrophic cardiomyopathy?
Hypertrophic Cardiomyopathy:
- A condition where the heart’s left ventricle is hypercontractile and leads to high ejection fraction.
What is restrictive cardiomyopathy?
Restrictive Cardiomyopathy:
The heart muscle becomes stiff, resulting in poor filling during diastole.
What is left-sided heart failure?
The left ventricle cannot pump enough blood, leading to fluid accumulation in the lungs.
What is right-sided heart failure?
The right ventricle is too weak to pump blood to the lungs, leading to systemic fluid buildup.
What is biventricular heart failure?
Biventricular Heart Failure:
- Both sides of the heart fail, leading to symptoms from both left and right-sided heart failure.
What are the signs of CHF?
Tachypnea, dyspnea on exertion, crackles, S3 heart sound, orthopnea.
Functional Heart Failure
What is systolic heart failure?
Systolic Heart Failure: The heart’s contractile function is reduced, causing reduced cardiac output and ejection fraction (< 40%).
Functional Heart Failure
What is diastolic heart failure?
Diastolic Heart Failure: The ventricles cannot fill enough, but the heart still pumps out a normal amount of blood (preserved ejection fraction).
.
.
What happens during the…
- 1st compensatory phase in CHF
- 2nd compensatory phase in CHF
- 3rd compensatory phase in CHF
(1) Fluid accumulates in the lungs, causing pulmonary congestion.
(2) SNS activation increases heart rate and contractility to improve cardiac output.
(3) Decreased blood flow to the kidneys activates the RAA system, leading to edema.
What diagnostic tools are used for heart failure?
- Echocardiogram: Creates a picture of the heart using sound waves.
- Brain Natriuretic Peptide (BNP) Levels:
- Compensation: 100-700
- Decompensated: >700
S3 heart sound:
What is the medical management of heart failure?
- controlling sodium intake
- medications
- physical activity
- fluid management
What is a ventricular assist device (VAD)?
A mechanical pump used to support heart function in people waiting for a heart transplant.
What are common medications for CHF?
- ACE inhibitors = Block the formation of angiotensin II, reducing vasoconstriction.
- Beta-blockers =
- Diuretics =
- Inotropic agents =
How do ACE inhibitors work?
They block the formation of angiotensin II, reducing vasoconstriction.
What is digoxin?
A positive inotropic agent used to increase the force of heart contraction.
What is the role of diuretics in heart failure management?
They reduce fluid volume and preload by acting on the kidneys.
What is the importance of the 6-minute walk test (6MWT)?
It assesses functional status, exercise tolerance, and survival in heart failure patients.
What are PT interventions for CHF?
- breathing exercises (IMT, diaphragmatic breathing)
- aerobic training
- strengthening
- education
What are the signs of CHF exacerbation?
Increased dyspnea, weight gain, chest pain, and fluid retention.
What are the NYHA classes of CHF?
- Stage 1: fully functioning.
- Stage 2: slight limitation
- Stage 3: marked limitation
- Stage 4: waiting for transplant
What is inspiratory muscle training (IMT)?
A PT intervention to strengthen the diaphragm and improve breathing in CHF patients.
What are the key PT outcomes to monitor in CHF patients?
- exercise tolerance
- breathing patterns
- oxygen consumption
CHF: Signs and Symptoms
- Green Zones = ?
- Yellow Zones = ?
- Red Zones = ?
- Green Zones:
- No shortness of breath
- No swelling
- No weight gain
- No chest pain
- No decrease in ability to maintain your activity level
- Yellow Zones:
- Weight gain of 2-3 lbs in 24 hours
- Increased cough
- Peripheral edema: increased distal extremity swelling
- Increase in SOB with activity
- Orthopenea: increase in the number of pillows needed
- Red Zones:
- Shortness of breath at rest
- Unrelieved chest pain
- Wheezing or chest tightness at rest
- Paroxysmal nocturnal dyspenea: requiring to sit in chair to sleep
- Weight gain or loss of more than 5lbs in 3 days
- Confusion
Heart Failure
.
.
