Cardiac Part 2 Flashcards
1
Q
Define Heart Failure
A
- Complex clinical SYNDROME of symptoms and signs that suggest the efficiency of the heart is impaired
2
Q
Basic definition of why heart failure is bad
A
- Due to the hearts inability to fill or eject blood properly from its chambers it means that they body is also compensating for the reduction in cardiac output by placing the body in a permanent state of `sympathetic response. This means that it is constantly trying to raise the heart rate by realising adrenaline which vasocontricts the vessels.
- As with illness in the body it starts to draw in and shut down things in the body that are not essential like digestion, and lymphatic system, this then causes the body to fail in them areas i.e. disease fighting
3
Q
Some signs and symptoms of heart failure are
A
- SOB, on exercise, rest and lying down
- Tachycardia
- Tachypnoea
- Plurel effusion
- JVP
- Hepatomegaly
- Cx pain
- Pulmonary and peripheral oedema
- Cough
- Ascity - Fluid in abdomen
4
Q
What does ACPO stand for
A
- As AHF develops, increased back pressure on the pulmonary circulation creates congestion of the pulmonary wins, resulting in increased pulmonary capillary pressure, leakage of fluid into the alveoli thus creating a state known as Acute Cariogenic Pulmonary Oedema.
5
Q
Summarise LVF
A
- LVF causing pulmonary venous return
- Increase in preload
- Increase in hydrostatic pressure within pulmonary capillaries resulting in fluid into the alveolar space
6
Q
What could be the effects of LVF
A
- Decreased Cardiac Output
- Pulmonary congestion
- Decrease in tissue perfusion
- Impaired gas exchange
- Pulmonary oedema
- Hypoxia
- Frothy sputum
7
Q
Effects of RVF
A
- Congestion of peripheral tissues
- Liver congestion
- GI tract congestion
- Impaired liver function
- Anorexia
- Weight loss
8
Q
Explain what happens in Systolic dysfunction
A
- Loose contractility of the heart wall which has become enlarged over time, making it harder to pump the blood out of the ventricle fully
9
Q
Explain what happens in diastolic dysfunction
A
- Larger muscle that doesn’t allow the heart chambers to fill up properly, thus meaning that there is less volume to pump around the body if the chamber don’t fill up.
10
Q
Summary of what happens with HF and the Kidneys
A
- Cardiac failure will result in a lower Cardiac output causing Low BP.
- Renin is then secreted and aldosterone increases to maintain sodium and water levels in the blood to increase BP
- The increased blood volume results in congestion, oedema and exacerbation of the heart failure
11
Q
Main cause of Heart failure
A
- Coronary Heart Disease
- Essential hypertension
12
Q
What are the Classes of Heart Failure
A
- Class 1, No limitation
- Class 2, Slight limitation of physical activity
- Class 3, Marked limitation of physical activity
- Class 4, Unable to carry on any physical activity, symptoms can be present at rest
13
Q
What can fluid congestion cause
A
- Orthopnoea
- Raised JVP
- Pulmonary inspiratory crackles
- Peripheral oedema
- Ascites
14
Q
What can Low Cardiac Output cause
A
- Tcahycardia
- Hypotension
- Cool extremities
- Poor Capillary refill
- Confusion
- Pulsus Alternans
15
Q
Three main reasons for pharmacocological management of HF
A
- Reduce Preload
- Reduce Afterload
- Improve Contractivity
