CHF

Question 1

CHF: what (3)

Answer 1

heart not able to pump enough blood for the body -> bad CO
-> inadequate perfusion of organs/tissue

Question 2

CHF: etiology (4)

(Cat in the Hat Does Vegas)

Answer 2

*CAD
*HTN
*DM
*Valvular heart disease

others but basically anything that is putting stress on the heart causing it to malfunction

Question 3

CHF: patho (3 problems and what they lead to)

Answer 3

conditions lead to the CHF by causing
*myocardial damage -> myocardial remodeling
*increasing cardiac workload -> impaired contractility
*impaired cardiac function -> activation of neurohormonal pathways

Question 4

which HF is most common

Answer 4

left

Question 5

LHF: causes (2)

Answer 5

inability of the LV to empty during systole or fill adequately during diastole, or both

Question 6

LHF: leads to

Answer 6

inadequate blood flow into systemic circulation

Question 7

RHF: causes

Answer 7

when RV does not pump effectively

Question 8

RHF: leads to

which type of circulation

Answer 8

forward flow of blood into pulmonary circulation

Question 9

most common cause of RHF

Answer 9

LHF

Question 10

common s/s of LHF (8)

Answer 10

*LV heaves
*tachycardia
*alternating between strong and weak pulse
*crackles
*presence of S3 and S4 sounds
*Pleural effusion
*AMS
*restlessness/confusion

Question 11

common s/s of RHF (9)

Answer 11

*RV heaves
*tachycardia
*murmurs
*jugular venous distention
*edema (pedal, scrotal, sacrum)
*wt gain
*ascites
*anasarca (massive generalized body edema)
*hepatomegaly

Question 12

Acute vs Chronic HF

Answer 12

*acute: sudden onset or exacerbation of s/s, requires urgent medical intervention (vasodilators, diuretics) to relieve congestion and improve cardiac function

*chronic: manifest slowly w/ persistent/recurrent s/s, requiring long-term management w/ meds (ACE inhibitors, beta-blockers) and lifestyle changes

Question 13

HF diagnostics (4)

Answer 13

*Echo: assess EF and valve abnormalities
*CXR: detect pulmonary congestion, cardiomegaly, or PE
*EKG: arrhythmias or conduction abnormalities
*BNP: shows stress on heart

Question 14

pertinent labs CHF (3)

Answer 14

*elevated BNP
*elevated serum Cr and BUN
*electrolyte imbalances (hyponat, hypokal)

Question 15

CHF long-term complications (5)

pach k

Answer 15

*arrhythmias
*Pulmonary edema
*kidney dysfunction
*cardiogenic shock
*hepatic congestion

Question 16

CHF pt teaching (10)

Answer 16

*adhere to medication regimen
*monitor for s/s of long-term complications
*make regular follow ups w/MD
*Educate on early s/s of volume overload (wt gain, dyspnea, edema)
*restrict Na and monitor fluid intake
*monitor wt daily
*recognize s/s of shock (HoTN, AMS, cold extremities)
*maintain healthy lifestyle
*no smoking
*recognize s/s of hepatic congestion (abd pain, jaundice, edema)

Question 17

frank-starling law

Answer 17

*what: the more the heart muscle stretches before it contracts, the stronger the contraction will be. This helps the heart pump blood effectively.

*what this has to do with CHF: So, the Frank-Starling law is important in CHF because it shows how the heart tries to compensate for its weakness, but this compensation can actually make the problem worse in the long term.

more EDV (More blood)=more preload=more SV=more forceful contraction

Question 18

ejection fraction

Answer 18

*what: a measure of how well your heart is pumping out blood with each beat. A healthy heart pumps out about half of the blood inside it with each beat, which is around 50-60%.

*effect of/on CHF: EF drops bc heart isn’t pumping properly -> blood not being pumped effectivly

Question 19

reduced (HFrEF) vs preserved (HFpEF) ejection fraction

Answer 19

*HFrEF: (systolic failure) hallmark sign is a decrease in LVEF (<40%). Loses the ability to generate enough pressure to eject blood forward to the aorta. This and a lot of other malfunctions lead to fluid accumulation in the lungs (crackles, dyspnea) and fluid leakage into pulmonary capillary beds (pulmonary congestion and edema).

*HFpEF: (diastolic failure) d/t an inability of the ventricles to relax and fill during diastole. HTN is major cause. Has the same results as HFrEF.

Question 20

NYHA class of HF

Answer 20

*1-4 categories based on physical activity limitation d/t symptom burden.
1. No limitation of physical activity. Oridinary physical activity does not cause s/s of HF
2. Slight limitation on physical acitivity. Comfortable at rest but ordinary physical activity causes HF s/s
3. Marked limitation on physical activity. Comfortable at rest, but less than ordinary activity causes HF s/s
4. unable to carry on any physical activity w/o HF s/s or HF s/s at rest.