Cardiomyopathy/Heart Failure FINAL Flashcards
Heart cannot pump enough blood/oxygen causing tissue perfusion
Heart failure
Impaired contractility
Thin/weak heart muscle
Low ejection fraction
S3 gallop
Etiologies- ischemic heart disease, chronic HTN, dilated cardiomyopathy, myocarditis
Systolic dysfunction
Impaired filling/relaxation
Stiff/thick heart muscle
Normal ejection fraction
S4 gallop
HTN w/ LV hypertrophy, restrictive and hypertrophic cardiomyopathies, fibrosis, amyloidosis, sarcoidosis, constrictive pericarditis, hemochromatosis, valvular disease
Diastolic dysfunction
The amount of blood pumped from the ventricles in one minute
cardiac output
The number of ventricular contractions per minute
heart rate
The volume of blood ejected with each heartbeat
stroke volume
The amount of cardiac muscle fiber stretches just prior to contraction affected by volume
preload
The resistance against which the heart must eject blood volume during contraction
afterload
The ability of heart muscles to shorten and contract. Any effect on the ability of the heart to contract results in some type of heart failure.
contractility
The percentage of blood in the ventricle that is ejected during systole, normal is > 50-60%.
ejection fraction
Crackles, S3 heart sound, blood tinged sputum, exertional dyspnea, restlessness, cyanosis
Left sided ventricular heart failure
Pulmonary HTN, ascites, distended jugular veins, weight gain, tight shoes, decrease in urine output, splenomegaly, hepatomegaly
Right sided ventricular heart failure
AKA Cor pulmonale
The faces of heart failure
Fatigue, limited activity, chest congestion & cough, edema, and SOB
What type of cardiomyopathy?
Fatigue & weakness
L sided HF
Dysrhythmias
Systemic or PE
S3 or S4 gallops
Moderate to severe cardiomegaly
Dilated cardiomyopathy
-systolic dysfunction
-enlargement of all cardiac chambers
-most common type
Treatment options for dilated cardiomyopathy
Treat HF symptoms, vasodilators, & heart transplant
What type of cardiomyopathy?
Dyspnea
Angina
Fatigue, syncope, palpitations
Mild cardiomegaly
S4 gallop
Sudden death common
HF
Hypertrophic obstructive cardiomyopathy
-diastolic dysfunction
-risk of sudden death in young athletes
-thickened left ventricular wall
Treatment options for hypertrophic obstructive cardiomyopathy
Treat HF symptoms, beta blockers, mitral valve replacement, digoxin, nitro
What type of cardiomyopathy?
Dyspnea and fatigue
R sided HF
Heart block
Emboli
S3 and S4 gallops
Mild to moderate cardiomegaly
Restrictive cardiomyopathy
-diastolic dysfunction
-rigid ventricular walls
-least common type
Treatment options for restrictive cardiomyopthy
Treat HF & HTN symptoms, exercise restrictions
Levels for BNP testing
B-type natriuretic peptide
less than 100 = normal
100-300 = mild heart failure
300-700 = moderate heart failure
700+ =severe heart failure
Signs of digoxin toxicity
anorexia, nausea, visual disturbances, bradycardia, changes in mental status
May cause PVCs or nearly any dysrhythmias
Therapeutic ranges for digoxin
0.8-2 for dysrhythmias
0.5-1 for HF
Digoxin is a cardiac glycoside that provides symptomatic benefits for patients w/ chronic heart failure. Benefits include: increased contractibility, reduced HR, slowing of conduction, inhibition of sympathetic activity & enhancement of parasympathetic activity. What levels need to be monitored to identify toxicity?
Serum digoxin and potassium levels.
Hypokalemia potentiates digoxin toxicity.
Medications
Goal is to decrease afterload, decrease preload, and increase contractility
ACEis & ARBs
Beta blockers
Oxygen
Nitrates
Calcium channel blockers
Hydralazine
Diuretics
