Cardiomyopathy/Heart Failure FINAL Flashcards

1
Q

Heart cannot pump enough blood/oxygen causing tissue perfusion

A

Heart failure

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2
Q

Impaired contractility
Thin/weak heart muscle
Low ejection fraction
S3 gallop
Etiologies- ischemic heart disease, chronic HTN, dilated cardiomyopathy, myocarditis

A

Systolic dysfunction

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3
Q

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

A

Diastolic dysfunction

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4
Q

The amount of blood pumped from the ventricles in one minute

A

cardiac output

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5
Q

The number of ventricular contractions per minute

A

heart rate

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6
Q

The volume of blood ejected with each heartbeat

A

stroke volume

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7
Q

The amount of cardiac muscle fiber stretches just prior to contraction affected by volume

A

preload

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8
Q

The resistance against which the heart must eject blood volume during contraction

A

afterload

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9
Q

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.

A

contractility

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10
Q

The percentage of blood in the ventricle that is ejected during systole, normal is > 50-60%.

A

ejection fraction

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11
Q

Crackles, S3 heart sound, blood tinged sputum, exertional dyspnea, restlessness, cyanosis

A

Left sided ventricular heart failure

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12
Q

Pulmonary HTN, ascites, distended jugular veins, weight gain, tight shoes, decrease in urine output, splenomegaly, hepatomegaly

A

Right sided ventricular heart failure

AKA Cor pulmonale

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13
Q

The faces of heart failure

A

Fatigue, limited activity, chest congestion & cough, edema, and SOB

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14
Q

What type of cardiomyopathy?

Fatigue & weakness
L sided HF
Dysrhythmias
Systemic or PE
S3 or S4 gallops
Moderate to severe cardiomegaly

A

Dilated cardiomyopathy

-systolic dysfunction
-enlargement of all cardiac chambers
-most common type

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15
Q

Treatment options for dilated cardiomyopathy

A

Treat HF symptoms, vasodilators, & heart transplant

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16
Q

What type of cardiomyopathy?

Dyspnea
Angina
Fatigue, syncope, palpitations
Mild cardiomegaly
S4 gallop
Sudden death common
HF

A

Hypertrophic obstructive cardiomyopathy

-diastolic dysfunction
-risk of sudden death in young athletes
-thickened left ventricular wall

17
Q

Treatment options for hypertrophic obstructive cardiomyopathy

A

Treat HF symptoms, beta blockers, mitral valve replacement, digoxin, nitro

18
Q

What type of cardiomyopathy?

Dyspnea and fatigue
R sided HF
Heart block
Emboli
S3 and S4 gallops
Mild to moderate cardiomegaly

A

Restrictive cardiomyopathy

-diastolic dysfunction
-rigid ventricular walls
-least common type

19
Q

Treatment options for restrictive cardiomyopthy

A

Treat HF & HTN symptoms, exercise restrictions

20
Q

Levels for BNP testing

B-type natriuretic peptide

A

less than 100 = normal
100-300 = mild heart failure
300-700 = moderate heart failure
700+ =severe heart failure

21
Q

Signs of digoxin toxicity

A

anorexia, nausea, visual disturbances, bradycardia, changes in mental status

May cause PVCs or nearly any dysrhythmias

22
Q

Therapeutic ranges for digoxin

A

0.8-2 for dysrhythmias
0.5-1 for HF

23
Q

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?

A

Serum digoxin and potassium levels.

Hypokalemia potentiates digoxin toxicity.

24
Q

Medications

Goal is to decrease afterload, decrease preload, and increase contractility

A

ACEis & ARBs
Beta blockers
Oxygen
Nitrates
Calcium channel blockers
Hydralazine
Diuretics

25
Q

Heart Failure Self-Management Education

MAWDS

A

Medications
Avoid NSAIDS to prevent sodium & fluid retention
Take meds as prescribed
Know purpose and side effects of meds

Activity
Don’t overdo it
Know your limits
Be able to carry on a conversation while exercising

Weight
Weigh each day at the same time on the same scale

Diet
Limit daily sodium to 2-3 grams
Limit fluid intake to 2L

Symptoms
Notify provider of any new or worsening sx

26
Q

Action alert for HF

Symptoms that could indicate worsening or recurrent heart failure

Report to provider immediately

A

-rapid weight gain (3lb in one week or 1-2lb overnight)
-decrease in exercise tolerance lasting 2-3 days
-cold sx lasting 2-3 days
-excessive awakening at night to urinate
-development of dyspnea or angina at rest
-increased swelling of feet, ankles, or hands