Cardiovascular 2 Flashcards
HF
Causes (3)
decreased pumping action
systemic fluid congestion
failure of vital organs
Results of right side HF
(3)
pulmonary edema
coughing
peripheral edema (arms and legs mostly)
Left side HF
(3)
affects all organ systems; decrease kidney function contributes to fluid retention
pulmonary edema
coughing
Heart Failure
Pathophysiology
*Increased workload →problems with
cardiac muscle
*— ventricle typically fails first →can lead to — ventricle failure
Left
right
Heart Failure
reduced –
decreased –
blood backed up in –
pulmonary –
increased workload on – ventricle
volume overload (3)
ventricles – to try to compensate
activation of – to compensate
cardiac output
perfusion
pulmonary vessels (SOB, foamy cough, pulmonary)
hypertension
R
venous congestion, peripheral edema, ascites
dilate
RAAS and neurohormonal responses
Past Myocardial Infarction
>1 month
* Consider
(2)
severity of cardiac status and
comorbidities
appropriate management
protocols
- Ejection Fraction can measure the
degree of heart failure
➢Measures
amount (%) of blood that
leaves the left ventricle after
contraction.
- Ejection Fraction (EF) %: 55% to 70%
- Pumping Ability of the Heart: Normal
- Level of Heart Failure/Effect on Pumping: Heart function may be normal or you may have heart failure with preserved EF (HF-pEF).
- Ejection Fraction (EF) %: 40% to 54%
- Pumping Ability of the Heart: Slightly below normal
- Level of Heart Failure/Effect on Pumping: Less blood is available so less blood is ejected from the ventricles. There is a lower-than-normal amount of oxygen-rich blood available to the rest of the body. You may not have symptoms.
- Ejection Fraction (EF) %: 35% to 39%
- Pumping Ability of the Heart: Moderately below normal
- Level of Heart Failure/Effect on Pumping: Mild heart failure with reduced EF (HF-rEF).
- Ejection Fraction (EF) %: Less than 35%
- Pumping Ability of the Heart: Severely below normal
- Level of Heart Failure/Effect on Pumping: Moderate-to-severe HF-rEF. Severe HF-rEF increases the risk of life-threatening heartbeats and cardiac dyssynchrony/desynchronization (right and left ventricles do not pump in unison).
EF =
blood vol. pumped out x 100
blood vol. in chamber
normal EF
50-70% is pumped out
during each contraction (usually comfortable during activity)
borderline EF
41-49% is pumped out
during each contraction (symptoms may become noticeable during activty)
reduced EF
< 40% is pumped out
during each contraction (symptoms may become noticeable even during rest)
*Systolic failure
➢ Reduced left ventricular ejection fraction (HFrEF)
*Diastolic failure
➢ Normal left ventricular ejection fraction (HFpEF)??
*Cardiac abnormalities
(3)
➢ Valvular Disease
➢ Arrhythmias
➢ Myocardial necrosis
*Decompensation
(3)
➢ Inability to compensate
➢ Increased peripheral blood flow
➢ Increased metabolic needs
Predisposing Factors
➢ Acute CVD
(1)
➢ Chronic CVD
(3)
oMI
oHypertension
oCoronary artery disease
oArrhythmia, etc
HF
Result (signs and symptoms)
(2)
➢ Volume overload
➢ Inadequate perfusion
HF
Complications
(3)
➢ Cardiac arrest (stops beating)
➢ Myocardial infarction (blood flow blocked)
➢ Stroke
Heart Failure
Signs
➢Rapid, shallow breathing
➢Inspiratory rales (crackles)
➢Increased heart rate
➢Distended jugular (neck) veins
➢Peripheral edema
➢Ascites
➢Cyanosis
➢Weight gain
➢Clubbing of fingers