ch 34 heart failure Flashcards
what is considered a reduced ejection fraction
less than 50%
primary risk factors HF (6)
- CAD
- HTN
- rheumatic heart disease
- congenital heart defects
- pulmonary HTN
- hyperthyroidism
other risk factors HF (just for reference - 6)
- anemia
- smoking
- obesity
- infection
- dysrhythmias
- diabetes
what body system will L sided heart failure affect
pulmonary
what body system will R sided heart failure affect
systemic (all of body)
L sided HF S+S (10)
- pulmonary edema
- hypoxia
- SOB
- crackles
- pink frothy sputum
- cough
- tachypnea
- orthopnea
- cyanosis
- paroxysmal nocturnal dyspnea
R sided HF S+S (6)
- JVD
- hepato+splenomegaly
- ascites
- peripheral edema
- weight gain
- heart murmurs
how does hypertrophic cardiomyopathy affect bp
affects diastolic bp
muscle enlarged, less room in ventricles
how does dilated cardiomyopathy affect bp
affects systolic bp
stretching and thinning of muscles
FACES of HF - when the pt should call hcp
Fatigue A limited activity Chest congestion + cough Edema Shortness of breath
2 ways to diagnose HF
- echocardiogram (transthoracic or transesophageal)
- blood test for BNP
what BNP is indicative of HF
> 100
what type of echocardiogram is better to see ventricles
transthoracic
what type of echocardiogram is better to see atria
transesophageal
what does decreased cardiac output lead to (with kidneys)
kidneys conserve water, fluid overload
complications of HF (4)
- fluid volume overload (pleural effusion, pulmonary edema)
- atrial fibrillation
- loss of atrial contraction (reduces CO by 10-20%)
- fatal dysrhythmias
HF + ?% EF is high risk for fatal dysrhythmias
EF <35%
how to treat fluid volume overload (2)
- loop diuretic
- O2
how would a thiazide diuretic help treat HF (2)
- decreases bp
- treats fluid volume overload
how would a ACE inhibitor or ARB help treat HF (2)
- decreases bp
- treats fluid volume overload
how would vasodilators (nitrate, hydralazine) help treat HF (1)
-addresses CAD
how would b blockers help treat HF (1)
-decreases HR
how would positive inotropes (dobutamine, digoxin) help treat HF (1)
-increase force of contraction
how would anticoagulants help treat HF (1)
-stroke prevention for Afib
for what amount weight gain should pt call hcp
within 1 week: 3-5 lbs
overnight: 1-2 lbs
max salt intake per day for HF pts
2.5 g
S+S acute decompensated HF (8)
- pulmonary edema
- orthopnea
- dyspnea
- cough
- pink sputum
- crackles
- wheezes
- increased or decreased bp
what ethnicities develop HF at earlier age and have higher mortalities (2)
- black
- hispanic
what is normal ejection fraction %
55-65%
most common cause of HF in men and best way to treat it
ischemic heart disease (MI, CAD)
treat with ACE inhibitor
most common cause of HF in women
HTN
S+S digoxin toxicity (5)
- confusion
- lethargy
- N/V
- blurred vision
- yellow halos in vision
fluid overload S+S (6)
- edema
- ascites
- JVD
- S3 heart sound
- crackles
- hypoxia
indications for heart transplant (4)
- end stage HF
- severe inoperable valvular heart disease
- recurrent life threatening dysrhythmias unresponsive to medical treatment or defibrillators
- heart abnormalities that severely limit normal function and/or have mortality risk of 50%+ within 2 years
absolute contraindications for heart transplant (5)
- 70 yo +
- life threatening illness with survival of <5 years
- advanced cerebral or peripheral vascular disease
- active infection (including HIV)
- severe pulmonary disease that will require ventilator support
