Chapter 26: Heart Failure and Circulatory Shock Flashcards
Is systolic or diastolic failure more common?
systolic is more common
What is systolic heart failure?
decrease in the contractility and cardiac out put with an ejection fraction less than 40% resulting in Increased preload and pulmonary or systemic edema
What is the normal ejection fraction of the heart?
65%
What is the ejection fraction?
Ejection fraction = the amount of blood needed to pump out of your heart
What is diastolic heart failure?
normal contraction of the heart but an abnormal relaxation of the heart (decrease in preload) resulting in decreased cardiac output and increase in venous edema.
What are the 2 types of heart failure?
right sided or left sided
What is right sided heart failure?
Failure of the right heart to pump blood forward into the pulmonary circulation and blood backs up into the systemic circulation because the venous return isn’t all getting pumped out so it backs up in systemic circulation
what are the clinical manifestations of right sided heart failure
large distended abdomen, peripheral edema, congestion of abdominal organs, ascites, distension of jugular veins
What is left sided heart failure?
Represents failure of the left heart to move blood from pulmonary circulation into the systemic circulation and blood backs up in the pulmonary circulation, Capillary fluid moves into the alveoli, lung expansion is more difficult and gas exchange is impaired, RBCs leave the pulmonary circulation without being fully oxygenated
What are the clinical manifestations of left sided heart failure?
SOB, labored breathing, cyanosis, lack of oxygenated RBCs, fluid build up and congestion around the lungs
How does the body help maintain blood flow and cardiac function when in heart failure?
frank starling mechanism, activation of the SNS, Renin-angiotensin-aldosterone mechanism, myocardial hypertrophy and remodeling
What is the frank-starling mechanism?
Increases preload increasing the strength of heart contractions – come into effect to maintain cardiac function during heart failure
What does the activation of SNS to maintain blood flow and cardiac function during heart failure do?
increases blood pressure and heart rate
What does the activation of the renin-angiotensin-aldosterone mechanism do for someone in heart failure?
decreases renal blood flow and activates the RAAS, increases blood volume (by resorption of water and sodium) and increases venous return
What does the myocardial hypertrophy and remodeling mechanism do for someone in heart failure?
improves heart rate performance short termly
What is acute heart failure?
heart failure that develops rapidly, and immediately life threatening
What can acute heart failure result from?
cardiopulmonary bypass surgery, acute infection (sepsis), acute myocardial infarction, valve dysfunction, severe arrhythmias
What is chronic heart failure?
long term condition associated with the heart undergoing adaptive responses (which can make the heart fail because it masks the heart failure)
Is chronic or acute heart failure more common?
chronic
What are the manifestations of heart failure? Physiologically
impaired pumping ability of the heart, decreased renal blood flow, activation of the sympathetic compensatory mechanism
What are the signs and symptoms of heart failure?
fluid retention and edema, SOB, cyanosis, distension of jugular veins, diaphoresis and tachycardia (sympathetic response)
What is circulatory shock?
Circulatory shock is an acute failure of the circulatory system to supply the peripheral tissues and organs of the body with an adequate blood supply, resulting in cellular hypoxia – result of heart failure from not pumping blood around the body
