CHF Flashcards
Heart failure:
The heart is not pumping well enough to meet body’s demand for oxygen
Decreased heart ________ means that the heart has to work ______ to try to make up for the __________ in function.
efficiency
harder
shortcoming
Causes:
- CAD/ Atherosclerosis
- Lt ventricle damage or dysfunction/ Lt ventricular hypokinesis ( LT ventricle is the major pumping station to the body) Secondary to MI or multiple MI’s, systolic dysfunction, alcohol abuse
- Rt heart failure/ Cor pulmonale: long term HTN in the pulmonary arteries & Rt ventricle of the heart: associated with COPD or pulmonary decease : When the Rt side of heart cannot generate enough force to pump blood through diseased lungs
- Cardiomyopathy: weakening of the heart mm
- Congenital heart disease: birth defects that give rise to heart problems; multiple disorders
- Valvular heart Disease:
- Chronic hypertension:
Valvular heart disease:
Stenosis, regurgitation; valvular endocardities-confined to the endocardium of the heart valves; rheumatic heart disease-inflammatory disease following streptococcus progenies infection, bacterial.
Lt ventricle damage or dysfunction:
Lt ventricular hypokinesis; Lt ventricle is the major pumping station of the body
-Secondary to MI or multiple MI’s systolic dysfunction, alcohol abuse
Rt heart failure/ Cor pulmonale:
Long term HTN in the pulmonary arteries and Rt ventricle of the heart
- Associated with COPD or pulmonary disease
- When the Rt side of the heart cannot generate enough force to pump blood through diseased lungs.
OTher contributing factors:
- Diabetes
- Lpus: leads to long term, chronic inflammation
- RA: chronic disease that leads to inflammation of the joints and surrounding tissues
- Hyper or hypo thyroidism: leads to unstable chemical reactions in the body; increased LDL
- Alcohol abuse
- Drug abuse; amphetamines, cocaine
- Bacterial or viral infections
Risk factors:
- Smoking
- Obesity
- Sedentary life style; lack of exercise
- Poor dietary habits: high salt intake
- Uncontrolled HTN
- Prolonged high emotional stress.
Signs and Symptoms:
- Pulmonary edema: fluid buildup in the interstitial space of the lungs with rales.
- Peripheral edema with rapid weight gain
- Tachycardia/arrhythmias
- Decreased peripheral blood flow
- Pre-renal failure progressing to kidney failure
- Increased fatigue at lower levels of activity.
- Dyspnea/ orthopena/ paroxysmal sudden Nocturnal dyspnea
- Crackles, wheezing, coughing
- Hypoxia/cyanosis or pallor
- Presence of s3 heart sounds: 3rd heart sound associated with heart failure (ken tuck- ky represents 3rd sound)
- possible heart murmurs, esp. with a valve-related disorder: mitral regurgitation
- Swollen neck veins
- Mental confusion
- Enlarged heart/ Cardiomegaly
- Decreased pedal pulses
Diagnostic test to confirm CHF:
- EKG: ECG: electrocardiogram, line graph of heart condition
- Chest X-ray
- Pulmonary artery monitoring elevated pressure
- Echocardiogram: sound waves to produce heart images
- Exercise tolerance (stress Test (ETT)
- Blood tests
- Radionuclide imagin
- Coronary angiogram:
Blood tests:
Albumin levels to detect elevated levels indicated CHF
-B- type natriuretic peptide (BNP) is a protein that is produced by the heart as it fails.
Radionuclide Imaging:
Infected into tissues/ MRI; radionuclide ventriculogram, injected material can be viewed circulating the heart
Coronary angiogram:
-ray images of the hearts blood vessels
Treatment for CHF:
- Limit activity until cleared by MD, initiate cardiac rehab program
- progress slowly, especially if pt is very limited initially
- Monitor signs of peripheral edema
- Red Flags
- Angioplasty:
- Pacemaker to treat bradycardia if present
- Heart transplant is most severe cases
Red Flags:
- Shoes, belt or pants become too tight to fasten
- Normal activities become more difficult
- Pt begins to need more sleep than usual
- urination becomes more frequent at night
- Decreasing BP over time
- Flat or decreasing systolic BP with increasing activity
