CHF Flashcards
CHF: what (3)
heart not able to pump enough blood for the body -> bad CO
-> inadequate perfusion of organs/tissue
CHF: etiology (4)
(Cat in the Hat Does Vegas)
*CAD
*HTN
*DM
*Valvular heart disease
others but basically anything that is putting stress on the heart causing it to malfunction
CHF: patho (3 problems and what they lead to)
conditions lead to the CHF by causing
*myocardial damage -> myocardial remodeling
*increasing cardiac workload -> impaired contractility
*impaired cardiac function -> activation of neurohormonal pathways
which HF is most common
left
LHF: causes (2)
inability of the LV to empty during systole or fill adequately during diastole, or both
LHF: leads to
inadequate blood flow into systemic circulation
RHF: causes
when RV does not pump effectively
RHF: leads to
which type of circulation
forward flow of blood into pulmonary circulation
most common cause of RHF
LHF
common s/s of LHF (8)
*LV heaves
*tachycardia
*alternating between strong and weak pulse
*crackles
*presence of S3 and S4 sounds
*Pleural effusion
*AMS
*restlessness/confusion
common s/s of RHF (9)
*RV heaves
*tachycardia
*murmurs
*jugular venous distention
*edema (pedal, scrotal, sacrum)
*wt gain
*ascites
*anasarca (massive generalized body edema)
*hepatomegaly
Acute vs Chronic HF
*acute: sudden onset or exacerbation of s/s, requires urgent medical intervention (vasodilators, diuretics) to relieve congestion and improve cardiac function
*chronic: manifest slowly w/ persistent/recurrent s/s, requiring long-term management w/ meds (ACE inhibitors, beta-blockers) and lifestyle changes
HF diagnostics (4)
*Echo: assess EF and valve abnormalities
*CXR: detect pulmonary congestion, cardiomegaly, or PE
*EKG: arrhythmias or conduction abnormalities
*BNP: shows stress on heart
pertinent labs CHF (3)
*elevated BNP
*elevated serum Cr and BUN
*electrolyte imbalances (hyponat, hypokal)
CHF long-term complications (5)
pach k
*arrhythmias
*Pulmonary edema
*kidney dysfunction
*cardiogenic shock
*hepatic congestion
CHF pt teaching (10)
*adhere to medication regimen
*monitor for s/s of long-term complications
*make regular follow ups w/MD
*Educate on early s/s of volume overload (wt gain, dyspnea, edema)
*restrict Na and monitor fluid intake
*monitor wt daily
*recognize s/s of shock (HoTN, AMS, cold extremities)
*maintain healthy lifestyle
*no smoking
*recognize s/s of hepatic congestion (abd pain, jaundice, edema)
frank-starling law
*what: the more the heart muscle stretches before it contracts, the stronger the contraction will be. This helps the heart pump blood effectively.
*what this has to do with CHF: So, the Frank-Starling law is important in CHF because it shows how the heart tries to compensate for its weakness, but this compensation can actually make the problem worse in the long term.
more EDV (More blood)=more preload=more SV=more forceful contraction
ejection fraction
*what: a measure of how well your heart is pumping out blood with each beat. A healthy heart pumps out about half of the blood inside it with each beat, which is around 50-60%.
*effect of/on CHF: EF drops bc heart isn’t pumping properly -> blood not being pumped effectivly
reduced (HFrEF) vs preserved (HFpEF) ejection fraction
*HFrEF: (systolic failure) hallmark sign is a decrease in LVEF (<40%). Loses the ability to generate enough pressure to eject blood forward to the aorta. This and a lot of other malfunctions lead to fluid accumulation in the lungs (crackles, dyspnea) and fluid leakage into pulmonary capillary beds (pulmonary congestion and edema).
*HFpEF: (diastolic failure) d/t an inability of the ventricles to relax and fill during diastole. HTN is major cause. Has the same results as HFrEF.
NYHA class of HF
*1-4 categories based on physical activity limitation d/t symptom burden.
1. No limitation of physical activity. Oridinary physical activity does not cause s/s of HF
2. Slight limitation on physical acitivity. Comfortable at rest but ordinary physical activity causes HF s/s
3. Marked limitation on physical activity. Comfortable at rest, but less than ordinary activity causes HF s/s
4. unable to carry on any physical activity w/o HF s/s or HF s/s at rest.
