CHF Digoxin

Question 0

Factors affected in CHF
Preload
Afterload
contractility
HR

Answer 0

High Preload due to increased volume (H2O retention?) and increased venous tone (?): use diuretic or Venodilator
High Afterload due to high aortic impedance (peripheral resistance?) and increased arterial constriction (TPR?): use Arteriodilator
Low contractility due to chronic ventricular dilation which reduces pumping force: use inotropic drug like DIGOXIN (GLYCOSIDE)
Increase HR to do Reflex Tachy caused by SNS hyperactivity (due to decreased BP which is low bc contractility is low): use BB

Question 1

Heart Failure - inability of heart to supply O2 to tissues (unable to pump)
High output is rare
Low output

Answer 1

High output Hyperthyroidism, anemia, (heart already working hard - no inotropic drug (increases contractility/chronotropi=increases HR) benefit, tx underlying cause
LOW OUTPUT CHF: HTN, MI, CAD, Hrt Dz