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CABS cardiology > CHF / HF / Shock > Flashcards

CHF / HF / Shock Flashcards

1
Q

What does the phrenic nerve do

A

Assist with sensory signaling from the pericardium

Innervates the diaphragm to help maintain respiration (main innervation of diaphragm)

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2
Q

Where is the phrenic nerve located

A

on the left and it crosses over the aorta (comes out of C3-C5)

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3
Q

What is heart failure

A

clinical syndrome of decreased cardiac output

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4
Q

How does HF present

A

fluid overload
may be systolic or diastolic
*often associated with underlying cardiac etiology

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5
Q

What are the different classifications of CHF

A

Acute vs chronic
Compensated vs decompensated
Right side vs left side
Systolic vs diastolic

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6
Q

What is chronic HF

A

More common type
Develops over months to years
m/c w/ cardiomegaly
*hallmarked by fluid overload

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7
Q

What are some causes of chronic HF

A

Ischemia
Valve disease
HTN

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8
Q

What is acute HF

A

ACS with wall motion abnormality, acute valve disease, arrhythmia, infection

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9
Q

How does acute HF present

A

Flash pulmonary edema
shock
normal cardiac silhouette

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10
Q

What is flash pulmonary edema

A

Rapid onset of pulmonary edema because the heart can not keep up with the fluid volume in body

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11
Q

What is LV HF

A

Most common type
LV failure
Decreased CO -> pulmonary edema

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12
Q

What is RV HF

A

Primary:
-Pulm valve stenosis
-pulm HTN
-increased preload & decreased CO

Secondary:
-most common (Left sided HF)

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13
Q

What is compensated HF

A

Body is able to compensate for the underlying condition

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14
Q

What is decompensated HF

A

Acute exacerbation within a patient that has known CHF

Body can no longer keep up with condition

Increase in sx with volume overload

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15
Q

How do patients with decompensated HF present

A

orthopnea
exertion dyspnea
fatigue

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16
Q

How does the body compensate for heart failure

A

Sympathetic system increases B1 effects (contractility / SV / BP)

and a1 (increase vasoconstriction = increase preload and BP and decrease BF to kidneys)

17
Q

What happens when RAAS is activated

A

Angiotensin 2: Vasoconstrict = increased thirst

Aldosterone: Fluid retention through Na+ resorption

Adrenergic: Release catecholamines = increase HR/ Vac. resistance/ contractility

18
Q

What is systolic HF

A

reduced ability for the heart to squeeze effectively

19
Q

What is diastolic HF

A

Maintain EF but unable to relax and fill with blood during diastole

20
Q

What occurs as a result of systolic HF

A

Reduced ejection fraction (HFrEF)

21
Q

What are the causes of systolic HF

A

MI effecting LV
Dilated cardiomyopathy
increased preload
valvular disease
Tacchyarrythmia

22
Q

How does diastolic HF present

A

Decreased preload
increased afterload

23
Q

What are the most common causes of HF

A

Chronic HTN
Ischemia
Chronic valvular disease

24
Q

What on a physical will you find with CHF

A

S3 heart sound
Crackles
Elevated JVD
Hepatojugular reflux
peripheral edema
Ascites
SOB / orthopnea

25
Q

What is anasarca

A

Diffuse edema

26
Q

At what volume will a patient be symptomatic with edema

A

2.5-3L

27
Q

Pitting vs non pitting edema

A

Pitting: more common

Non pitting: More reflective of lymphatic obstruction

28
Q

What is shock

A

Supply / demand mismatch
= hypo perfusion

*lack of O2 and nutrients to vital organs relative to their vital demands

29
Q

What are the types of shock

A

hypovolemic
cardiogenic
obstructive
distributive

30
Q

What is seen in patients with shock

A

Low / high temp
tachycardia
low BP
MAP <65
AMS
pale /clammy/cyanotic
tachypneic
decreased GFR
acidosis

31
Q

What are cariogenic shock associated with

A

MI
Arrythmia
HF
Valve dysfunction

32
Q

What does a positive chronotrope do

A

increase HR

33
Q

What do vasopressors do

A

cause vasoconstriction

34
Q

What causes distributive shock

A

redistribution of blood volume

*septic shock is most common

35
Q

What type of shock is septic shock

A

distributive shock

36
Q

what is obstructive shock

A

from decreased venous return or decreased cardiac compliance

-PE
-tamponade
-tension pneumo
-LVOF obstruction

CABS cardiology (10 decks)

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