Congestive / Chronic Heart Failure

Question 1

What is Congestive/Chronic Heart Failure?

Answer 1

inability of the heart to pump adequate blood through the entire system

Question 2

CHF results from any structure or functional cardiac disorder that impairs the ventricles ability to ____ or _____ blood.

Answer 2

Fill or eject

Question 3

“Big-Hearted Friends”

Answer 3

Ventricle walls become too thick (impairs filling)

Question 4

“Old Underwear”

Answer 4

Thin/stretched out ventricle walls (impairs ejection)

Question 5

Half of the people who develop heart failure die within how many years?

Answer 5

5

Question 6

Causes of CHF

Answer 6

-Coronary artery disease
-HTN
-pulmonary HTN (cor pulmonale)

Question 7

What is Left Sided Heart Failure?

Answer 7

Inability of the left ventricle to pump or eject blood enough blood

Question 8

What are the 2 types of Left Sided Heart Failure?

Answer 8

Systolic Dysfunction
Diastolic Dysfunction

Question 9

What is Systolic Dysfunction in Left Sided Heat Failure?

Answer 9

Inability to contract or shorten against a load (weakened heart muscle)

Question 10

What is Diastolic Dysfunction in Left Sided Heart Failure?

Answer 10

Stiff heart muscle during filling of the ventricle/can’t relax normally

Question 11

What does the delayed relaxation in diastolic dysfunction L sided HF lead to?

Answer 11

-reduction in ejection fraction
-pulmonary congestion
-pulmonary hypertension

Question 12

What is the %EF that classifies someone as high risk for HF?

Answer 12

≤40%

Question 13

What is the primary cause of Left Sided Heart Failure?

Answer 13

Previous MI
Long-standing HTN

Question 14

Signs/symptoms of Left Sided Heart Failure

Answer 14

Fatigue
Dyspnea
Wet cough
Pulmonary crackles
Edema

Question 15

What causes Right-sided Heart Failure

Answer 15

Left-sided failure

Question 16

What is Right-sided Heart Failure?

Answer 16

Enlargement of the right ventricle due to high BP in the arteries and lungs

Question 17

Signs/Symptoms of Right-sided heart failure

Answer 17

Fatigue
Pitting edema
S3 heart sound

Question 18

What does an S3 sound indicate?

Answer 18

Heart failure or enlarged heart

Question 19

What are crackles?

Answer 19

Discontinuous, intermittent, brief popping sounds

Question 20

What are crackles caused by?

Answer 20

Fluid in small airways

Question 21

How do we diagnose CHF?

Answer 21

Chest radiograph
Echocardiography
EKG
Exercise stress test
Blood test (renal or liver function)

Question 22

What increases as your VO2 peak decreases?

Answer 22

Risk of death

Question 23

What VO2 peak classifies end stage heart failure?

Answer 23

16 mlkgmin

Question 24

What is the functional classification for Class IV Heart Failure?

Answer 24

Experiences heart failure symptoms while at rest

Question 25

What is the functional classification for Class III Heart Failure?

Answer 25

Comfortable only at rest

Question 26

What is the functional classification for Class II Heart Failure?

Answer 26

Mild symptoms and slight limitation during ordinary activity. Comfortable at rest

Question 27

What is the functional classification for Class I Heart Failure?

Answer 27

No symptoms and no limitations

Question 28

Treatment for CHF

Answer 28

Surgery Medications Exercise Behavior modification

Question 29

Exercise effects of Heart Failure medications

Answer 29

Decreased BP Decreased HR

Question 30

Peak VO2, Type I fiber characteristics, Cardiac Output and Quality of life all ______ with exercise.

Answer 30

Increase

Question 31

Pulmonary ventilation needs and blood lactate _________ with exercise.

Answer 31

Decrease

Question 32

CHF FIIT guidelines for aerobic exercise

Answer 32

F: 3-5x per week I: 60%-80% HRR or RPE 11-14 T: 5-15 minute sessions, increase to 30min/day then 60min/day T: Non-weightbearing until BP is WNL; long warm-up

Question 33

CHF FIIT guidelines for strength training

Answer 33

F: 1-2 non-consecutive days/week I: 50% of 1RM lower body 40% of 1RM upper body T: Higher repetition and lower resistance T: Fixed machines (no free weights

Question 33

CHF FIIT guidelines for strength training

Answer 33

F: 1-2 non-consecutive days/week I: 50% of 1RM lower body 40% of 1RM upper body T: Higher repetition and lower resistance Fixed machines (no free weights SEATED T: 1-2 sets for each muscle group, 10-15 reps

Question 34

CHF FIIT guidelines for flexibility

Answer 34

F: 2-3 days/wk I: to point of feeling tightness T: 10-30 sec static hold 2-4 reps each T: static, dynamic, PNF

Question 35

When should exercise be stopped with CHF patients?

Answer 35

-Rapid or irregular heart beat -heart palpitations

Question 36

If a patients pulse is ________ after resting for 15 minutes, they should call their doctor.

Answer 36

120-150 BPM

Question 37

At a respiratory rate of _______, exercise should be terminated

Answer 37

>40 breaths/min

Question 38

Exercise should be modified or terminated with development of _______ and ________.

Answer 38

S3 heart sound and pulmonary crackles

Question 39

Exercise should be modified or terminated when HR and BP decrease by _____bpm

Answer 39

10