Congestive Heart Failure Flashcards
What is Heart failure?
-A condition where the heart is not able to pump well enough to meet the bodies needs
-It can involve right, left, or both sides of the heart
-The left side of the heart usually fails first since it has to pump aginist greater resistance than the right ventricle
Some common conditions that make Heart failure more likely
-Arrhythmia
-CAD
-Diabetes Mellitus
-Pharmacy and thyrotoxicosis
-Pulmonary embolism (can cause right side heart failure)
-MI
Right side heart failure
-When the ability of the RV to contract is inspired (I.e. RV MI, pulmonary embolus)
-Blood pools in the RV and eventually the RA causing pressure and congestion in the vena cavae and systemic circulation
Left sided heart failure
-Blood backs into LV due to poor LV function
-As pumping ability is decreased blood is not fully pumped out of the LV
-Blood backs up from the LA to pulmonary veins and can eventually cause pulmonary edema
-Without treatment the blood will back up into RV and cause right sided heart failure as well
Common causes of LV failure
-Aortic or mitral valve stenosis or regurgitation
-Hypertension
-LV MI
Forward failure
-caused by increased afterload (I.e. in hypertension)
-When afterload increases, the LV can’t eject as much blood as usual, therefore there is decreased flow to the vital organs
Backward failure
-Results when the LV fails to empty completely, leftover blood then accumulates in the LV and lungs can lead to right sided heart failure
Acute heart failure
-S and S are new
-Typically Na+ and water retention have not occurred yet
Chronic heart failure
-S and S have been present for an extended period
-Fluid volume is increased
Heart failure primary prevention
-Primary prevention = modifying risk factors such as:
-Salt intake
-Weight
-Lack of exercise
-Smoking
-Stress
Heart failure secondary prevention
-Treating CAD
-Preventing MI
-Treating anemia
-Treating infections
Heart failure early signs
-Exertional, nocturnal or paroxysmal Dyspnea
-Fatigue
-Hepatomegaly
Heart Failure Late signs
-Anorexia
-Chest tightness
-Cyanosis
-Dependent edema
-Diaphoresis
-Dulness over lung bases
-Hemoptysis
-Hypotension
-Inspiratory crackles
-Hepatomegaly
-Narrow pulse pressure
-Nausea
-Oliguria
-Pallor
-Palpitations
-Pitting ankle edema
-S3
-Decreased LOC
-Tachypnea
-Unexplained steady weight gain
Goals in management of heart failure
- Decreasing intravascular volume
2.Decreasing venous return - Decreasing after-load
- Improving oxygenation and gas exchange
- Improving cardiac function
- Reducing anxiety
Improving pump preformance
-Cardiac glycosides
-Other positive inotropics