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BIO407 exam 2 > Congestive heart failure > Flashcards

Congestive heart failure Flashcards

1
Q

low output failure

A

due to poor heart function

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2
Q

high output failure

A

good heart function but metabolic demands are too high (ex. pregnancy and hypothyroidism)
leads to exhaustion and worsening heart failure

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3
Q

pre-load

A

amont of blood in LV in cardiac filling

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4
Q

after load

A

amount of force needed by LV to force blood throgh the body

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5
Q

Congestion

A

back up of blood in vessels upstream of the heart

HTN and edema

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6
Q

myocardial weakness

A 
atheroscleorsis 
coronary artery thrombosis
myocarditis
cardiomyopathies 
coronary vasospasm
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7
Q

restriction to pumping

A 
Unable to cope with preload 
valve defects and incompetent valves 
internal blockage
malformation, thrombosis, t
pericarditis/pericardial effusion
dysrythmia
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8
Q

increased afterload

A

systemic HTN, high vascular resistance= increased work load

pulmonary HTN- increase pressures with in pulmonary vessels

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9
Q

high demands are due to

A

chronic anemia
thyrotoxicosis
pregnancy

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10
Q

pulmonary HTN can predispose someone to

A

pnuemonia

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11
Q

blood backing into right side of heart

A

right sided failure- leads to cardiomegaly, s/s of rs hf

capillaries increase their permeability- leads to edema

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12
Q

why is there fluid in the lower extremities?

A

gravity

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13
Q

systemic venous congestion leads to

A

hepatomegaly

splenomegaly- advanced CHF

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14
Q

compensatory mechanism

A 
normal= increased blood left behind= stretching of the fibers to increase force to increase SV (starlings law)
abnormal= dilation is excess and leads to thinning of the wall which= decrease of contractile force
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15
Q

increased afterload

A 
normal= increased afterload= increase of cardiac cells (increased strength and thickness)
abnormal= enlarged heart which decreases otpt
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16
Q

increased sympathetic nervous stimulation

A

normal=
increase catecholamine to increase HR
vasoconstriction to maintain BP
abnormal=
increase hr= less time for LV to fill= added stress
increased BP= increased after load and pressure on heart

17
Q

stimulation of angiotensin system

A 
normal= vasoconstriction and aldosterone release, increased na and water retention
abnormal= higher volume-> increased congestion and vasoconstriction- higher afterload and LV cardiomegaly
18
Q

ANF

A

atria in response to increase hr
suppresses renin and ADH this helps decrease plasma volume and increased afterload
unable to counter antagonistic effects on enhanced renin secretion in CHF

19
Q

TRX for CHF

A 
diet- salt and fluid intake 
exercise rehab
valve replacement 
bypass 
angioplasty 
transplant
20
Q

chronotrophs

A

altering HR

21
Q

positive chronotroph=

A

increased HR

22
Q

negative chronotroph=

A

decreased HR

23
Q

B blockers

A

decrease HR and contractility, lowers BP, slows contractions, increase SV
care w astha and COPD becase B2 receptors also in lung

24
Q

introphs

A 
\+ = increased contractility 
-= decreased contractility
25
Q

Digitalis

A

most widely used inotrope
increases intracellular Ca for better contraction
allows more forceful contraction at lower degree for myocardial distension
Response= increased Hr and arterial BP
less sympathetic response and decreased HR
also known as a cardiac glycoside

26
Q

diuretics

A

decreased plasma volume
works at renal tubular level
prevents reabsorption of Na and water
increase urinary output - decreased plasma volume- less work load
problems- electrolyte loss
lower BP which activates the renin angiotensin system

27
Q

anti arrhythmic drugs

A

regulate HR and rhythm provides more constant control of CO

28
Q

vasodilators

A

nitroglycerin
relax smooth muscles which allows coronary arteries to provide more oxygen
pooling of blood in extremities also= decreased demand on heart

29
Q

calcium channel blockers

A

inhibits ca into vascular smooth muscle, which reduces vasoconstriction

30
Q

ACE inhibitors

A 
prevent angiotensin 1 to 2 
angiotensin 2 is a potent vasodilator
inhibits release of aldosterone and vasoconstriction
helps decrease compensatory responses
only drug shown to help with CHF

BIO407 exam 2 (5 decks)

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