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Paige: CARDIO > Exam 2 - Heart Failure > Flashcards

Exam 2 - Heart Failure Flashcards

1
Q

what is the MC cause of HF?

A

coronary artery disease

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2
Q

what is the MC mechanism of HF?

A

heart injury from something leads to progressive weakening

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3
Q

what is systolic heart failure?

A

the heart doesn’t contract as well

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4
Q

what is diastolic HF?

A

the ventricles can’t relax as well

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5
Q

can systolic HF and diastolic HF occur together?

A

yes and often do

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6
Q

what is the difference between acute and chronic HF?

A

acute is like a large MI, with sudden symptoms like pulm edema and hypotension

chronic is slow onset of symptoms like peripheral edema and fatigue

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7
Q

what is the MC common cause of RHF?

what are other causes?

A

MC = left-sided heart failure

other: COPD/pulm HTN

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8
Q

what are the MC causes of L sided HF?

A

CAD and HTN

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9
Q

what else can cause left-sided heart failure?

A

post MI

L sided valvular disease

to name some

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10
Q

what is backward failure?

A

ventricles don’t empty correctly and pressure builds up behind ventricles

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11
Q

what is forward failure?

A

poor CO leads to decreased renal perfusion, decreased activation of RAA axis, and Na/H20 retention

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12
Q

One of the mechanisms of HF is redistribution of CO. what does this mean?

A

you have low CO, so your body increases blood flow to vital organs, and decreases blood flow to skin and muscle.

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13
Q

When your body redistributes CO, what system does that activate?

A

sympathetic/adrenergic system

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14
Q

Why is it bad that your sympathetic/adrenergic system is activated in HF?

A

it tries to maintain your BP by increasing cardiac afterload

this makes your weak heart weaker

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15
Q

what hormones does you sympathetic system secrete?

A

epi/NE

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16
Q

What does a longterm increase of epi/NE do to your heart?

A

remodeling

muscle thins, stretches, and dilates

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17
Q

Another mechanism of HF is water and Na retention. what “axis” guides this process?

A

renin-angiotensin-aldosterone axis

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18
Q

What triggers the RAA axis to begin?

A

your kidneys sense that they have decreased perfusion/BP

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19
Q

what happens once your kidneys sense decreased perfusion/BP?

A

kidneys release renin

20
Q

what does renin do?

A

converts the enzyme angiotensinogen to angiotenin I

21
Q

What then happens to angiotensin I?

A

the enzyme ACE converts angiotensin I into angiotensin II

22
Q

What does angiotenin II do? (2 things)

A
  1. vasoconstricts (increases resistance/BP)
  2. stimulates release of aldosterone from adrenal glands
23
Q

what does aldosterone do?

A

increases the reabsoption of Na and H20 into the body

24
Q

what do long-term high levels of aldosterone do to the heart?

A

remodeling

25
Q

what is class 1 HF?

A

no limitations

no symptoms

26
Q

what is class 2 HF?

A

can do ADLs

get symptoms on exertion

27
Q

What is class 3 HF?

A

increasing limitations with physical activity

doing ADLs cause symptoms

28
Q

What is class 4 HF?

A

getting symptoms at rest or with minimal activity

29
Q

What are the 3 symptoms of HF that are associated with breathing?

A

dyspnea (on exertion, then with rest)

orthopnea

paroxysmal nocturnal dyspnea

30
Q

what patho causes dyspnea?

A

increased venous pressure

31
Q

what patho causes orthopnea?

A

redistribution of excess fluid to the lungs while supine

32
Q

What is another sx caused by Na and water retention?

A

unexplained weight gain

33
Q

what patho causes these symptoms: fatigue, weakness, abdominal discomfort?

A

decreased CO to muscles, GI system

34
Q

Why would a person also get cerebral symptoms with HF (like memory loss)?

A

decreased perfusion to the brain

35
Q

There are legit so many things for PE so i’m just going to touch on a few.

What will you hear when listening to the lungs?

A

inspiratory crackles

starting at bases and moving upward

36
Q

what will you hear when listening to the heart?

A

S3 gallop

37
Q

what does an S3 gallop sound like?

A

after S2 (during diastole), a low-pitched thud

38
Q

what causes an S3 gallop?

A

as blood hits the stiff wall, it rapidly decelerates

this hitting and deceleration makes a “thud” sound.

39
Q

On PE you see a + hepatojugular reflux. what is this?

A

you push on the liver, and see the jugular vein pop out because of all the fluid

40
Q

overall physically, what will this person look like?

A

cachexic

41
Q

What 2 signs on CXR are somewhat unique to HF?

A

increased upper lung markings

Kerley B lines

42
Q

What is the best diagnostic test for HF?

A

echo/doppler

43
Q

On ECG, what is it super important that you assess?

A

ejection fraction

44
Q

what does ECG look like for systolic and diastolic failure?

A

systolic: low EF, thin ventricle walls, dilated LV

diastolic: high EF, thick ventricle walls, small LV

45
Q

You could also get a BNP level. What’s the deal with that?

A

it’s released by the ventricles when the heart is acutely stressed

46
Q

How about treatment?

A

in the next deck :))))))

Paige: CARDIO (11 decks)

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