Heart Failure Flashcards
HF signs and symptoms
- exertional dyspnea
- orthopnea (supine)
- paroxysmal nocturnal dyspnea (SOB at night)
- Fatigue
HF: common clinical signs
- fluid retention
- ascities
- pleural effusions
- JVD
- hepatomegaly
- pitting edema
- tachycardia
- s3 gallop
L sided HF
contractility of LV is reduced.
- reduced SV, EF, CO
- collectively blood flow to body reduced
- fatigue, exercise intolerance, SOB
L sided HF
Causes
- HTN
- CAD
- Arrhythmias
- Decreased CO caused by impaired ventricular filling and decreased ventricular relaxation
How does HTN cause L sided HF
- cardiac hypertrophy leads to dec. myocardial damage.
2. leads to cardiac remodeling and reduced contractility
How does CAD cause L sided HF
- chronic ischemic damage to myocardium
2. remodeling and scarring in myocardium = decreased contractility
Vascular congestion
- an engorgement of a vascular structure with blood
- changes the pressure within that structure
With L sided HF, why does LA diastolic pressure increase?
- reduced contractility of L side leads to increased LVEDV and LVEDP
- Decreased blood movement from LA into LV during ventricular diastole
- Blood accumulates in LA (increased pressure)
How does L sided HF lead to pulmonary edema?
- increased LA diastolic pressure
- decreased movement from lungs into LA during LA diastole
- Increased blood volume in pulmonary circulation / congestion
Hemoptysis
bloody sputum
T/F: R sided HF leads to decreased urine production
False
L sided
LHF
“DO CHAP”
- Dyspnea
- Orthopnea
- Cough
- Hemoptysis
- Adventitious breath sounds
- Pulmonary congestion
R sided HF
- contractility of RV is reduced
2. accumulation of blood in RV, RA, and systemic circulation
R sided HF signs and symptoms
- abdominal blotting/swelling/ascites
- kidney failure
- JVD
- Weight Gain
- Dependent edema
- DVT and PE
CHF
heart is unable to pump enough blood to meet metabolic needs of body due to pathological changes to myocardium.
Clinical stages of CHF
- normal
- asymptomatic LV dysfunction
- compensated CHF
- decompensated CHF
- Refractory CHF
Compensated CHF
- no symptoms
- dec exercise
- abdnormal LV fxn
Decompensated CHF
- symptoms
- decreased exercise
- abnormal LV fxn
Refractory CHF
symptoms not controlled with treatment
HF
Stage A
at high risk for developing HF in future
HF
Stage B
structural heart disorder with no symptoms at any stage
HF
Stage C
previous or current symptoms of HF managed with med treatment
HF
stage D
advanced disease requiring hospital based support, transplant, or palliative care
Acute HF
- exacerbation
- sudden onset of dyspnea and limb/LE swelling
- increase of 5 lbs within 24 hrs
Systloic HF
- HRrEF
- LV contractility reduced
- reduced EF
- reduced delivery of blood (dec O2 delivery)
Diastolic HF is seen more commonly in:
- females
- older age
- HTN
- metabolic syndrome
- renal dysfunction
- obesity
Diastolic HF pathophysiology
- ventricles lose ability to relax normally
- ventricle less compliant
- heart chambers can’t fill normally
- global loss of cardiac, vascular, and peripheral reserve
HFrEF vs HFpEF:
more frequent hospitalization
HFrEF
HFrEF vs HFpEF:
more common in women than men
HFpEF
HFrEF vs HFpEF:
more common in men than women
HFrEF
HFrEF vs HFpEF:
Chronic comorbidities include HTN, T2DM, obesity, renal disease)
Both
HF medications
- diuretics
- beta blockers
- ace inhibitors/ ARB
- calcium channel blockers
- vasodilators
- positive ionotropes
HF: “non cardio-centric” components
- endothelial dysfunction
- skeletal muscle damage
- dec systemic blood flow causing vasoconstriction
- kidney dysfunction
