Heart Failure

Question 1

Heart Failure

Answer 1

abnormal clinical syndrome involving impaired cardiac pumping or filling

heart is unable to produce an adequate cardiac output to meet metabolic needs

Associated with continual HTN, CAD, MI

Question 2

L sided HF

Answer 2

backup blood into the L atrium and pulmonary veins

pulmonary edema

Question 3

R sided HF

Answer 3

causes backward blood flow to R atrium and venous circulation

peripheral edema, weight gain, JVD

Question 4

Abnormal loading conditions

Answer 4

increased preload (hypervolemia)
increased afterload (force that is needed to eject blood)

Question 5

Systolic Failure

Answer 5

inability for heart to pump blood effectively

decreased in the L ventricular ejection fraction (unable to eject blood through the aorta

Question 6

Ejection Fraction

Answer 6

fraction or percentage of total amount of blood in the LV that is ejected during each contraction

normal >55%

Question 7

Diastolic Failure

Answer 7

impaired ability of ventricles to relax and fill during diastole resulting in decreased stroke volume and CO

normal EF

Question 8

Compensatory mechanisms

Answer 8

Ventricular dilation
Ventricular hypertrophy
Increased sympathetic nervous system stimulation
Neurohormonal Responses

Question 9

Cardiac Decompensation

Answer 9

Pitting edema
pink frothy sputum
dry cough
Increased RR
Cold clammy skin

Question 10

Management of Decompensation

Answer 10

goal: improve L ventricular function

decrease intravascular volume (lasix)
decrease venous return
decrease afterload (loop diuretic)
improve gas exchange
improve cardiac function (meds)
decrease anxiety

Question 11

Meds used

Answer 11

Diuretics (lasix)
ACE inhibitors (first line of therapy)
Beta Blockers
Vasodilators (nitrates)