Heart Failure Flashcards
1
Q
heart failure
A
- cardiac dysfunction that leads to inadequate tissue perfusion
- decrease in contraction and ejection fraction
- causes = diminished contractility, increased workload, restriction of filling, myocardial infarction
2
Q
ejection fraction
A
proportion of blood ejected during each ventricular contraction compared with left ventricular end diastolic volume
3
Q
result of heart failure
A
- Significant loss of functioning myocardial tissue
- Necrotic cells – leading to decreased contractility
- Scarring and hypertrophy
- Decreased CO and decreased BP
- Baroreceptors activated
- Vasomotor centers in medulla stimulated
- SNS activated – vasoconstriction
- Increased adrenal release of catecholamines (epi and norepi) to restore CO
- Increased afterload, blood pressure, HR, myocardial oxygen demand
- Calcium pump fails – Ca gets stuck in cells which increases cardiac workload
- Weakened heart stretches d/t increased volume = dilation of heart
4
Q
Preload
A
- Filling pressure, end diastolic pressure
- Increases with decreased contractility or excess volume
- Stimulation of RAAS contributes
5
Q
Afterload
A
- resistance to ejection of blood from left ventricle
- increased afterload r/t hypertension
- decreased afterload and inhibition of the RAA system
6
Q
Left Sided Heart Failure
A
Dysfunction of the LV in which output of left ventricle is less than total blood received from the right heart
7
Q
Causes of left side heart failure
A
- acute MI
- valvular heart disease – mitral and aortic
- systolic hypertension
- restrictive cardiomyopathy
8
Q
pathophysiology of left sided heart failure
A
- Ventricular remodeling-recurrent ischemia
- Hypertrophy/myocyte contractility dysfunction
- Decreased stroke volume/increased end diastolic pressure
- Increased preload and afterload
- Decreased CO, activation of RAA system
- Blood backs up into the lungs
9
Q
Manifestations of left side heart failure
A
- Paroxysmal nocturnal dyspnea
- Elevated pulmonary capillary wedge pressure
- Cough
- Crackles
- Wheezes
- Blood tinged sputum
- Restlessness
- Confusion
- Orthopnea
- Tachycardia
- Exertional dyspnea
- Cyanosis
10
Q
right sided heart failure
A
- also called COR PULMONALE
- output of right ventricle is less than input from the circulatory system
- resistance to right ventricular emptying increases
- right ventricle will dilate and fail
11
Q
causes of right sided heart failure
A
- Left heart failure is most common cause
- RV infarction
- Pericarditis
- Cardiomyopathy
- Valve disease– tricuspid, pulmonic
- Increased pressure in pulmonary circulation
- Right ventricles dilated and fails
- Increased pressure in systemic venous circulation
- Increased edema
12
Q
Manifestations of right sided heart failure
A
- Fatigue
- Increased peripheral venous pressure
- Ascites
- Enlarged liver and spleen
- Distended jugular veins
- Anorexia and complaints of GI distress
- Swelling in hands and fingers
- Dependent edema
