Heart failure Flashcards
cardio myopathy
Disease that affects the myocardium – heart muscle
causes of cardiomyopathy
Usually idiopathic**
Canby, ischemia, HTN, inherited disorders, infections, toxins, myocarditis, Auto immune
Types of cardiomyopathy
dilated
Hyper trophic
Restrictive
heart failure
Chronic progressive condition
Heart muscle is unable to pump enough blood to Meet bodies needs for blood and oxygen
Myocardium is weakend, pump is insufficient
What is the most common cause of hospitalization?
Heart failure
T/F cardiac output, increases with heart failure
False, decreases
Preload
Fluid in left ventricle
Afterload
Pressure needed for a contraction
myocardial contractility
Pump effectiveness
which two factors of cardiac output increases with heart failure
Preload and after load
which factor decreases with heart failure?
Myocardial contractility
pathophys of heart failure
Volume overload – fluid back up, not pumping enough
Impaired ventricular filling
Weakened ventricular muscle
Decrease ventricular contractile function
when does the impaired ventricular filling occur?
During diastole in between contractions
when does decreased ventricular contractile function occur?
During systole
cause of heart failure
Repeated ischemic episodes
MI – papillary muscle rupture
Chronic HTN
COPD
Dysrhythmias
Valve disorders – mitral, insufficiency, aortic stenosis
Pulmonary embolus
risk factors for heart failure
1 – HTN
Diabetes
MI within six months - 22% men, 46% women
post menopausal women
African-American
Genetic link, family history
>65
Ischemic, heart disease
Obesity, smoking, sedentary lifestyle
COPD – right sided
Severe anemia
Congenital heart defects
Viruses
Alcohol/drug abuse
Kidney conditions
Frank starling law
An increase in resting muscle fiber length results in a greater muscle tension
The heart has the ability to change its force of contraction and stroke, volume in response to changes in venous return
left sided heart failure
Congestion and left Chambers and lungs
Left ventricle size increases
Backflow in pulmonary veins
** left=lungs
sx left-sided failure
(Pulmonary)
cough, crackles, wheezes
Frothy, sputum, blood tinged
paroxysmal nocturnal dyspnea
Orthopnea
Tachycardia, fatigue, tachypnea, cyanosis, restlessness
right sided heart failure
Congestion in right Chambers
Increase in right ventricle size
Backflow into vena cava, decreased to lungs
Congestion in jugular veins, liver, lower extremities
sx right sided heart failure
JVD – jugular vein, distention
Dependent edema – below heart
Weight gain
Enlarged spleen and liver
ascites, anorexia, G.I. distress
HTN is associated with which side heart failure
Left
COPD is associated with which sided heart failure
Right
Ejection fraction
amount of blood pumped out of left ventricle with each squeeze
Normal: 55 to 65%
reduced ejection fraction/systolic HF
HFreF
EF <40%
Left ventricle, lose his ability to generate pressure to eject blood
Weekend muscle cannot generate stroke, volume and decreased cardiac output
Left ventricle fails, blood backs up, fluid back up in pulmonary system
Who is HFreF more common in?
Younger age, male
History of CAD, DM
cause of HFreF
Impaired contractile function
Increased afterload
Cardiomyopathy
Mechanical problems
preserved ejection fraction/diastolic HF
HFpeF
Inability of ventricles to relax and fell during diastole
Left ventricle is stiff and non-compliant leading to high feeling pressures
EF is normal or moderate decrease 40-49%
what occurs with decreased cardiac output?
Fluid congestion
cause of HFpeF
Chronic hypertension
Who is HFpeF more common in?
older, female
Obese, DM
chronic heart failure
Progressive
Episodes of decompensated HF
New/worst symptoms
Frequent ER visits
Hospitalization
ventricular remodeling
A weakened heart muscle secretes molecular substances
Overtime – provoke, genetic changes, apoptosis, hypertrophy of cardiac cells , collagen deposits, and mile cardio fibrosis
molecular changes
Angiotensin two, aldosterone, endothelin, TNF alpha, catecholamines, insulin like growth, factor, growth factor
enlargement in dilation of left ventricle, worsens heart failure
S3 Gallup
Low pitch sound heard after S2
During rapid filling of ventricle, in early part of diastole
High ventricular and end-diastolic volume
Increased pressure within ventricles
T/F greater than 40 years old and presence of S3 is indicative of heart failure
True
