heart failure Flashcards
Ejection fraction
- the amount of blood leaving your body by %
- high mortality rate if <5-10%
- normal is between 55-60%
preload?
After load?
contractikity?
- preload is blood in the ventricles after it relaxes or at the end of diastole pressure
- Afterload: resistance the left ventricle must overcome to circulate blood
- Contractility: how much your heart muscles can contract and relax
Heart failure is
- inability of the heart to pump
- unable to maintain a cardiac output
- inadequate tissue perfusion which causes
1. increase in diastole filling pressure of the left ventricle
2. lead to increase in pulmonary capillary pressures
Patho of hart failure is
- a disease process caused by impaired contractility, increased pre and after load
- decrease in stroke volume and CO2
- compensatory mechanisms are initiated to maintain cardiac output in an overloaded heart
RAAS
SNS
ventricular dilatation..streaching
ventricular hypertrophy…..thickening - eventually compensatory mechanisms fail
Cause of heart failure
- advanced age
- MI..common cause
- hyperlipidemia
- hypertension
- diabetics
- tobacco use
- valve disorders
- infections
- lung disorders
- CAD
types of heart failure
- Left heart failure
- right heart failure
Left heart failure
Clinical manifestations
- affects the lings because there is a high pressure and fluid build up
Diastolic ( preserved EF): inability of the left ventricular filling
- stiff and thick chambers can’t relax
- less blood fills the ventricles
Systolic ( reserved EF): inability of the heart to pump
- dysfunction in the left ventricular ejection
- streached and thin chambers
Clinical manifestations
- dizziness
- fatigue
- restlessness
- confusion
- tachycardia
- cyanosis
Right heart failure
clinical manifestation
affects the rest of the blood by the inadequate blood supply into the pulmonary circulation
- pressures/ fluid backs up into the venous system and moves into the tissues and organs
Clinical manifestation
- fatigue
- increase peripheral venous pressure
- weight gain
- dependent edema
- ascites
- enlarged liver and spleen
- secondary chronic pulmonary problem
- anorexia
Shock is caused when…
manifestations?
- cardiovascular system fails to perfuse adequately
- leads to impaired metabolism ( glucose and oxygen)
- five types …. cardiogenic, hypovolemic shock, septic shock, neurogenic shock, and anaphylactic
manifestations include tachycardia, hypotension, and increased respiratory rate
Cardiogenic?
Cause?
ClinicaL MANIFESTATION?
-inability of the heart to bump again
- caused by lack of cardiac output and tissue hypoxia the presence of adequate intravascular volume
- severe heart failure= organ failure
- high mortality rate
cause
- MI
- drug toxicity
- left heart failure
- dysrhythmias
- vascular dysfunction
- cardiac tamponade
- infection of the heart
- massive pulmonary embolism
clinical manifestations
- dyspnea
- tachypnea
- level of consciousness
- systemic edema
- pulmonic edema
- hypotension
- oliguria
- death
Hypovolemic shock?
cause?
Clinical manifestation?
Treatment?
- blood loss
cause
- ischemia
- whole blood hemorrhage
- plasma (burns)
- interstitial fluids
clinical manifestation
- poor skin turgor
- increase in stroke volume and BP initially
- hypotension eventually
- thirst
- rapid heart rate
- oliguria
- thready weak pulse
Treatment?
- replace fluids with crystalloids and blood product
- the GOAL IS = to restore fluid in the body
compensatory mechanisms of hypovolemic shock
- heart rate and stroke volume increase= increased cardiac output and perfusion
- increase in ADH retains fluid
- spleen and liver release RBC and plasma
-RAAS system stimulates aldosterone to retain H2O and NA
what happens when the compensatory mechanisms fail
- decrease in tissue perfusion and lack of O2 and nutrient delivery to the cells which decrease cellular metabolism
Septic shock
- severe progression of an inflammation
- inflammatory process issue
- top 3 diseases are
- bladder infection
- cellulitis
- community acquired pneumonia
Manifestation of septic hock
early
- tachycardia
- hyperthermia
- normal elevated cardiac output
Late shock
- temperature instability
- hypotension
- decrease in urine output
- clotting abnormalities
- mental status detrition
- acute respiratory distress syndrome
